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Therapy: year 3 > Travel medicine > Flashcards

Travel medicine Flashcards

1
Q

Why are antibiotics not routinely used for the prevention of TD?

A

Because of R.A.P.E

Resistance
Adverse effects
Predispose to infection (c.diff)
Expense

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2
Q

when would it be recommended to use a antibiotic for prophylaxis of TD?

A
  1. high risk of getting diarrhea
  2. risk of complications from diarrhea
    3/ when staying healthy is critical
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3
Q

What are the medications that can be used for TD prevention?

A
  • antibiotics (floroquinoles, azithromycin, and rifaximin)
  • bismuth subsalisylate
  • dukoral
  • natural health products
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4
Q

what are the different types of FG used for TD?

A

ciprofloxacin, levofloxacin and norafloxicin

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5
Q

What would be the first line antibiotic used for prevention of TD? one limitation of it?

A

FQ - ciprofloxacin

Some areas have increased resistance to it such as EA asia, nepal and Indonesia so we have to use azithromycin

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6
Q

When would we use azithromycin over ciprofloxacin?

A

cases of resistance

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7
Q

how does dosing change baded on prohylais dose and treament dose?

A

prophylaxis dose is lower then the tretament dose

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8
Q

How does rifaximin work? MOA?

A

it works in the gut by limiting systemic absorption

  • it is 70% effective for prophylaxis treament
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9
Q

why isn’t rifaximin indicated for prophylaxis use in Canada

A

the dosage form we have available is too high

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10
Q

What are some adverse effects of BSS use for prevention?

A

black stool

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11
Q

how long can we use BSS for prevention of TD?

A

less then 3 weeks

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12
Q

When is BSS use CI in TD prevention?

A
  • pregenancy
  • less then 18
  • blood thinners
    -SA allergy
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13
Q

How does dukoral work for TD prevention

A

it’s an oral vaccine with cholera and inactivated TD diarrhea

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14
Q

how is dukoral effective against ETEC?

A

the cholera vaccine has the same sub unit as ETEC

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15
Q

What preventive medications are not highly effective?

A

Azithromycin - limited evidence to prove it works well

Dukorla - should only be used in high-risk indivduals

Natural health products

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16
Q

Are are the treament options for TD?

A

-oral rehydration solutions
- BSS
-Loperamide
- antibiotics

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17
Q

When are Oral rehydration solutions indicated?

A

for infants, children, elderly and special populations

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18
Q

when is BSS use indicated for tx?

A

in mild TD

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19
Q

How does BSS use help in treatment of TD?

A

it reduces stoll passes by 50%

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20
Q

What’s an advantge of BSS over loperimide?

A

helps with Nausea

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21
Q

What’s the advantage of loperamide over BSS?

A

loperamide is faster acting and can be used in combiantion with antibiotics to help

22
Q

when is loperamide recommended for tx of TD?

A

for mild, moderate, and severe TD

23
Q

when is loperamide contraindiacted for tx of TD? and why

A

-fever, bloody stool
because it slows down peristalsis in gut and won’t let infectious agents out of body causing more complications

  • also in children under 2 year of age
24
Q

When are antibiotics indicated for tx of TD?

A

in severe cases with fever and bloody diarrhea

25
Q

What is a big CI of rifaximin use in tx of TD?

A

can’t be used in for patients with dysentry (fever, bloody diarhea)

26
Q

is rifaximin indicated for tx of TD in cacnda?

A

No

27
Q

What antibiotic if any should be given to pregnant women and childre?

A

Azithromycin

28
Q

in what time frame can malaria develop?

A

7 days to months after initial exposure

29
Q

What are some malaria prevention agents?

A

DEET 30%
Picardin 20% - in off spray
permethrin 0.5%

30
Q

What should clothes be treaed with to help avoid malaria?

A

permethrin 0.5%

31
Q

Whihc prevention products CANNOT have direct contact with skin?

A

permethrin 0.5%

32
Q

What are chemoprophylaxis options for malaria

A

chlorquine, hydroxychlorquine, mefloquin, doxycycline, atovaquone/proguanil

33
Q

what chemoprophylaxis options for malaria cause horrible psychiatric conditions

A

mefloquin

34
Q

If a tarveler presents with a fever around a year after travling to a malaria endmic country do we assume it may be malaria or has it been too long to conclude that?

A

they may have malaria

35
Q

What product/s can a pregnant woman use as insect repellent?

A

DEET

36
Q

What product/s can a pregnant woman use as chemoprophylaxis for malaria?

A

chloroquine

37
Q

What product/s can children NOT use as chemoprophylaxis for malaria?

A

Doxy

38
Q

What product/s can children use as chemoprophylaxis for malaria?

A

chloroquine

39
Q

what are the three reasons for immunizations?

A
  1. routine preventavie helath
  2. required for travel
  3. recommended according to diseases acquisition
40
Q

what immunization are we focusing on?

A

Hep A and B

41
Q

whihc Hep is more common

A

Hep A

42
Q

How many doses and what dosing schedule exist for hep A

A

2 doses

second dose 6-12 months after first

gives 10 years of protection

43
Q

how is hep A transmitted?

A

the fecal-oral route

44
Q

how is hep B transmitted?

A

percutanous or mucousal exchange (sexual conduct, pericings, tattoes)

45
Q

How many doses and what dosing schedule exist for hep B

A

3 doses

0, 1, 6 months

protection for life

46
Q

What is the combination vaccine for hep a and hep b called?

A

twinrix

47
Q

fill in the blank: in terms of jet lag for every __ of travle 1 day is needed to acclimatize

A

1

48
Q

going east or west is harder? Y?

A

going east because the day gets shorter and not longer

49
Q

Is melatonin IR or SR more effective?

A

IR

50
Q

Going west how should we adjust our sleep schulde

A

go to bed one to two hours later

51
Q

What are some preventive measure for venous thromboembolism

A

excerisie
hydrate (no alcohol)
compression socks

Therapy: year 3 (14 decks)

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