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Therapeutics Exam 2 > RTI 2 > Flashcards

RTI 2 Flashcards

0
Q

How is CURB score used?

A

CURB is used to determine tx of CAP.

Outpatient 0-1
Inpatient 2
ICU 3+

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1
Q

What does CURB stand for?

A 
Confusion
BUN >= 20
Respiratory Rate > 30
BP (SBP65
One point each
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2
Q

Describe Acute Bronchitis…

A

Mostly viral
Cough is most common symptom
Fever uncommon, but may occur
Cough + Fever suggests something else (flu or pn)

Tx with NSAID, APAP, ipratropium, and nasal decongestants

No proven benefit of Abx use in AB

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3
Q

Tx of CAP, outpatient with NO comorbidities…

A

Macrolide (Azithromycin,clarithromycin, erythromycin)

Alt. Doxy

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4
Q

Tx of CAP, outpatient with comorbidities…

A

FQL (levofloxacin, Moxifloxacin, gemifloxacin)

Beta-lactam (amoxicillin) plus macrolide

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5
Q

Tx of CAP, inpatient…

A

FQL

Beta-lactam PLUS macrolide

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6
Q

Tx of CAP, ICU…

A

Beta-lactam PLUS FQL

Beta-lactam PLUS azithromycin

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7
Q

Tx of HCAP, wih NO RFs for MDR pathogens…

A

Similar to CAP

Ceftriaxone or FQL or amp/sulbactam or ertapenem

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8
Q

Tx of HCAP, RFs for MDR pathogens…

A

Beta-lactam (cefepime, Ceftazidime, imipenem, meropenem, piper/tazo)
PLUS
Antipseudo FQL (cipro,levo) or Aminoglycoside
PLUS
Linezolid or Vancomycin

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9
Q

Tx of CAP aspiration pneumonia…

A

Clindamycin (DOC)
or
Amp/sulbactam, or Amox/clav, or pip/tazo

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10
Q

Tx of HCAP aspiration pneumonia…

A

Cefepime or Ceftazidime PLUS clindamycin or metronidazole

Or
Newer FQL plus clindamycin for PCN allergy

Vanc when MRSA is a concern

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11
Q

Why is cipro never used in RTIs?

A

It doesn’t cover strep pneumo

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12
Q

Which FQL does not cover pseudomonas?

A

Moxifloxacin

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13
Q

When do you use cipro in pneumonia pts?

A

When you need to cover pseudomonas

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14
Q

Tx for CAP if pseudomonas is a concern…

A

Antipseudomonal beta-lactam PLUS
Aminoglycoside PLUS
FQL -OR- Macrolide

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15
Q

Tx DUR for CAP…

A

At least 5 days
Pt should be afebrile for 48-72 hours
Should have no more than 1 CAP-associated sign of clinical instability before DC therapy

16
Q

When can you switch from IV to PO in CAP?

A

Clinically improving (90, oral intake, normal mental status)

17
Q

Common pathogens in CAP…

A

Strep. pneumo
M. pneumo
Atypical orgs
Inpatient - staph aureus

18
Q

Common pathogens in HAP…

A

Pseudomonas
Enterobacter
Staph. aureus
Klebsiella

19
Q

Most common MDR

A

Pseudomonas
Klebsiella
Enterobacter
ESKAPE

20
Q

RFs for MDR pathogens

A

Abx within 90 days
ICU stay
High frequency Abx resistance in comm. or hospital
Hospitalization

21
Q

How long is a pt in hospital before risk of MDR?

A

5+ days

22
Q

Pip/tazo dose and use…

A

4.5g q 6 hr in MDR HAP

23
Q

Levofloxacin dose and use

A

750 mg qdaily in MDR HAP

24
Q

When do you treat for 4-8 wks or more?

A

Cavitary pneumonia or lung abscess

Therapeutics Exam 2 (15 decks)

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