NR 566 / NR566 Advanced Pharmacology Care of the Family Midterm Exam | Already graded A 2020 / 2021, Latest

NR 566 / NR566 Advanced PharmacologyCare of the Family

Midterm Exam | Already graded A 2020 / 2021 Chamberlain

College

1. Pneumonia goals of treatment

- Return to baseline respiratory status

- Fever resolves in 2 to 4 days

- Leukocytosis resolves by day 4 of treatment

- Chest x-ray may take 4 weeks or more to return

2. Common bacterial pathogens of Adult pneumonia

- S. pneumoniae

- Patients with underlying lung disease

- Nontypeable Haemophilus influenza and Moraxella catarrhalis

- Staph aureus: co-pathogen with influenza

- Mycoplasma pneumoniae

- Viral pneumonia

3. Common bacterial pathogens of Adult Community-Acquired

Pneumonia

- Consult current treatment guidelines for the most recent

treatment guidelines forcommunity acquired pneumonia

(CAP)

4. Common bacterial pathogens of CAP in pregnant women

- Main pathogens are S. pneumoniae

- H. influenzae, M. pneumoniae, and viruses

- Macrolides

- Pregnancy category B: erythromycin, azithromycin

- Pregnancy category category C: clarithromycin

- Comorbid conditions or recent antibiotics:

- Beta-lactam plus a macrolide

5. Common pediatric pneumonia pathogens

- S. pneumoniae is the most common cause of bacterial

pneumonia in patients of allages

- Increase in viral pneumonia with PCV7 vaccine

- Infants 4 to 16 weeks

- Consider chlamydia

- Over 5 years through adolescence

- Consider mycoplasma

- Community-acquired methicillin-resistant staphylococcus aureus

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- Virus

6. Clinical practice guidelines for treatment of CAP

- Children under age 5 years

- Bacterial pneumonia (S. pneumoniae)

- Amoxicillin: 80 to 90 mg/kg/day

- Ceftriaxone: 50 mg/kg/day until able to take oral antibiotics

- Penicillin allergy: clindamycin or a macrolide

- Infant with suspected chlamydial pneumonia

- Azithromycin 20 mg/kg/day for 3 days OR erythromycin

(EryPed) 50 mg/kg for 14days

- Children 5 Years or Older

- Mycoplasma or other atypical most likely

- Azithromycin: 10 mg/kg on day 1 and 5 mg/kg on days 2 through

5

- Clarithromycin: 15 mg/kg per day in two divided doses (maximum

1 g/day)

- Erythromycin: 40 to 50 mg/kg/day

7. CAP treatment in pregnancy

- abx treatment:

- 1st choice: Erythromycin or azithromycin cat B. or Clarythromycin

cat C.

8. Radiologic findings during CAP treatment

- assist in confirming the dx of pneumonia vs other resp disorders

such as lung abscess ortuberculosis

9. Treatment of chlamydial pneumonia

- he standard treatment for infants is erythomycin

10. Nicotine patch teaching

- Advise patients to dispose of used nicotine patches out of the

reach of children or animals. Enough nicotine is left in a used

patch to lead to toxic levels in a child or smallanimal.

- The transdermal nicotine system, or "patch," provides a slow,

cutaneous absorption of nicotine over many hours. The patch is

applied to clean, nonhairy skin on the upper bodyor upper arm

when the patient wakes up. Peak nicotine levels occur in 2 to 6

hours (brand-dependent) and then gradually decrease. Once the

patch is removed, nicotine levels in the blood reach a

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nondetectable level in 10 to 12 hours in nonsmokers.

11. Nicotine gum patient teaching

- Patients complain about the taste of the nicotine gum. Suggest

that the patient try theflavored variety, which patients seem to

tolerate better.

- The patient should not eat or drink for 15 minutes before or

while the lozenge is dissolving in the mouth. There may be a

tingling sensation in the mouth as the lozengedissolves.

- Chewing too quickly causes an excess amount of nicotine to be

released into the bloodstream, producing nausea, throat irritation,

and hiccoughs. The patient should avoid

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smoking while chewing nicotine gum because toxicity

symptoms may occur (nausea,vomiting, and headache).

12. Common side effects associated with smoking cessation therapy

- Constipation.

13. Contraindications for smoking cessation therapy.

- Hypersensitivity to nicotine.

- Myocardial infarction.

- Life-threatening arrhythmias.

- Severe or worsening angina pectoris.

- Bupropion is contraindicated in patients with seizure disorders,

bulimia, and anorexianervosa and within 14 days of MAOIs.

14. Tuberculosis Etiology

- Infectious disease caused by M. tuberculosis· Inhaled into the

alveolus and spreads fromlungs· M. tuberculosis grows slowly·

Infection is spread almost exclusively by aerosolization of

contaminated lung secretions

15. Rational drug selection for pregnancy for tuberculosis

- INH and RIF. EMB should be included unless INH resistance

is unlikely. 6 monththerapy. Pyridoxine (vit b6) 25 mg/d

should be added to the regimen to decrease incidence of

peripheral neuropathy assoc with INH.

16. Rational drug selection for children for tuberculosis

- INH and RIF are used for asymptomatic infection for 6-9 months.

Multidrug regimens (INH RIF PZA EMB) are used for

progressive disease. EMB may be used if risk of drug-resistant

organisms is present. DOT should be used for all children.

17. Criteria for resistant TB diagnosis

- Primary resistance risk factors: exposure to a patient with drugresistant TB, immigration from a country with a high prevalence of

d-r TB, and greater than 4% incidence of d-r RBin the community.

- Acquired/Secondary risk factors: poorly or inadequately treated TB.

- DRUG RESISTANCE CAN ONLY BE PROVEN BY

SUSCEPTIBILITY TESTING.

- Second-line treatment usually requires injectable medications,

which complicates the treatment regimen. Fluoroquinolones such

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