Pharmacology 1 LRI (PDF)
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South College
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Summary
This document provides a quick overview of several respiratory illnesses, including acute bronchitis, chronic bronchitis, and bronchiolitis, along with some notes on the influenza. It also gives a summary of the treatment. This is likely lecture notes or study materials for a pharmacology course.
Full Transcript
Acute Bronchitis Etiology o Viral Treatment o Antitussives: Dextromethorphan, Codeine/Guaifenesin Not covered by Medicare Use caution when cough is productive o Expectorants: Guaifenesin, H2O...
Acute Bronchitis Etiology o Viral Treatment o Antitussives: Dextromethorphan, Codeine/Guaifenesin Not covered by Medicare Use caution when cough is productive o Expectorants: Guaifenesin, H2O o Antibiotics: not recommended for viral Viral may precede bacterial Chronic Bronchitis Etiology o Smoking o Flu, M. catarrhalis, S. Pneumoniae Diagnosis o Chronic cough w/ productive sputum lasting ≥3 consecutive months/yr for 2yrs w/o underlying etiology o "Pink puffer" "Blue Bloater" Treatment o Stop smoking NRT, bupropion/varenicline o Pulm rehab, chest physiotherapy o Aerosolized mucolytic aerosols N-acetylcysteine (NAC): cleaves disulfide bonds in mucus o See COPD for further tx Bronchiolitis Etiology o Think babies (100% ≥2yo) o Most due to RSV Treatment per AAP o Nebulized hypertonic saline o Others that are case-by-case Aerosolized B2 agonists, systemic corticosteroids, Ribavirin Prevention o Abrysvo Vx for older adults and pregnant pt's depending on the time of year o Arexvy Vx for older adults o Monoclonal Antibodies Palivizumab < Niresevimab NOTE: "I will ask you what is routinely recommended for treatment by the AAP, and if there are vaccines or monoclonal antibodies (prevention)." Influenza Etiology o A (seasonal) and B o Drift: seasonal o Shift: new variant Pathophys o Hemagglutinin: allows virus to enter cell via sialic acid receptors o Neuraminidase: allows virus to exit by cleaving link to sialic acid o NOTE: mRNAs are exported to cytoplasm for translation = important for Vx Transmission o Avg 2 day incubation period o Infectious period is 1 day before s/s - up to 7 days after s/s onset Peds can be up to 10 days after s/s onset Diagnosis o Rapid test (relatively new) Prevention o Influenza vx 1st does in peds 6mns and 9yrs w/ booster 4 weeks later High dose ≥65yo, soiled organ transplant, or immunocomp. Post-exposure prophylaxis (NA inhibitors) o Must be given 48 hours intubation CURB-65 for Treatment Criteria Scoring Confusion 30) =2 = In pt RR ≥30 >2 = ICU BP
