Pharmacology: The treatment of respiratory infections

Question 1

URTI

Describe the agents you would use to treat Acute Sinusitis/Otitis media (Streptococcus pneumonia and Haemophilus influenza)

Answer 1

1.High dose Amoxicillin
2.Co-amoxiclav
3.Cefuroxime or cefpodoxime
4.A macrolide(Erythromycin or Azithromycin)
5.FLuoroquinolone
6.Telithromycin(in macrolide resistance)

Question 2

URTI

Describe the treatment of Chronic Sinusitis

Answer 2

Antibiotic treatment not always effective

Question 3

URTI

Describe the treatment of Pharyngitis/Laryngitis/Tonsilitis

Answer 3

Caused by Grou[ A beta-haemolytic streptococci(S.pyogenes)

Agents
1. Benzathine Penicillin
2. Phenoxymethylpenicillin(pen V)
3. Amoxicillin or co-amoxiclav
4. In penicillin allergy: Macrolide(clarithromycin or Azithromycin) or Cephalosporins(Cefpodoxime, cefprozil, cefuroxime) or Telithromycin

Question 4

URTI

Describe the treatment for Epiglotitis (caused by H.Influenza)

Answer 4

1. Second or third generation of Cephalosporin (Cefuroxime, Ceftriaxone, Cefotaxime)
2. Chloramphenicol(side effects-severe bone marrow toxicity)
3. Co-amoxiclav.

Question 5

Describe the treatment of Conjunctivitis

Answer 5

Purulent conjunctivitis: topical chloramphenical drops(for 5 days)
*If there is not response,
1. Topical tobramycin(aminoglycoside)
2. Topical ciprofloxacin
3. Topical fusidix acid
4. Bacitracin/Polymyxin B ointment

Question 6

LRTI

Describe the treatment of Acute bacterial bronchitis

Answer 6

This is inflammation of the aireaus usually caused by viral infection

Resolves on its own within a few weeks

Question 7

Describe the treatment of Acute bacterial pneumonia

Answer 7

This is infection in the lungs…so basically alveoli fill with pus/fluid

We treat this with Antibiotics

Question 8

LRTI

Describe the treatment of Acute bronchitis and Acute exacerbations of chronic bronchitis.

Answer 8

Acute bronchitis
(caused by B.pertussin, C.pneumoniae, M.catarrhalis, H.Influenza or M.Pneumoniae)
1. Macrolide
2. Doxycycline-Tetracycline

Acute exacerbations of chronic bronchitis
1. Amoxillin or co-amoxiclav or ceftriaxone
2. Fluroquinolones(mocifloxacin and Levofloxacin)

Question 9

List all the possible causes (infections) of bacterial pneumoniae

Answer 9

1. S.pneumonia
2. H.influenzae
3. S,Auerues
4. K.pneumonae
5. M.pneumonae
6. C.pneumonae
7. Legionella spp
8. B.pertussis

Question 10

Bacterial Pneumonia

Describe the treatment of Bacterial Pneumonia.
Patients less than 5 years and no cormobidities

Answer 10

Patients less than 5 years and no cormobidities
1. Amoxillin or Penicillin G or Ampicillin
2. Add macrolide or Ampicillin if there’s no response after 48 hours.

Question 11

Describe the treatment of Bacterial Pneumonia.

Patients over 65 years, no cormobidities, no usage of antibiotics within prior 90 days

Answer 11

1. Co-amoxiclav
2. Second or Third Generation Cephalosporin (cefuroxime, ceftriaxone, cefotaxime)
3. In case of poor response, add a macrolide or azalide

Question 12

Describe the treatment of Bacterial Pneumonia.

Severe Pneumonia

Answer 12

1. Co-amoxiclav
2. second or third generation cephalosporin and macrolide/azalide
3. in case of penicillin allergy, give Levofloxacin or Moxifloxacin or Macrolide/Azalide.

Question 13

Describe the treatment of Bacterial Pneumonia.

Atypical Pneumonia(Mycoplasma Pneumonia or Chlamydophila Pneumonia)

Answer 13

1. Macrolide
2. Levofloxacin or Moxifloxacin

Question 14

Describe the treatment of Bacterial Pneumonia.

Atypical Pneumonia (legionella Pneumophilia)

Answer 14

1. Macrolide
2. Levofloxacin or Moxifloxacin
3. Beta-Lactams not effective
4. Co-amoxiclav
5. Cefuroxime or Ceftriaxone or Cefotaxime

Question 15

Describe the treatment of Bacterial Pneumonia.

In Children

Answer 15

1. Amoxicillin or Ampicillin or Co-amoxiclav
2. Ceftriaxone or Cefotaxime(severe)
3. In penicillin allergy: Macrolide

Question 16

Describe the treatment of Bacterial Pneumonia.

Neonates

Answer 16

Require hospitalisation
Penicillin G or Ampicilllin
Add Gentamycin or Cefotaxime/Ceftriaxone