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28 Cards in this Set

  • Front
  • Back
What are the causative organisms for RSV?
1)single-stranded RNA in genus Pneumovirus
2)Two strains, type A and type B
-type A accounts for more severe infection
_____ is the MAINSTAY OF THERAPY for RSV
Role of bronchodilators in RSV
1)treats reactive airway disease (RAD) not the RSV
Bronchodilator that should be used in children <2 years old
racemic epinephrine
Bronchodilator that should be used in older children
What is the only drug with an FDA indication for the treatment of RSV?
Ribavirin must be started within _____ of onset of infection
Ribavirin regimen
6gm/day via nebulization over 12-18hrs for 3-14days, diluted to concentration of 20mg/ml
Ribavirin adverse effects
2)wheezing, rash, conjuntivitis, reticulocytosis, anemia
3)eye irritation and headache in health care workers
When is prophylaxis for RSV indicated?
For those at highest risk
2)prematurity (<35wks) w/ emphasis on those born <28weeks because of poor lung development
What two products are available for prophylaxis of RSV?
=given monthly during RSV season
What is Respigam (RSV immune globulin)?
1)polyclonal antibody purified from pooled plasma (PASSIVE IMMUNITY)
Respigam regimen
1)750mg/kg (15ml/kg) IV monthly over several hours
2)1.5ml/kg/hr for 15mins then check clinical stability then 3ml/kg/hr for 15mins then 6ml/kg/hr
Respigam regimen is made to watch for ______ reactions
Respigam disadvantages
1)infusion related rxns and sensitivity to pooled plasma agents
2)fluid overload
3)high nursing needs
4)high drug and administration costs
What is Synagis (Palivizumab)?
monoclonal antibody produced from recombinant DNA technology (95% human, 5% mouse)
Synagis regimen
15mg/kg IM monthly for 5 months during RSV season
Synagis adverse reactions
limited to site reactions
Synagis advantages
1)low nursing needs
2)no risk of fluid overload
3)administration related costs are low, but drug cost still high
Synagis disadvantages
1)limited success in immunocompromised patients
What are the 3 main forms of croup?
1)viral croup (laryngotracheobronchitis)
2)epiglottitis (supraglottis)
3)bacterial tracheitis (pseudomembranous croup)
What is the most common cause of viral croup?
What is the treatment of viral croup if stridor is present at rest?
2)racemic epinephrine 2.25% solution: 0.05ml/kg up to 1.5ml diluted in equal amt of saline to reduce inflammation
3)dexamethasone 0.6mg/kg IM for 1 dose only
Role of dexamethasone in viral croup
1)improve symptoms
2)decrease hospitalizations and intubations
What is the most common cause of epiglottitis?
1)haemophilis influenza type B
(non-typeable haemophilus and strep pneumonia can also be causes)
What is the treatment for epiglottitis?
1)endotracheal intubation
2)culture of blood and epiglottis
-ceftriaxone 150mg/kg/day divided into 2 doses
-can switch to oral ceph once improved to finish 10 day course
What is the most common causative agent of bacterial tracheitis?
staphylococcus aureus
What is the treatment of bacterial tracheitis?
1)similar to epiglottitis
3)antibiotic coverage for staph aureus and haemophilus influenza suggested