NR 566 Midterm Study Guide - Questions and Answers Common CAP pathogens S. Pneumoniae (most common) H. Influenzae (smokers/COPD) P. Aeruginosa (CF) CAP
... [Show More] first line treatment Macrolides, Doxycyline, Amoxicillin What to give if 1st CAP treatment doesn't work? Respiratory Fluoroquinolone if not received abx in the past 3 months Mycoplasma pneumoniae atypical pneumonia; commonly seen in children Pediatric atypical pneumonia treatment Macrolides (Erythromycin), if failed then Respiratory fluoroquinolone CAP treatment during pregnancy Amoxicillin, cephalosporins, or Erythromycin Treatment of chlamydial pneumonia in infant Macrolide (Azithromycin): 500mg orally on day 1 followed by 250 mg once daily on days 2-5 When to use broad/empiric spectrum antibiotics? Before cultures are resulted/ critically ill patient after first culture obtained, based on NP knowledge of patient history, local susceptibility/ geographic location When to use narrow spectrum antibiotics? Used when the culture and sensitivity is resulted, and pathogen is known. How to treat C.diff Stop the antibiotic that may have caused it 1st: Vancomycin 125 mg PO QID x 10 days. 2nd: Metronidazole 500mg PO TID x 10 days address hydration Drug class known for ALL drugs in class to promote development of C. Diff 2nd and 3rd generation Cephalosporins Penicillin: Cross-sensitivity reactions with which drug classes Cephalosporins & Carbapenems (Allergy may be mild or severe) Safe penicillin during pregancy Amoxicillin Patient education for Cephalosporins Report to provider any loose stools, complete full course of antibiotics, s/s of allergy Cephalosporins in pregnancy All appear safe for use Patient education for Tetracyclines photosensitivity (wear sunscreen!), complete full course, s/s of allergy Tetracyclines in pregnancy Can lead to fetal death; avoided for use Patient education for macrolides Take with meals to avoid GI upset, contraindicated w/ warfarin Aminoglycoside patient teaching Patients should report tinnitus, high-frequency hearing loss, persistent headache, nausea, dizziness or vertigo Sulfonamides patient teaching Finish full course Increase fluid intake to 8-10 cups/day Take on empty stomach Avoid sun exposure/wear sunscreen Sulfonamides during pregnancy not to be used during 1st trimester, can cause kernicterus in infants Gentamicin renal dose adjustments decreased dosage for renal impaired Tinea capitis treatment oral griseofulvin Drug to treat aspergillosis (Fungal Pneumonia) Voriconazole Which Anthelmintics carry risk for hypotension with patients on antihypertensives? Ivermectin and Moxidectin [Show Less]