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PHARMACOLOGY > Tx of LRTI > Flashcards

Tx of LRTI Flashcards

1
Q

How long does acute bronchitis take to resolve?

A

1-3 weeks. Symptoms are self-limited

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2
Q

Non-pharmacological Tx of acute bronchitis

A

Nonpharmacologic options for cough relief such as throat lozenges,
hot tea, honey, steam inhalation, adequate hydration and/or smoking
cessation or avoidance of second-hand smoke is a reasonable first
step.

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3
Q

3 types of cough preparations

A

Antitussives
Mucolytics
Expectorants

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4
Q

What should you exclude in a pt with acute bronchitis?

A

Exclude underlying bronchiectasis or acute exacerbation of chronic bronchitis

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5
Q

What are the signs and symptoms of acute on chronic bronchitis? (5)

A

wheeze
* breathlessness
* tightness of the chest
* respiratory distress
* cough

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6
Q

T/F bronchospasm is fully reversible with COPD

A

F. It is partially reversible

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7
Q

Explain the Mx of acute exacerbations of chronic bronchitis

A
  1. Regular doses of short acting bronchodilators (SABA, SAMA)
    -short acting muscarinic agonist
  2. Supplemental Oxygen (24-28%)
  3. Oral corticosteroids: Prednisone, PO, 30mg daily for 5 days
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8
Q

What is the management of acute INFECTIVE exacerbation of chronic bronchitis?

A

Amoxicillin, oral, 8 hourly for 5 days.
Doxycycline PO for 5 days if severe pen allergy.
(Pt must take full glass of water when taking Doxycyclin)

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9
Q

Name two structures of Influenza found that are important in influenza

A

It is has neuraminidase and haemagglutinin

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10
Q

Name 2 drugs that act as Neuraminidase inhibitors?

A

Oseltamivir
Zanamivir (Inhalor formulation)

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11
Q

When should Oseltamivir Tx be initiated?

A

Initiate tx within 24-48 hours of onset of symptoms reduce duration by less than 1 day

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12
Q

List pt groups that are high risk for influenza

A

Pregnant women
Immunocompromised children <2

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13
Q

Who is eligible for influenza PEP?

A

PEP only for high-risk close contacts (within 48 hours of exposure)

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14
Q

Adverse effects of Oseltamivir

A

N&V (report of fatal neuropsychiatric AEs)

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15
Q

How is the influenza vaccine formulated?

A

2 strains from influenza A and 1 or 2 strains from Influenza B

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16
Q

Who is eligible for the influenza vaccine? (6)

A

-Pregnant women
-HCWs
-HIV+ pts
-Elderly (>65yrs)
-Residents of Old age homes
-Chronic care facilities

17
Q

How long does the vaccine take to become effective?

A

Takes 2-3 weeks

18
Q

AEs of influenza vaccine

A

uncommon, myalgia, fever, headache and nausea

19
Q

Contraindications of influenza vaccine

A

known hypersensitivity to egg protein

20
Q

In the treatment of Covid-19, Which drug is recommended for pts requiring supplemental O2 or on mechanical ventilation

A

Dexamethasone

21
Q

Which drug is recommended for venous thromboembolism prophylaxis dosing is
recommended for all hospitalised patients?

A

Heparin

22
Q

Which drug is recommended for pts requiring only supplemental oxygen+

A

Baricitinib

23
Q

What is the vital signs criteria for mild covid-19 infection?

A

SpO2≥95% on room air
* Respiratory rate <25
* Heart rate <120
* Temp 36-39°C
* Mental status normal

24
Q

What is the vital signs criteria for severe covid-19 infection?

A
  • Breathless at rest or while talking
  • Respiratory rate ≥ 25
  • BP < 90/60
  • Pulse rate > 120
  • Confused or agitated
  • Unable to walk without help
  • Oxygen saturation < 95%
  • Coughs ≥ 1 tablespoon fresh blood
25
Q

What are the signs of tension pneumothorax?

A
  • Sudden breathlessness, more resonant/decreased breath sounds/pain on 1
    side, deviated trachea, BP < 90/60: tension
    pneumothorax likely
26
Q

What medications need to be given to COVID patients?

A

Analgesics & Antipyretics
Thromboprophylaxis
Corticosteroids

27
Q

What analgesic medication should you give to a patient with covid-19?

A

Paracetamol is more recommended than NSAIDs

28
Q

List corticosteroids options recommended for pt with covid and are on supplemental O2. Give dosage instructions and duration of use as well. (5)

A

Dexamethasone 6mg daily for 10 days
* OR
* Betamethasone 6mg (po/iv) for 10 days
* OR
* Prednisone 40mg PO daily for 10 days
* WHO recommended equivalents
* OR
* Hydrocortisone 50 mg IV TDS
* OR
* Methylprednisolone 8 mg QID or 16 mg BD PO or IV

29
Q

List medications that can can be used for thromboprophylaxis in pts with COVID-19

A

Unfractionated heparin
Low molecular weight heparin (Dalteparin and enoxaparin)

30
Q

Give 2 side effects of heparins

A

Bleeding, heparin induced thrombocytopenia (HIT)

31
Q

What is the MOA of heparins?

A

Inactivates thrombin & factor Xa through antithrombin III activation

32
Q

Dosage of enoxaparin for hospitalized pts?

A

40mg SC daily

33
Q

What is the dosage of unfractionated heparin in hospitalized patients?

A

5000 units SC 12 hourly

PHARMACOLOGY (20 decks)

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