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Clin Med Comprehensive > Pulm Therapeutics > Flashcards

Pulm Therapeutics Flashcards

1
Q

What is treatment for healthy patients with community acquired pneumonia?

A

macrolides (azithrymycin, clarithromycin, erythromycin) or doxy

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2
Q

What is treatment for patients with co-morbidity and community acquired pneumonia?

A

β-lactam (amoxicillin or augmentin) plus macrolide

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3
Q

What is inpatient treatment for community acquired pneumonia?

A

floroquinolones (moxifloxacin, gemifloxacin or levofloxacin)

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4
Q

What is outpatient tx for S. pneumonia?

A

Macrolide (azithromycin, clarithromycin)

Add β-lactam if likely resistance

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5
Q

What is inpatient tx for S. pneumonia?

A

respiratory fluoroquinolone (moxifolxacin, gemifloxacin, levofloxacin plus β-lactam)

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6
Q

What is treatment for H. influenzae pneumonia?

A

Hospitalize

Azithromycin & respiratory fluroquinolone

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7
Q

What is tx for mycoplasma pneumonia?

A

macrolide

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8
Q

What is tx for viral pneumonia?

A

Supportive

Antiviral agents in sicker pts ( neuraminidase inhibitors or inhaled ribavirin)

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9
Q

What is tx for aspiration pneumonia?

A

β-lactam & clindamycin

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10
Q

What is tx for Coccidioidomycosis fungal pneumonia?

A

Itraconazole

Fluconazole

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11
Q

What is tx for Histoplasmosis fungal pneumonia?

A

Amphotericin then switch to itraconazole

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12
Q

What is tx for Blastomycosis fungal pneumonia?

A

Itraconazole

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13
Q

What is tx for acute bronchitis?

A

Symptomatic (fluids, cough, suppressants)

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14
Q

Tx for influenza

A

Supportive
Rest, hydration, NSAIDs
Stay home & stay away from others

Neuramindase inhibitors only useful in 1st 48 hrs for pts at risk

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15
Q

What are the neuramindase inhibitors?

A

oseltamivir
zanamivir
peramivir

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16
Q

Tx for latent TB

A

Isoniazid and Rifampin or rifapentine for 9 mo

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17
Q

Tx for active TB

A 
Isoniazid, pyrazinamide Rifampin (or rifapentine) for 9 mo 
plus ethambutol (or streptomycin)
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18
Q

Tx for Obstructive Sleep Apnea

A

Weight loss
CPAP
Uvulopalatopharyngoplasty
Tracheostomy

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19
Q

Tx for central sleep apnea

A

Treat underlying disease

CPAP

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20
Q

Tx for Pickwickian Syndrome

A

Weight loss
CPAP
BIPAP
Tracheostomy

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21
Q

How do you treat hypoxemia?

A

O2

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22
Q

How do you treat hypercapnia?

A

ventilation

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23
Q

Tx of ARDS

A

Postive pressure mechanical ventilation
Use low volumes, mode of ventilation doesn’t matter, use PEEP
Prone the pt

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24
Q

What are indications for ECMO in severe ARDS?

A

Postive pressure mechanical ventilation (CPAP)
Use ↓ tidal volumes (<60), use ↑ PEEP (>55)
Conservative fluid management
Prone the pt
If nothing working try ECMO

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25
Q

Tx for PE

A

anticoags for 3 mo, TPA, if large then TPA or embolectomy

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26
Q

PE pphx

A

Ambulation, pneumatic compression devices

Smoking cessation, discontinue OCP or anticoagulant (Heparin, enoxalarin or fondaparinox) if at risk

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27
Q

Tx for pulmonary HTN

A

Secondary: treat underlying cond

Primary: 1st lline calcium channel blockers (nifefipine or diltiazem) if vasoreactive
If not: endothelian receptor antagonist, phosphodiesterase inhibitors, prostainoids

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28
Q

Endothelin receptor antagonists to treat pulm HTN

A

bosentan or ambrisentan

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29
Q

Phosphodiesterase inhibitors to treat pulm HTN

A

sildenafil or tadalafil

30
Q

Prostanoids to treat pulm HTN

A

epoprostanol, iloprost, treprostinil

31
Q

Tx for Cor Pulmonale

A

Acute: fluids to maintain CO, correct underlying cause

Chronic: O2, diuretics (furosemide), vasodilators, digoxin

32
Q

What vasodilators can be used to treat cor pulmonale?

A

nifedipine, diltiazem or long acting nitrates

33
Q

What anticoags can be used to treat PE?

