3A4 PgP substrate cough URTI myalgias arthralgias diarrhea transaminitis

3a4 pgp substrate cough urti myalgias arthralgias

This preview shows page 19 - 22 out of 31 pages.

3A4, PgP substrate cough, URTI, myalgias, arthralgias, diarrhea, transaminitis, hepatotoxicity presceded by HSR Fusion Inhibitor Pharmacology MOA: binds to gp41 subunit of viral envelope glycoprotein —> inhibits fusion of viral and cell membranes Enfuvirtide (Fuzeon) 36 amino acid peptide fusion inhibitor BID sub-q injections injection site reactions, insomnia, HA, dizziness, nausea, HSR Community Acquired Pneumonia What is pneumonia Acute infection of pulmonary parenchyma Result of: Defect in host defense Exposure to virulent organism Overwhelming inoculum Organisms get there by: Inhalation of contaminated droplets Aspiration of oropharyngeal contents Hematogenous spread from extrapulmonary sites Then: Pathogens cause alveolar inflmmation, irritation, swelling Inflammatory mediators —> alveolar capillary leak Fluid or pus fill alveoli Host response — resulting sign/symptoms Release of inflammatory mediators (alveolar capillary leak) fever, chills, rigors Fluid or pus fill alveoli Radiographic infiltrate on chest x-ray Rales on auscultation Hypoxemia/increased respiratory drive Increased secretions Physical Exam Findings Tachycardia which day inhibits fusion earn in tr
Image of page 19

Subscribe to view the full document.

Tachypnea +/- use of accessory muscles Diminished breath sounds Inspiratory crackles during lung expansion Diagnosis Clinical signs/symptoms + demonstrable infiltrate by chest radiograph or other imaging technique +/- microbiological data Definitions of Pneumonia CAP Community-dwelling outpatient Inpatient if diagnosis < 48 hrs of admission Hospital acquired 48 hrs after admission Ventilator associated pneumonia 49-72 hrs after endotracheal intubation Healthcare associated pneumonia Community dwelling patient admitted with recent healthcare contact Recent hospitalization 2 days within 90 days Residence in NH or LTCF Home infusion, wound care, HD within 30 days Family member with MDR pathogen Initial Assessment of Severity CURB-65 Confusion Uremia (BUN > 20) Respiratory rate ( 30 breathes/min) Blood pressure (SBP < 90 or DBP 60) Age ( 65) Score 0-1 1.5% mortality Outpatient treatment 2 ~10% mortality Inpatient treatment, non-ICU 3 ~25%+ mortality Inpatient treatment, ICU Direct ICU admission Septic shock, requiring vasopressors Acute respiratory failure requiring intubation with mechanical ventilation Organism that we need to cover Score 0-1 S. Pneumoniae M. Pneumoniae Had to do CURB 65 score and select therapy
Image of page 20
H. Influenzae C. Pneumoniae Respiratory viruses Score 2 S. Pneumoniae M. Pneumoniae C. Pneumoniae H. Influenzae Legionella sp. aspiration Respiratory viruses Score 3 S. Pneumoniae S. Aureus Legionella sp Gram-negative bacilli H. Influenzae
Image of page 21

Subscribe to view the full document.

Image of page 22
  • Fall '19
  • Tetracycline, UTI, Ceftriaxone

What students are saying

  • Left Quote Icon

    As a current student on this bumpy collegiate pathway, I stumbled upon Course Hero, where I can find study resources for nearly all my courses, get online help from tutors 24/7, and even share my old projects, papers, and lecture notes with other students.

    Student Picture

    Kiran Temple University Fox School of Business ‘17, Course Hero Intern

  • Left Quote Icon

    I cannot even describe how much Course Hero helped me this summer. It’s truly become something I can always rely on and help me. In the end, I was not only able to survive summer classes, but I was able to thrive thanks to Course Hero.

    Student Picture

    Dana University of Pennsylvania ‘17, Course Hero Intern

  • Left Quote Icon

    The ability to access any university’s resources through Course Hero proved invaluable in my case. I was behind on Tulane coursework and actually used UCLA’s materials to help me move forward and get everything together on time.

    Student Picture

    Jill Tulane University ‘16, Course Hero Intern

Ask Expert Tutors You can ask 0 bonus questions You can ask 0 questions (0 expire soon) You can ask 0 questions (will expire )
Answers in as fast as 15 minutes