Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
61 Cards in this Set
- Front
- Back
|
S. pyogenes treatment pharyngitis
|
1. PCN, amox/clav, cephalexin, cefuroxime, cefixime 2. Clindamycin, FQ(levo or moxi), ML, tetracycline, doxycycline
|
|
|
Viral pharyngitis tx
|
NSAID, tylenol, hydration, (caines and menthol drops)
|
|
|
Pharyngitis dx symptoms for bacteria
|
puss pockets, red spots in throat
|
|
|
pharyngitis dx symptoms for virus
|
erythema
|
|
|
N. gonnorhea treatment of pharyngitis
|
1. Cefixime (3rd gen at least) 2. ML, FQ, tetracyclines,
|
|
|
Fusobacterium sp treatment of pharyngytis
|
clindamycin, amox/clav, metronidazole, levo and moxi,
|
|
|
S. aureus treatment of otitis externa
|
Any G+ oral minus PCN,AMP,AMOX. 1. Amox/clav, Diclox, Cephalexin
|
|
|
P. aerguinosa treatment of otitis externa
|
In severe cases ciprofloxacin or levofloxacin for 10 days
|
|
|
Certain Diagnosis of otitis media:
|
Must meet all 3 criteria: rapid onset, signs and symptoms of middle ear inflammation, and signs of middle ear effusion
|
|
|
Severe otitis media definition:
|
Moderatevee t fever > o =to 39 degree Celsius
|
|
|
Pathogens of otitis media
|
S. pneumoniae, H. influenzae, M. catarrhalis
|
|
|
Child less than 6 months with otitis media
|
antibacterial treatment
|
|
|
Child who is 6 months up to two years with otitis media
|
Treat certain diagnosis, or antibacterial if severe illness
|
|
|
Child 2 years and older with otitis media
|
only treat if certain diagnosis and severe illness
|
|
|
Tx of otitis media
|
1. amoxicillin per guidelines unless failing then amox/clav 2. cephalexin 3. macrolides or bactrim 4. levo/moxi (last option)
|
|
|
Acute otits media criteria for resistant pathogens to amoxicillin
|
children treated with antibiotics in last 30 days, or concurrent purulent conjunctivitis.
|
|
|
Acute otitis media supportive care
|
ibuprofen>APAP>placebo
|
|
|
Symptoms of acute otitis media
|
bulging membrane, erythema, whitish discoloration
|
|
|
Sinusitis bugs
|
S. pneumoniae, H.influenzae, M. cat
|
|
|
Sinusitis drugs
|
1. Amox/clav 2. clindamycin plus cefixime, 3. Levo
|
|
|
Rhinosinusitis with resistant pathogens
|
1. Amox/clav (high dose) 2. clindamycin plus cefixime. Levo
|
|
|
Severe rhinuosinusitis
|
1. Amp/Sulb 2. Cefttriaxone and cefotaxime 3. levofloxacin
|
|
|
Number 1 virus for common cold
|
Rhinovirus
|
|
|
How is rhinovirus
|
influenza virus shared,via respiratory
|
|
|
1st generation antihistamine (cold)
|
global benefit due to anticholinergic effect
|
|
|
2nd generation antihistamine (cold)
|
no global benefit, zyrtec may be most beneficial
|
|
|
FDA warning for decongestants
|
heart disease, HTN, thyroid, diabetes, enlargement of prostate gland
|
|
|
zyrtec (generic)
|
cetirazine
|
|
|
1st gen antihistamines (generic names)
|
diphenhydramine, brompheniramine, doxylamine, chlorpheniramine, dimenhydrinate
|
|
|
Anticholinergic (ipratropium bromide)
|
improvement in rhinorrhea and sneezing; ADR: nasal dryness, blood-tinged mucus, and epistaxis
|
|
|
OTC oral decongestant for cold
|
very little impact on symptoms
|
|
|
OTC intranasal decongestant for cold
|
global benefit for rhinorrhea
|
|
|
OTC intranasal sprays names
|
oxymetazoline, phenylephrine, xylometazoline, naphazoline
|
|
|
rhinits medicamentosa
|
rebound effect of intranasal decongestion use greater than three days
|
|
|
Codeine for cold
|
only works for chronic cough, not from common cold
|
|
|
Centrally-acting Antitussives
|
MOA: GABA agonist, NMDA agonist, mu receptor agonist…..codeine and dextromethorphan. Not recommended by ACCP
|
|
|
dextromethorphan for cold
|
only modest benefit in adults for cough associated with cold, not recommended by ACCP. Not a good option
|
|
|
honey for cough
|
global benefit in children for cough in cold. 2.5mL-10mL at bedtime. Maybe soothing, high antioxidant and antimicrobial effect
|
|
|
honey for cough CI
|
never give to child less than one year
|
|
|
Guaifenesin for cold (cough)
|
guess:increases volume and reduces viscocity facilitating removal of the secreations. Small benefit in productive cough, not for children
|
|
|
Neti Pot dangers
|
Naegleria fowleri warm water brain eating amoeba
|
|
|
Normal saline in pneumonia
|
modest benefit
|
|
|
intranasal glucocorticoids for cold
|
not effective in treatment of the common cold
|
|
|
Vit C for cold
|
really no data, 1 trial suggest benefit with 4 grams bolus at first onset of symptoms
|
|
|
zinc for cold
|
good benefit, however heavy metal toxicity is bad. Can have ADRs related to taste and smell. It is beneficial as an antiviral, studies are hard to blind, therefore no good data
|
|
|
echinacea for cold
|
ADR: bad taste, allergic…..has ability to be good, problem is no homogeneity of available preparations….root? flower? etc?
|
|
|
Non-pharmacolgic benefit for cold
|
Sleep right after first innoculation less likely to develop cold.. Need to get >8 hours of sleep.
|
|
|
Most dangerous influenza virus?
|
Influenza A Virus
|
|
|
Influenza symptoms
|
fever, myalgia, sore throat…fever 101-102….extreme fatigue
|
|
|
Influenza diagnostic test
|
Rapid Antigen < 30minutes, does not distinguish between A and B
|
|
|
osltamavir route
|
oral
|
|
|
zanamivir route
|
inhaled
|
|
|
olsetamivir FDA indication
|
1 year and older treatment, 1 year and older prophylaxis
|
|
|
zanamivir FDA indication
|
7 years and older treatment, 5 years and older prophylaxis
|
|
|
Zanamivir not recommended
|
those with repsiratory diseases
|
|
|
ADR oseltamivir
|
seizures, CNS toxic, neropsychiatric events
|
|
|
ADR zanamivir
|
bronchitis, cough
|
|
|
olsetamivir dose adjustment
|
renal with CrCl<30 ml/min
|
|
|
Indication for flu vaccine
|
all people 6 months and older are recommended
|
|
|
65 y/o flu shot
|
need to get high-dose
|
|
|
contraindications for flu shot
|
allergy to raw eggs or thimerosal
|
