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Z A Pharm III > LRTI > Flashcards

Flashcards in LRTI Deck (29):
1

What are some examples of LRTI

acute bronchitis
acute exacerbation of chronic bronchitis
pneumonia
- CAP
- HAP
Influenza
SARS
Anthrax

2

What is acute bronchitis

inflammatory syndrome of the tracheobronchial tree

3

What is acute bronchitis caused by

Viral pathogens mainly
M. pneum
C. Pneum
Bordatella pertussis

4

What is the clinical presentation of acute bronchitis

cough
sputum
smokers have prolonged cough

5

What is txt for acute bronchitis

no antibiotics
symptomatic support
-rest
- clear fluids
- NSAIDS
- Antitussive
- bronchodilators

DON'T USE cold medications

6

What is AECB

acute infection exacerbation in patients with existing chronic bronchitis

7

What is AECB caused by

Viral 20-50%
C, M, S pneum
H flu
M Cat

8

What are AECB symptoms

DOE
sputum purulence
sputum volume

9

What is txt for mild/moderate AECB

stop smoking
antichol bronchodilator
oral prednisone
usually no abx
- Amoxicillin
- Coxycycline

10

What is txt for severe AECB

stop smoking
antichol bronchodilator
oral prednisone
abx
- amox/clav
- macrolides
- cepharlosporins
- flouriquinilones

11

what is CAP

most common infectious cause of death US
mortality increases if hospitalized

12

What is CAP MOA

inhalation of particles
seeding via bloodstream from extra-pulmonary infection
aspiration

13

What is CAP caused by

atypical
S pneumon
Viral
infections with co-morbidities

14

What are some symp for CAP due to strep. pneum

Rust colored Sputum
Rapid onset fever
High WBC
CXR - lobar consolidation

15

What are some symp for CAP due to Mycoplasma pneumoniae

slow course
non-productive cough
WBC normal or slightly high

16

What are some symp for CAP due to Legionella pneumoniae

Pleuritic chest pain
hemoptysis
increased LFT
Hyponatremia

17

How diagnosis CAP

CXR
sputum stain
sputum culture
BP
RR
signs dehydration
mental status
pulse oximetry
CBC
serum electrolytes
LFT
BUN/Cr
glucose

18

What do you use to determine hospitalization when dealing with CAP

CURB-65

19

What is CURB-65

Confusion
Uremia > 19
RR > 30
BP < 90/60
age > 65

20

What is the txt choice for CAP in Outpatient that was previously healthy with no abx in last 3 months

Macrolide

21

What is the txt choice for CAP in Outpatient with presence of co-morbidity or high resistance

Respiratory fluoroquinolone
OR
Macrolide + amino-penicillin option

22

What is the txt choice for CAP in Inpatient in non-ICU

IV route
Respiratory fluoroquinolone
OR
Macrolide + cephalosporin

23

What is the txt choice for CAP in Inpatient in ICU

IV route
Cephalosporin + azithromycin
OR
Respiratory fluoroquinolone

24

when to switch from IV to oral therapy with CAP

Hemodynamically stable
improving clinically
able to ingest medications
normally functioning gastrointestinal tract

25

What are the current guidelines for CAP duration of therapy

Minimum of 5 days
afebrile 48-72 hrs
1 or less CAP-associated signs of clinical instability

26

What is the 2nd most common nosocomial infection in US

HAP

27

What are mortality rates for HAP

30-50%

28

What is on the pathogen list for CAP

Pseudomonas aeruginosa
E. Coli
Klebsiella pneumoniae
Acinetobacter species
Staphylococcus aureus (MRSA)

29

What are Clinical Stability Criteria

Temp LE 100
HR LE 100
RR LE 24
Systolic GE 90
PaO2 GE 90
PO2 GE 60
Oral Intake
Mental Status