Pharmacotherapy of Pneumonia Flashcards
What are the main treatment goals?
Treat the infection and treat the symptoms
How would you treat the infection as part of the immediate management?
Give empirical therapy, until causative bacteria is confirmed with lab tests
How to treat the symptoms in immediate management?
Oxygen
IV fluids
Analgesia
What kind of treatments fall under analgesia?
Paracetamol
NSAIDs
Opioids
For CAP Outpatient with NO comorbidities or resistant bacteria what kind of treatment would you give?
Aminopenicillin –> Amoxicillin
Macrolides or Doxycycline –> Azithromycin or Clarithromycin
FOR CAP outpatients WITH comorbidities or resistant bacteria what kind of treatment would you offer?
Combination therapy or mono therapy
What are the options for combination therapy for CAP outpatients with comorbidities?
Beta - lactam + Macrolide
Beta - lactam + Doxycycline
What are the different options of beta lactams for CAP outpatients (combination therapy)?
Amoxicillin/ Clavulanate, Cefuroxime
What are the different options of macrolides for CAP outpatients (combination therapy)?
Azithromycin, Clarithromycin
What are the available mono therapies available for CAP outpatients with comorbidities?
Respiratory Fluoroquionoles
What are the examples of respiratory fluoroquionoles?
Levofloxacin
Moxifloxacin
What is the best option of treatment for any kind of organism that has caused pneumonia?
Quinilone
If the pneumonia is caused by Strep. Pneumoniae what are the treatment options? (CAP Outpatient)
Macrolides or High dose beta lactams
When do we give macrolides? (organisms) (CAP Outpatient)
Strep. Pneumoniae
Haemophilus Influenzae
Legionella
Mycoplasma pneumoniae
Chlamydophila pneumoniae
Staphylococcus aureus
What is the standard treatment for non-severe CAP? (Inpatient)
Beta lactam + macrolide
Respiratory Fluoroquionoles
What are the beta lactams that can be used for non-severe CAP? (Inpatient)
Ampicillin/ Sulbactam, Cefotaxime, Ceftriaxone
What are the macrolides that can be used fro non-severe CAP? (Inpatient)
Azithromycin, clarithromycin
What are the respiratory fluroquinoles that can be used for non-severe CAP? (Inpatient)
Levofloxacin
What is the standard treatment for severe CAP? (Inpatient)
Beta - lactams + macrolides
Beta lactams + respiratory fluoroquinoles
If MRSA coverage is required then which drug/ drugs are added?
Vancomycin or linezolid
If Pseudomonas aeruginosa coverage is required what do you change to the treatment?
Switch beta lactam to an antipseudomonal beta lactam
OR
Add aminoglycoside
What are the examples of antipseudomonal beta lactams? (CAP) (Inpatient)
Piperacillin-tazobactam
Cefepime
Imipenem
Meropenem
Aztreonam
What are the examples of aminoglycosides? (CAP) (Inpatient)
Tobramycin
In case of a penicillin allergy, what are the alternatives? (CAP) (Inpatient)
Doxycycline
Clarithromycin
Erythromycin
In case of pregnancy, what drugs can be taken ? (CAP) (Inpatient)
Amoxicillin
Azithromycin
Which kind of treatment should be avoided during pregnancy? (CAP) (Inpatient)
Why?
Doxycycline
Inhibit bone growth
For early set HAP what is the treatment?
Ceftriaxone
Quinolone
Ampicillin/ Sulbactam
Ertapenem
For late onset HAP, caused by pseudomonas aeruginosa or enterobacteriaceae what is the treatment?
Antipsudomonal cephalosporin, piperacillin, tazobactam or quinolone
Aminoglycoside
Carbapenem
For late onset HAP, caused by pseudomonas aeruginosa or enterobacteriaceae or acinetobacter spp. what is the treatment?
Aminoglycosides
Carbapenem
What are the adverse effects of beta lactams?
GI Disturbances
What are the adverse effects of doxycycline?
Photosensitivity
Inhibit bone growth
Liver failure
What are the adverse effects of macrolides?
Prolonged QT interval
Hepatic dysfunction
What are the adverse of fluroquionolones?
Tendon rupture
Who should get vaccinated against pneumonia bacteria?
Babies
People > 65
Individuals of high risk
