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22 Cards in this Set
- Front
- Back
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Review diagnostic criteria for acute otitis media.
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1. History of acute onset and signs and sx.
2. Presences of Middle Ear Effusion (MEE) a. bulging of the TM B. limited or absent mobility of TM c. air-fluid level behind the TM D. otorrhea 3. Signs and Symptoms of middle ear inflammation: a. distinct erythema of the TM or otalgia. |
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Name the common organisms which cause AOM?
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S. pneumoniae
H. influenzae non-typable M. catarrhalis |
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Review mechanisms of bacterial resistance to antibiotics.
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S. pneumoniae: can be overcome with higher doses of amoxicillin.
H. influenza and M. catarrhalis: B-lactamase producing (need to use amoxicillin/clavulanate, cefdinir, cefuroxime, ceftriaxone) |
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What are some characteristics of COMPT of otitis media?
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Color: red, pale yellow
Other: fluid, pus, perforation with otorrhea, bullae Mobility: 0 - 3 + Position: Full, bulging Translucence: Opacified |
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Who gets antibiotics and who does not?
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Certain uncertain
<6 mo antibio antibio 6-2 yrs antibio sever:anti nons: obs. > 2 yrs sev: an observ nonsev:obser |
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Treatment of Otitis Media:
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type I: azithromycin, clari.
non - type I: cefdinir, rocephin, Cefpodoxime. Recommended: with fever: augmentin Nontype 1: I.m. Ceftriaxone (1 or 3 days.) |
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Treat of Otitis media after failure of antibacterial tx:
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No fever: augmentin 90 mg/kg
type I: clindamycin nontype I: I.M. ceftriaxone x 3 days. Yes fever: I.m. ceftriaxone for 3 days. allergy...tympanocentesis then clindamycin |
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Treatment for OTITIS MEDIA:
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Amoxicillin
Augmentin Cefdinir Cefuroxime (Ceftin): Ceftriaxone Azithromycin Clarithromycin Clindamycin |
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Ceftriaxone (Rocephin)
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- IM injection
- reconstitute vial with 1% lidocaine in final conc. of 350 mg/mL to reduce pain of injection. - increase in serum bilirubin |
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Azithromyin
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- CYP 450 (3A4 SUBSTRATE)
- CYP 450 (3A3 AND 4 inhibitor) |
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14 days at room temperature:
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- Clarithromycin
CYP450 3A3/4 SUBTRATE CYP450 1A2 3A4 Inhibitor - Clindamycin: c. difficile CYP 450 3A3/4 SUBSTRATE - Amoxicillin |
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What are some of the NON -preventable risk factors?
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Genetics
Gender (boy) Ethinicity (native, alaskan, inuit) Low socioeconomic class. Large families Special Medical conditions |
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What are some preventable risk factors?
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1. Day care attendance
2. Exposure to tobacco smoke 3. Lack of Breast-feeding 4. Extended pacifier use for greater than 10 month. |
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Common organism of pharyngitis
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- M. catarrhis
- Group A strept - Strept Pneumonie - H. influenza |
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Diagnoses of pharyngitis:
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- Age (5-15)
- Season - Evidence of acute pharyngitis (erythema, edema, exudates) - Tender, enlarged anterior cerivical lymph nodes. - Middle grade fever (101-104 F) - Absence of sx associated with viral URI |
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Pencillin V
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- take with water on an empty stomach 1 hour before or 2 hours after meals.
- 14 days need to ref. |
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Medications for pharyngitis:
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- Pencillin
- Amoxicillin - Cephalosporins - Clindamycin - Azithromycin |
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What cephalosporins are 10 days therpay:
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cephalexin
cefaclor cefixime cefprozil |
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Which are 4-5 days:
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cefdinir
cefadroxil cefuroxime cepodoxime |
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What are some ways to ensure eradication of the organism/
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- cephaloporin
- add rifampin to pencillin for the last 4 days. - clindamycin |
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What are some supportive complications that can occur from pharynigitis?
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- Acute otitis media
- Acute bacterial sinusitis - Cervical adenitis - Peritonsillar and retropharyngeal abscess - Meningitis - Sepsis - necrotizing fascitis |
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What are some non-supportive complications that can occur from pharynigitis?
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- Acute Rheumatic Fever
- Scarlet fever - Acute Glomerulonephritis |
