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Pharmacotherapeutics > Pharyngitis > Flashcards

Pharyngitis Flashcards

P

1
Q

Etiology of Pharyngitis


A
  1. Most common cause is viral infections like Rhinovirus, Coronavirus, Adenovirus
  2. Some bacterial causes include Group A β-haemolytic Streptococcus (GABHS) or Streptococcus pyogenes
  3. other causes- allergy, trauma, toxins and neoplasm
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2
Q

Clinical presentation of Pharyngitis


A
  1. Sore throat
  2. Dysphagia
  3. Fever
  4. Headache, Nausea/Vomiting, Abdominal pain
  5. Erythema in tonsils and pharynx with or without exudate
  6. Enlarged lymph nodes
  7. Petechia especially in the soft palate
  8. Scarlatiniform rash on the body
  9. Exudate
  10. Petechia
  11. Inflammation of the pharyngeal mucosa
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3
Q

Types of Pharyngitis


A

Acute pharyngitis
Chronic pharyngitis

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4
Q

Other pathogens causing Pharyngitis


A
  • H. influenza
  • Staph aureus
  • Corynebacterium diphtheria
  • Neisseria spp (Gonococcal)
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5
Q

Other causes of Pharyngitis


A
  • Allergy
  • Trauma
  • Toxins
  • Neoplasm
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6
Q

Pharyngitis (Sore throat) is ——-

A

an acute inflammation or irritation of the pharyngeal mucosa following infection of the nasopharynx or oropharynx

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7
Q

Risk factors for Pharyngitis


A
  • Exposure to cigarette smoking
  • Frequent common cold and flu
  • GERD
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8
Q

Pathophysiology of Pharyngitis


A
  • Bacterial and viral infections lead to invasion of the mucosa
  • local inflammatory response
  • increased capillary permeability
  • Leading to swelling, erythema, exudate, fever, and production of extracellular toxins and proteases in Streptococcal infections
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9
Q

Diagnosis of GABHS infection

A

Group A beta-hemolytic streptococcal rapid antigen detection test is the preferred method for diagnosing GABHS infection in the emergency department

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10
Q

Centor criteria for GABHS pharyngitis


A

Fever (1 point)
Anterior cervical lymphadenopathy (1 point)
Tonsillar exudate (1 point)
Absence of cough (1 point)

  • > predictive for GABHS pharyngitis in children
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11
Q

Differential diagnosis


A
  • Allergic rhinitis with postnasal drip
  • Airway obstruction
  • Neoplasms - head and neck
  • Gastroesophageal reflux disease (GERD)
  • Peritonsillar cellulitis
  • Candidiasis
  • Diphtheria
  • Croup (Laryngotracheobronchitis)
  • Gonorrhea
  • Epiglottitis
  • Herpes Simplex Virus (HSV)
  • Infectious Mononucleosis (IM)
  • Pneumonia, Mycoplasma
  • Retropharyngeal abscess
  • Scarlet Fever
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12
Q

——— is less expensive than the rapid antigen detection test but not the best test to use in the emergency department due to difficulty with follow-up

A

Throat culture

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13
Q

Physical examination


A
  1. Assessment of airway patency
  2. Temperature
  3. Hydration status
  4. HEENT
  5. Lymphadenopathy
  6. Cardiovascular evaluation
  7. Pulmonary assessment
  8. Abdominal examination
  9. Skin examination
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14
Q

———- is the preferred method for diagnosing GABHS infection in the emergency department

A

GABHS rapid antigen detection test

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15
Q

Factors to rule in or rule out diagnosis of GABHS pharyngitis


A
  1. Sore throat
  2. Fever
  3. Most common in children aged 4-7 years (but other ages may also be affected)
  4. Associated w/ sudden onset of symptoms
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16
Q

Complications of pharyngitis


A
  • Acute rheumatic fever
  • Acute glomerulonephritis
  • Mastoiditis
  • Peritonsillar abscess
  • Otitis media
  • Rhinosinusitis
  • Necrotizing fasciitis
17
Q

Treatment of Pharyngitis


A
  1. Antimicrobial treatment
    2 . Analgesic and antipyretic
18
Q

Analgesic and antipyretic treatment for Pharyngitis includes pain and fever management with ———-

A

Paracetamol or Ibuprofen

19
Q

If allergic to penicillins, alternatives include ——–

A

cephalosporins, Macrolides, or Clindamycin

20
Q

What is the first-choice treatment for Pharyngitis

A

Penicillin V

21
Q

Follow and monitoring parameters


A
  1. Alleviation of signs and symptoms after 3 days and at the end of the course of antibiotics
  2. Culture if history or evidence of rheumatic fever or if symptoms are consistent with a relapse
  3. Patients advised to avoid contact sports
  4. Viral pharyngitis generally requires no specific follow-up unless immunosuppression is suspected or symptoms worsen
22
Q

Antimicrobial treatment for Pharyngitis should be based on ?

A

laboratory confirmation of GABHS pharyngitis

23
Q

Advantage of the GABHS rapid antigen test ?

A

The GABHS rapid antigen detection test decreases the use of unnecessary antibiotics in pediatric patients when used properly

24
Q

The goal of treatment for Pharyngitis

A
  • to improve clinical signs and symptoms
  • minimize adverse drug reactions
  • prevent transmission to close contacts
  • prevent complications

complications – including rheumatic
fever, peritonsillar abscess, cervical
lymphadenitis or mastoiditis

25
Q

Criteria for Steroids use

A

Steroids may improve clinical symptoms and shorten the clinical course in patients with;
* severe or exudative pharyngitis
* airway obstruction
* significant swelling
* odynophagia

26
Q

Duration of antibiotic therapy?

A

Antibiotics may be given up to 7-10 days after onset of symptoms to prevent acute rheumatic fever

27
Q

Pharmacological management of Pharyngitis

A
  • Penicillin V = first choice treatment
    – 250mg PO q8h (children) X 10 days
    – 250mg PO q6h or 500mg PO q12h (adults)
  • Benzathine penicillin i.m. stat
  • or amoxicillin (50 mg/kg/d in 2-3 doses orally) X 10
    days

Pharmacotherapeutics (6 decks)

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