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pharma Omamah > URTI > Flashcards

URTI Flashcards

1
Q

Symptomatic management of AOM

A

Ibuprofen / acetaminophen

Topical lidocaine ( >2 yrs )

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2
Q

Topical lidocaine precautions

A
  1. > 2 yrs

2. Not in children with tympanic membrane perforation

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3
Q

Strategies of antibiotic treatment in AOM

A
  1. Immediate treatment with antibiotic

2. Observation w/initiation of antiB if the syms didn’t improve within 48-72 hrs

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4
Q

Choice of strategy depending on age?

A
  1. 6mon-2yrs: Treat immediately with antibiotic
  2. > = 2 yrs who appear toxic , otalgia >48 hrs, temp >=39: treat immediately
  3. > =2yrs w/mild syms: observe
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5
Q

First line AOM

A
  1. Amox

2. Amox-clav

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6
Q

First line amox /amox-clav DF?

A

Oral

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7
Q

When is amox first line before trying amox-clav

A

If there are NO risk factors for amoxcillin resistence

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8
Q

Alternatives for AOM children with mild or remote allergy to penicillins (ie without anaphylaxis, bronchospasm, or angioedema)

A

Cephalosporins like:

  1. Cefdinir
  2. Cefpodoxime
  3. Cefuroxime
  4. Ceftriaxone
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9
Q

Cephalosporins used for AOM DF?

A

All oral only ceftriaxone IM/IV

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10
Q

What is duration of action in all AOM drugs except Azithromycin?

A
  1. Children <2 years and children (any age) with tympanic membrane perforation or history of recurrent AOM: 10 days
  2. Children ≥2 years with intact tympanic membrane and no history of recurrent AOM: 5 to 7 days
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11
Q

Azithromycin dose & duration & what happens if there is pneumococcal resistance

A
  1. 10 mg/kg once on day 1 then 5mg/kg once per day on days 2 through 5
  2. 5 days
  3. Increasing the dose of macrolides generally will not overcome the resistance
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12
Q

Clinical presentations most consistent with bac vs viral rhinosinusitis

A
  1. Onset with persistent signs or symptoms, lasting for ≥ 10 days without any evidence of clinical improvement
  2. Onset with severe signs or symptoms of high fever (≥39°C [102.2°F]) and purulent nasal discharge or facial pain lasting for at least 3 to 4 consecutive days at the beginning of illness
  3. Onset with worsening signs or symptoms characterized by new-onset fever, headache, or increase in nasal discharge following a typical viral URI that lasted 5 to 6 days and were initially improving (“double sickening”)
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13
Q

Symptomatic treatment of acute bacterial rhinosinustitis

A
  1. Analgesics
  2. Glucocorticoids ( not used in AOM )
  3. Antihistamines ( not used in AOM )
  4. Decongestant
  5. Saline spray
  6. Anticholinergic spray
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14
Q

First line rhinosinusitis antibiotic treatment

A
  1. No risk factors for pneumococcal resistance: Amoxicillin or amoxicillin-clavulanate
  2. Risk factors for pneumococcal resistance: high dose Amoxic-calv
  3. In severe infection (hospitalization): IV ampicillin-sulbactam
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15
Q

Risk factors for pneumococcal resistance

A
  1. Age>65
  2. hospitalization in the last 5 days
  3. severe infection
  4. comorbidities (DM, cardiac, hepatic, or renal diseases)
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16
Q

Alternatives for AOM children with severe reaction◊ to beta-lactams including cephalosporins

A
  1. Azithromycin
  2. Clarithromycin
  3. Clindamycin

All Oral

17
Q

Which antibiotics are used in penicillin allergy in acute bacterial rhinosinusitis?

A
  1. Doxycycline
  2. Cefixime / cefpodoxime w/ or w/out clindamycin
  3. Levofloxacin /moxifloxacin
18
Q

Preferred Antibiotic for pharyngitis & its duration

A

Peniciillins

  1. Pencillin V oral
  2. Amoxicillin oral
  3. Pen G benzathine IM

10 DAYS except IM only single dose

19
Q

alternative for mild reaction to penicillin in pharyngitis

A

Cephalosporins
1. 1st generations are preferred due to narrow spectrum

  1. Choose agents with side chain dissimilar to penicillin: cephalexin / cefadroxil / cefuroxime / cefpodoxime / cefdinir / cefixime
  2. Duration: 10 days
20
Q

alternative in severe (IgE-mediate allergy) in pharyngitis

A

Macrolides:

Azithromycin
Clarithromycin
Clindamycin

Alternative to all lincosamide

21
Q

What can we use if initial treatment failed?

A
  1. Choose different drug class
  2. broader-spectrum Amoxi-clav
  3. high dose Levofloxacin or moxifloxacin (these are better for redp & S.pneu)
    ( in cystitis levo & cipro not moxi )
22
Q

Which drug is better for reducing rates of acute rhematic fever

A

Penicillins preferably IM single dose

24
Q

Antiviral treatment for influenza

A
  1. Neuroaminidase inhibitors:
    A. Zanamivir
    B. Oseltamivir
    C. Peramivir
  2. Baloxavir
  3. Amantadine / ramantadine

1,2 for both inf A & B
3 is for inf A only

pharma Omamah (4 decks)

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