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28 Cards in this Set
- Front
- Back
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What are the causative organisms for RSV?
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1)single-stranded RNA in genus Pneumovirus
2)Two strains, type A and type B -type A accounts for more severe infection |
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_____ is the MAINSTAY OF THERAPY for RSV
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?
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Role of bronchodilators in RSV
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Controversial
1)treats reactive airway disease (RAD) not the RSV |
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Bronchodilator that should be used in children <2 years old
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racemic epinephrine
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Bronchodilator that should be used in older children
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albuterol
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What is the only drug with an FDA indication for the treatment of RSV?
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Ribavirn
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Ribavirin must be started within _____ of onset of infection
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72hours
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Ribavirin regimen
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6gm/day via nebulization over 12-18hrs for 3-14days, diluted to concentration of 20mg/ml
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Ribavirin adverse effects
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1)TERATOGENIC
2)wheezing, rash, conjuntivitis, reticulocytosis, anemia 3)eye irritation and headache in health care workers |
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When is prophylaxis for RSV indicated?
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For those at highest risk
1)BPD 2)prematurity (<35wks) w/ emphasis on those born <28weeks because of poor lung development |
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What two products are available for prophylaxis of RSV?
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1)Respigam
2)Synagis =given monthly during RSV season |
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What is Respigam (RSV immune globulin)?
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1)polyclonal antibody purified from pooled plasma (PASSIVE IMMUNITY)
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Respigam regimen
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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 |
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Respigam regimen is made to watch for ______ reactions
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?
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Respigam disadvantages
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1)infusion related rxns and sensitivity to pooled plasma agents
2)fluid overload 3)high nursing needs 4)high drug and administration costs |
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What is Synagis (Palivizumab)?
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monoclonal antibody produced from recombinant DNA technology (95% human, 5% mouse)
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Synagis regimen
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15mg/kg IM monthly for 5 months during RSV season
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Synagis adverse reactions
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limited to site reactions
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Synagis advantages
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1)low nursing needs
2)no risk of fluid overload 3)administration related costs are low, but drug cost still high |
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Synagis disadvantages
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1)limited success in immunocompromised patients
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What are the 3 main forms of croup?
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1)viral croup (laryngotracheobronchitis)
2)epiglottitis (supraglottis) 3)bacterial tracheitis (pseudomembranous croup) |
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What is the most common cause of viral croup?
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parainfluenza
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What is the treatment of viral croup if stridor is present at rest?
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1)oxygen/intubation
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 |
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Role of dexamethasone in viral croup
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1)improve symptoms
2)decrease hospitalizations and intubations |
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What is the most common cause of epiglottitis?
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1)haemophilis influenza type B
(non-typeable haemophilus and strep pneumonia can also be causes) |
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What is the treatment for epiglottitis?
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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 |
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What is the most common causative agent of bacterial tracheitis?
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staphylococcus aureus
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What is the treatment of bacterial tracheitis?
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1)similar to epiglottitis
2)intubation 3)antibiotic coverage for staph aureus and haemophilus influenza suggested |