A

heparin, enoxaparin, warfarin, fondaparinux, rivoxaban, apixaban, edoxaban, dabigatran

34
Q

Tx for coal workers pneumonia

A

None
Avoid further exposure
Stop smoking

35
Q

Tx for silicosis

A

Prevent by ↓ exposure
Treat complications w/ bronchodilators, O2, steroids and vaccinations
Lung lavage if acute

36
Q

Tx for abestosis

A

None→respiratory failure

37
Q

Tx for BAPE

A

follow up and cleared once gone 3 yrs

38
Q

Tx for pleural plaque

A

No tx just follow -rarely becomes malignant

39
Q

Tx for hypersensitivity pneumonitis

A

Avoid exposure

Steroid if subacute or chronic

40
Q

Tx for BO and BOOP

A

Systemic steroid

41
Q

Tx for Reactive Airway Dysfunction Syndrome (RADS)

A

Bronchodilator may help

42
Q

Tx for round atelectasis

A

Surgery

43
Q

Tx for mesothelioma

A

Surgery not so beneficial
Chemo is better
Survival 8-12 mo

44
Q

What mucolytics are used to treat CF?

A

Inhaled N-acetylcysteine, dornase alpha or hypertonic saline

45
Q

What anti-inflammatories are used to treat CF?

A

prednisone or ibuprofen

46
Q

What antibiotics are used to treat acute CF infections?

A

keflex, azithromycin, if MRSA use vanco or linezolid if pseudomonas use IV tobra and piperacillin

47
Q

What is Ivacaftor?

A

helps correct function of G551D mutation in CFTR gene but does not work on delta F508

48
Q

What is tx for CF?

A

refer to CF specialist, chest physiotherapy, mucolytics, bronchodilators (sometimes) and ant-inflam, if G551D then ivacaftor

49
Q

What is the MC tx for CF acute exacerbations?

A

tobramycin (inhaled) and ceftazidime

50
Q

Tx for bronchiectasis

A 
treat underlying cond
control infection (fluoroquinolone)
reduce inflammation
improve bronchial hygiene
surgical resection
51
Q

What fluoroquinolones are used to treat bronchiectasis infection?

A

levofloxacin, moxifloxicin, gemifloxacin

tobra and aztreonam if CF pt

52
Q

What is used to treat inflammation in bronchiectasis?

A

SABA, LABA, ipratropium, fluticasone

53
Q

Tx for bronchiolitis

A

symptom relief-hydration and oxygenation

hospitalize if severe

54
Q

What is best tx for asthma pt with nighttime awakenings?

A

SABA

55
Q

What is tx for asthma acute exacerbation

A

SABA: albuterol
Anticholinergic: ipratropium
Corticosteroids: prednison or methylprednisone

56
Q

What is tx for asthma long term maintenance?

A

ICS: beclomethasone or triamcinoline
LABA: Salmeterol
Mast cell stabilizers: cromolyn or necromil
Leukotriene modifiers: montelukast or theophylline

57
Q

What is the drug of choice for long term persistent chronic asthma maintenance?

A

ICS: Beclomethasome or fluinsolide or triamcinolone

58
Q

Tx for COPD exacerbation

A

Mild: change bronchodilator & Abx
Mod: prednisone
Severe: hospital admission

59
Q

What drugs can be used to help smoking cessation?

A

nicotine replacement or varenicline

60
Q

Tx for COPD management

A

bronchodilators, B2 agonists, anticholinergics, theophylline

systemic steroid for exacerbation

61
Q

What are the B2 agonists used to treat COPD?

A

SABA: albuterol, levoalbuterol
LABA: salmeterol, formoterol

62
Q

What are the anticholinergics used to treat COPD?

A

SAMA: ipratropium
LAMA: tiotropium

63
Q

What are the ICS used to treat COPD?

A

fluticasone, mometasone, budesonide

64
Q

What is first line tx for COPD?

A

SAMA (ipratropium) or

LAMA (tiotropium)

65
Q

What is tx to reduce exacerbations?

A

macrolides 3 x weekly

66
Q

Tx for IPF

A

lung transplant

67
Q

Tx for NSIP

A

steroids

68
Q

Tx for RB-ILD

A

smoking cessation

69
Q

Tx of DIP

A

systemic steroids

70
Q

Cancer immunotherapy tx

A

PDL1-PD1 to inhibit interaction and restore anti-tumor T cell activity

Clin Med Comprehensive (9 decks)

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