Therapeutics - LRTI 3

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Author:
kyleannkelsey
ID:
286973
Filename:
Therapeutics - LRTI 3
Updated:
2014-10-24 17:37:56
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Therapeutics LRTI
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Therapeutics - LRTI
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  1. What is the recommended treatment for a pneumonia patient with severe disease, no MRSA risk (not HCAP or VAP) and risk factors for pseudomonas aeruginosa?
    • Cefipime 2 gm IV Q 8 hrs
    • or
    • Imipenem/Cil. 500-1000 mg IV Q 6hrs
    • or
    • Meropenem 1 gm IV Q 8hrs
    • or
    • Piperacil./tazobact. 3.375 gms IV Q 6hrs
    • PLUS
    • Cipro or aminoglycoside with wither azithromycin or levofloxacin
  2. What is the recommended treatment for a pneumonia patient with severe disease, MRSA risk (HCAP or VAP) and risk factors for pseudomonas aeruginosa?
    • Cefipime 2 gm IV Q 8 hrs
    • or
    • Imipenem/Cil. 500-1000 mg IV Q 6hrs
    • or
    • Meropenem 1 gm IV Q 8hrs
    • or
    • Piperacil./tazobact. 3.375 gms IV Q 6hrs
    • PLUS
    • Cipro or aminoglycoside with wither azithromycin or levofloxacin
    • PLUS VANCO
  3. What is the target trough for Vancomycin in pneumonia?
    15-20
  4. What are the benefits of antibiotic de-escalation?
    • Decreased resistance
    • Decreased risk for antibiotic related side effects
    • Decreased cost
  5. How does the IV dose of Levo compare to the PO dose?
    Same
  6. How does the IV dose of Ceftriaxone compare to PO?
    No equivalent PO dose
  7. What is the only group of antibiotics that can orally cover pseudomonas?
    Quinolones
  8. How does the IV dose of Piperacillin/Tazobactam compare to the PO dose?
    No PO equivalent
  9. What drugs have equivalent IV and PO doses?
    • Doxycycline
    • Ofloxacin
    • Ciprofloxacin
    • Levofloxacin
    • Metronidazole
    • Clinadmycin
    • Trimethroprim/Sulfamethazole
  10. When can you switch from IV to PO meds in the treatment of pneumonia?
    • <100 F
    • Functioning GI
    • Decreasing WBC
    • Improvement in cough and dyspnea
  11. What is the duration of treatment for CAP?
    7-10 days (exception: Levo 750 QD or Azithro 500 QD can stopped after 5 days)
  12. What is the duration of treatment for HCAP, VAP and HAP?
    • 7-14 days
    • Pseudomonas or Staph aureus present: 21 days
  13. How can pneumonia be prevented?
    • Influenza vaccine annually
    • One time Pneumonia vaccine
  14. Who should get a Pneumonia vaccine?
    • All adults over 65
    • Smokers (any age)
    • > 6 years of age with chronic illness
    • > 6 with immunosuppressive drug therapy
  15. What tests should be performed on in patient pediatrics with pneumonia?
    • Blood and sputum cultures
    • CBC
    • Chest x-ray
  16. What I sthe empiric treatment for children with suspected bacterial pneumonia?
    • Inflants and pre-school age:
    • Outpatient: Amoxacillin
    • Inpatient: Ceftriaxone or Cefotaxime
    • School age:
    • Outpatient: Macrolide
    • Inpatient: Beta lactam + Macrolide
  17. Why are school age children with pneumonia treated differently than pre-school age?
    5-50 years = higher risk of mycoplasma
  18. What is the treatment duration for pediatrics with pneumonia?
    7-10 days
  19. Acute bronchitis is located on what part of the lungs?
    Bronchioles
  20. Pneumonia is located in what part of the lungs?
    Aveoli
  21. What are the supportive treatments for acute bronchitis?
    • APAP/IBU
    • Cough suppressant only at night
  22. When should a patient receive antibiotic therapy for acute bronchitis?
    • HR > or = 100
    • Elevated procalcitonin
    • Symptoms beyond 2 weeks
    • > 65 years
  23. What are the most common Bacterial pathogens impictaed in Acute bronchitis?
    • H flu
    • S pneumonia
    • M catarrhalis
  24. What are the usual antibiotic choices for acute bronchitis?
    • Macroide
    • Doxycycline
    • Amoxicillin/clavulanate
    • 2nd or 3rd generation cephalosporins
    • Flouroquinolones

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