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Resp Pharm- Bridges

Pharmacological Treatment of Influenza, RSV and Epiglottitis- Bridges 1/10/13

Patients at high risk for complications due to Influenza are Children under 2, adults over 65, immunocompromised
Two classes of drugs for influenza treatment Neuraminidase inhibitors and Adamantanes
Mechanism of action for neruaminidase inhibitors Prevents virus from being released from the HA and infecting other cells, shortens duration and severity of infection
Neuramindidase inhibitors are effective against Influenza A and B
Neuraminidase inhibitors (drugs) Zanamivir and Oseltamivir
Oseltamivir/Zanamivir is giving (when?) Prophylactically within the first 48 hours of exposure
Oseltamivir is given (how?) Orally
Adverse effects of Oseltamivir Nausea and vomiting, Neuropsychiatric events (especially in elderly)
Adverse effects of Zanamivir Bronchospasm
Zanamivir is given (how?) Inhalation
Zanamivir and Oseltamivir both interfere with what? Flu Vaccination
Amantadine/Rimantadine are currently not recommended for prophylaxis. Why? Almost all viruses are resistant
Amantadine/Rimantadine are used for the treatment of Influenza A
Mechanism of action of Amantadine/rimantadine? Prevents uncoating of viral RNA by inhibiting a viral proton channel preventing a required viron pH change
Amantadine or Rimantadine enters the CNS? Amantadine
Which has more adverse effects, Amantadine or rimantadine? Amantadine
Adverse effects of amantadine/rimantadine GI effects and CNS effects
Who is most susceptible to CNS side effects? The elderly
Who is most susceptible to extreme Respiratory Syncytial virus infections? Premmies and immunocompromised patients
Most common cause of bronchiolitis and pneumonia is infants under 1 Respiratory syncytial virus
Palivizamab Humanized monoclonal antibody (IgG) against RSV
Palivizamab mechanism of action Inhibits viral entry into cells
Palivizamab is given (how?) Monthly as a shot during RSV season
A life threatening RSV infection is treated with Ribavirin, oxygen therapy and mechanical ventilation
Ribavirin mechanism of action Unclear
Ribavirin adverse effects Inhalation causes reversible deterioration in pulmonary function, Oral causes reversible anemia due to hemolysis and bone marrow suppression
Common etiologies of Epiglottitis Strep pyogenes, Strep pneumoniae, Staph aureaus, Haemophilus influenzae
Treatment for epiglottitis Mainstay of airway, 3rd gen cephalosporin and anit-staph (for MRSA)
Treatment example for epiglottitis Cefotaximine (or ceftriaxone) and vancomycin
Treatment for epiglottitis in patient with beta lacatam allergy Levofloxacin and clindamycin
3rd gen cephalosporins Ceftiaxone, Ceftazidime, Cefotamin, Cefdinir
Excretion mechanism of almost all 3rd gen cephalosporins Renally
Cephelosporin to give to patient with renal failure Cetraiaxone because it is excreted biliary
If he asks a question on a Beta lactam that we learned 4 months ago instead of a flu drug for the quiz tomorrow, he is a dick.
Created by: mcasto