Upper/Lower Resp Flashcards
Otitis Media pathogens
- s. pneumonae
- m cat
- h flu
otitis media tx for kiddos
1. main stay
2. type 2 penicillin allergy
3. type 1 penicillin allergy
- amoxicillin 80-90 mg/kg/day BID OR augmentin if abx in the last month
- cefdinir (2 gen) or ceftriaxone (3rd gen)
- clindamycin 30-40 mg/kg/day TID
otitis media adults
- augmentin
acute bacterial rhinosinusitis pathogens
- s. pneumonae
- m cat
- h flu
acute bacterial rhiosinusitis tx kiddos
- augmentin 45 mg/kg/day PO BID x 10 days
- levofloxacin for type I allergy
- clindamycin for type 2
acute bacterial rhinosinusitis tx adults
- augmentin
500mg/125mg TID
875mg/125mg BID
x5-7 days - doxy for penicillin allergy
acute pharyngitis tx kiddos
- augmentin PO 50mg/kg/day BID
- cephalexin (1 gen)
- macrolides (azithromycin or clindamycin)
acute pharyngitis tx adults
- augmentin 500mg/125mg PO BID
- cephalexin
- macrolide (azithromycin or clindamycin)
acute chronic bronchitis tx
- antipyretics and anaglesics
- antitussives if NON-productive cough
- only give abx (azithromycin or fluoroquinolone) for severe sx or high risk
chronic bronchitis pathogens and main cause
- s. pneumoniae
- m cat
- h flu
SMOKING
Bronchiolitis (babies)
cause
tx
prevention
- caused by RSV
- tx nebulize hypertonic saline
- abrysvo vaccine (mother get when pregnant depending on time of the year)
Nirsevimab: monoclonal antibodies
Oseltamivir (tamaful)
1, what is it used for and when
2. dose for kiddos and adults
3. is it renally dosed?
4. side effects
- give within 48 hours for postexposure prophylaxis
- 75 mg PO BID x5 day for adults and weight based for kids
- renally dosed
CrCl 30-60 (30mg BID x5days)
CrCl <30 (30 mg Qday x5days) - side effects: neuropsychiatric and GI
*preferred during pregnancy and lactation
Zanamivir
- diskhaler
- side effects: bronchiospasms and neuropsychiatric
- no renal dosing
peramivir
- IV
- renally dosed like oseltamivir
- side effects: neuropsychiatric and GI
Baloxavir
- > 12 with chronic conditions
- contraindicated for pregnancy and BF
Benzonatate (Tessalon Perles)
1.what are they
2. MOA
3. dosing
4. renal dosing
5. side effects
- antitussive
- anesthetic action on respiratory stretch receptors
- 100-200 mg TID
- not renally dosed
- can numb the back of your throat if you chew them
Bromfed DM
1. what are the generic medications it contains and their MOA (3)
- brompheniramine: antihistamine
- pseudoephedrine (decongestant)
- dextromethorphan (antitussive)
Pneumonia pathogens
- viral
- atypical bacterial
- staphlococcal
what does staphlococcal pneumonia demonstrate on CXR
necrotizing lesions
Calculating CURB-65 score for pneumonia and how to determine bw out patient, in patient, and in patient ICU
Confusion
Uremia (BUN >20)
RR >30
BP <90/<80
Age >65
out patient: <2
in patient =2
in patient ICU >2
community acquired pneumonia pathogens
gram + s. pneumonae, s. aureus, group B strep
gram - : e. coli, H flu
atypical: m pneumonia, legionella, chlamydia pneumonia
out patient treatment for pt with community acquired pneumonia (healthy adults)
- amoxicillin (strongest recommendation)
- can also give doxy
- OR macrolide (azithro or clarithromycin) if pneumococcal resistance is <25%
out patient treatment for pt with community acquired pneumonia for adults with chronic condition
what is a chronic condition in this case?
how do you tx?
- chronic conditions of the heart, lungs, liver, kidneys, alcoholic, malignancy
- combo therapy (augmentin + azithro) OR (ceduroxime + doxy)
monotherapy: fluroquinolone (QT prolongation)
CAP in patient treatment (CURB-65 =2) for nonsevere (minor criteria <3) and wo risk factors for pseudomonas or MRSA
- Combo therapy aminopenecillin+ beta lactamase inhibitor + macrolide (ie ampicillin-sulbactum + azrithromycin)
- monotherapy: respiratory fluoroquinolone
(ie levofloxacin or moxifloxacin) - if there is a contraindication to macrolide or fluoroquinolone (such as a heart condition bc they can cause QT prolongation)
(use cefriatone + doxy)
