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Pharmacology > Unit 5-respiratory > Flashcards

Unit 5-respiratory Flashcards

1
Q

What is number one cause of URI? How long can it last on hard surfaces?

A

Rhinovirus. Lasts up to 3 hours

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2
Q

What are other causes of URI?

A

coronavirus, RSV, adenoinfluenza

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3
Q

What is incubation period for rhinovirus?

A

1-10 days

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4
Q

What is most common cause of rhino sinusitis?

A

S. Pneumoniae and H. Inffluenzae.

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5
Q

Differentiate between acute and chronic sinusitis?

A

Acute aries after prolonged cold et last less than 3 wks. Chronic is defined as symptoms lasting 3-8 weeks or greater than 3 months.

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6
Q

What is differential diagnoses for patients suspected to have sinusitis who present w/ light sensitivity, neck pain, HA, fever?

A

meningitis or brain abcess

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7
Q

When should abx therapy be given to patients with sinusitis?

A

Fever >102, pain or tenderness in ears sinus or face, purulent sputum, sore throat and symptoms that persist with NO improvement for over 10 days

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8
Q

How long is abx tx for sinusitis?

A

At least 14 days, or 7 days beyond resolution of symptoms

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9
Q

What is first line tx for sinusitis? Second line?

A

Amoxicillin and Augmentin. For allergic, Bactrim.

Macrolides,

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10
Q

What meds are used to treat acute attacks of asthma and are pen?

A

Beta agonists such as albuterol.

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11
Q

What is diagnostic criteria for asthma?

A

expiratory wheezing, h/o cough worse at night, reversible airflow restriction, increased symptoms w/ exercise, viral infection etc.

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12
Q

What is most effective therapy for treating asthma long term? How long does it take for them to achieve max effect?

A

Inhaled corticosteroids such as beclomethasone, fluticasone, triamcinolone
2weeks.

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13
Q

What is first line treatment for asthma in children?

How long does it take for them to be effective/max effect?

A

Mast cell stabilizers-cromolyn

1-2 wks and a bit longer for max effect

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14
Q

How long doe LABAs like Serevent last?

A

12 hours-do NOT act rapidly

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15
Q

What is normal starting dose for prednisone for treatment of acute asthma exacerbation?

A

30-60mg daily, then tapered if >14 days.

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16
Q

How is chronic bronchitis defined?

A

cough and sputum for 3 months for 3 consecutive years.

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17
Q

What is first line tx for COPD? Second Line?

A

SABA is first line. Second line for patients with persistent symptoms is combo therapy-SABA and anticholinergic.

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18
Q

When in COPD are systemic corticosteroids used?

A

only in severe flair ups.

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19
Q

When do you use abx to treat acute bronchitis?

A

If symptoms persist for >10-14 days. (4-6 if tob or pulm disease)

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20
Q

What are antibiotic choices for acute bronchitis?

A

ampicillin, amoxicillin, macrolides

21
Q

What are common signs of chronic bronchitis exacerbation

A

mild-severe cough, increase in frequency and severity of cough, loss of appetite, chills, hemoptysis.

22
Q

What is appropriate choice for non complicated chronic bronchitis?

Complicated chronic bronchitis?

How are the two differentiated?

A

ampicillin

2nd or 3rd gen cephalosporon, amox-clav, fluroquinolones

Simple-FEV1>50%, Complicated <50%

23
Q

What is the most common organism in Community Acquired pneumonia? What are others?

A

Most common strep pneumonia. Others are H Influenzae, S. aureus.

24
Q

What appears on cxr if pneumonia is present?

A

infiltrates

25
Q

What vaccine is helpful against strep pneumonia?

A

Pneumococcal vaccine 23-valent

26
Q

What abx are resistant to s. pneumonia and are therefor not good choices?

A

aminopenicillins and cephalosporins

27
Q

What is first choice to tx pneumonia as outpatient?

A

macrolide or doxycycline. Fluroquinolone if pt has had above therapy in the last 10-14 days.

28
Q

What is treatment of choice in MRSA pneumonia?

A

vanco, bactrim

29
Q

What is first choice for aspiration pneumonia?

A

Augmentin

30
Q

How is failure defined in treating pneumonia?

A

Symptoms >3-5 days, Leukocytosis >3 days, Fever >2-4 days-NO IMPROVEMENT IN 3 DAYS on abx

31
Q

What is good choice to treat mild CAP?

A

5 days of azithromycin

32
Q

What is first choice for pneumonia in presence of comorbidities such as heart lung liver or renal disease, DM, ETOH, malignancy, recent abx

A

2nd gen cephalosporin or Beta lactamase inhibitor

33
Q

When evaluating for asthma, what % increase in PEF or FEV1 from baseline is considered diagnostic (after beta adrenergic agonist is administered).

A

and improvement of 12% or more from baseline.

34
Q

What is recommended dose of inhaled steroids for treating asthma?

A

2-4 inhalations 2-4x daily.–LOWEST effective dose.

35
Q

What is recommended dose of mast cell stabilizers (cromolyn)?

A

2-4 inhalations 3-4x daily

36
Q

What precautions should be taken when taking Accolate (a leukotriene modifier)

A

Admin w/ meals reduces bioavailability

37
Q

In what patients should caution be used when giving beta adrenergic agonists for asthma?

A

ischemic heart disease, hypertension, cardiac arrhythmia, seizure, hyperthyroid

38
Q

If amoxicillin (or other first line abx for sinusitis) does not improved symptoms after ________days, change abx.

A

eight days

39
Q

What symptoms indicate a sinus infection is most likely bacterial rather than viral?

A

symptoms persiste for over 10 days, symptoms are unusually severe, facial tenderness, transient periorbital swelling, daytime cough, fever over 102.2

40
Q

What is normal dose and high dose amoxicillin?

A

45mg/kg 90 mg/kg

41
Q

what criteria indicate need for initiation of therapy for asthma in neonates to children age 4?

A

Four or more episodes of wheezing in the past year that lasted more than one day and that affected sleep AND those who have risk factors for developing persistent asthma

42
Q

what is considered first line asthma therapy in children? Why?

A

mast cell stabilizers-cromolyn

the do not affect linear growth as corticosteroids do

43
Q

what adverse affect can occur in women using inhaled corticosteroids?

A

decreased bone mineral content

44
Q

What genetic deficiency can cause emphysema?

A

deficiency of protein alpha1-antitrypsin

45
Q

what are presenting symptoms of emphysema?

A

dyspnea w/ light exertion, scant thick sputum, slight cough w/ little sputum production

46
Q

If albuterol (saba) is paired with ipratropium (anticholinergic), what order should they be used?

A

ipratropium first, then SABA two ours later

47
Q

what normally precedes the symptoms of acute bronchitis?

A

s/s of URI (coryza, malaise, chills, back and muscle pain, headache) **Fever rare and is more commonly seen with adenovirus, influenza and M. pneumoniae

48
Q

what is the hallmark sign of acute bronchitis?

A

cough that is initially dry and nonproductive that becomes productive.

49
Q

What are indications for hospitalization in pneumonia?

A

severe VS w/ HR >140, SBP 30, temp>101, altered mental status

Pharmacology (11 decks)

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