Lower Respiratory Tract Infections Flashcards Preview

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Flashcards in Lower Respiratory Tract Infections Deck (123)
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1

Risk factors for bronchitis

Cold or damp climate
Cigarette smoke
Air pollution

2

Causative organisms of bronchitis

Viral pathogens mcc
-Common cold virus
-Influenza
-Adenovirus
-RSV
Bacterial pathogens
-Chlamydophilia pneumonia
-Mycoplasma pneumonia
-Bordetella pertussis

3

Acute bronchitis tx

Symptomatic and supportive care
-Antipyretics
-Antitussives
-Bronchodilators
-Corticosteroids
--Medrol dose pack
--Prednisone dose pack

4

When are abx indicated for acute bronchitis?

High-risk pts
Persistent sx

5

Choice of abx for bronchitis

Similar to CAP
Macrolide or doxycycline
Respiratory FQ

6

ASA adult dose

325-650 mg q4h
Max: 4 gm/day

7

ASA pediatric dose

CI in children 2nd
Reye's syndrome

8

ASA pearls/side effects

Inhibit prostaglandin synthesis (AKI)
Tinnitus
Upper GI events

9

Ibuprofen adult dosing

200-800 mg Q4-6H
Max: 3.2 gm/day

10

Ibuprofen pediatric dosing

10 mg/kg PO q4-6h
Max: 50 mg/kg/day

11

Ibuprofen pearls/side effects

Use in age > 6 mos
Inhibit prostaglandin synthesis (AKI)
Epigastric pain/dyspepsia
GI ulcer/bleeding
Increased CV events

12

Acetaminophen adult dose

650 mg PO q4-6h
Max: 4 gm/day

13

Acetaminophen pediatric dose

10-15 mg/kg PO q4-6h
Max: 60 mg/kg/day

14

Acetamiophen pearls/side effects

Preferred in children
Caution in liver disease
Skin reactioAns

15

Influenza tx

Antivirals should be started within 48 hrs of symptom onset
-Reduces illness duration ~1.3 days

16

Amantadine
Rimantadine clinical pearls

Spectrum: Influenza A
Use not currently recommended due to resistance issues

17

Olsetamivir adult dose and influenza spectrum

Dose: 75 mg PO BID x 5 days
Spectrum: A and B

18

Zanamavir adult dose and influenza spectrum

Dose: 10 mg INH BID x 5 days
Spectrum: A and B

19

Olsetamivir pearls

Renally eliminated
Safe in children
Increased risk of neuropsychiatric events

20

Zanamivir pearls

Age >7
Increased risk of neuropsychiatric events
Bronchospasm

21

Azithromycin MOA

Inhibits protein synthesis (50s)
Bacteriostatic

22

Azithromycin typical adult dosing: pneumonia

Variable: 500 mg IV or PO daily on day 1, then 250 mg IV or PO daily on day 2-5

23

Azithromycin spectrum of activity

Some gram neg
Gram pos
ATYPICALS

24

Azithromycin pearls/ side effects

QT prolongation
Increased cardiac risk
D/N/V

25

Doxycycline MOA

Inhibits protein synthesis (30s)
Bacteriostatic

26

Doxycycline typical adult dosing pneumonia

100 mg IV or PO q12h

27

Doxycycline spectrum of activity

Gram neg
Gram pos
ATYPICALS

28

Doxycycline pearls/side effects

Esophageal irritation (take with water)
GI upset (N/V)
-Take with food
Decreased absorption with food
Photosensitivity
Tooth discoloration/hyperpigmentation
-Caution in age < 8 yrs

29

Clinical presentation of pneumonia

Cough +/- sputum
Fever/chills
Pleuritic chest pain
Dyspnea
Crackles on chest exam
Consolidation on chest radiography
AMS

30

Microbiologic diagnosis of pneumonia

Sputum gram stain/culture
- >25 PMN and < 5 epithelial cells
Blood culture
Broncho-alveolar lavage (BAL)
- > 10 to the sixth CFU/mL
Protected specimen brush (PSB)
- > 10 to the third CFU/mL
Urine antigen tests
-Legionella and S. pneumo