Break The Chain
Infectious Agent (Examples, Prevention)
bacteria, fungi, viruses, rickettsiae, protozoa / rapid accurate identification of organisms
Biologics (Med, MOA, Use, Risk)
omalizumab (Xolair)
MOA: Inhibits IgE binding to receptors on mast cells and basophils and therefore less IgE available to combine with allergens
Use: Adjunctive therapy for moderate to severe persistent allergic asthma not well controlled by inhaled corticosteroids
Risk of anaphylaxis
Hormones are Produced Where
Where is the adrenal cortex?
Allergic Asthma Medication
Biologics (omalizumab (Xolair))
Normal BUN & Creatinine
What are 0.6-1.2 mg/dL & 7-21 mg/dL?
Portal of Exit (Examples, Prevention)
excretions, secretions, skin droplets / hand hygiene, control of excretions and secretions, trash and waste disposal
Mast Cell Stabilizers (Use, Med, MOA, Consideration)
Cromolyn
An alternative, not preferred medication for prophylaxis of acute asthma in patients with persistent asthma
Stabilizes mast cells, there by prevent mast cell membranes from opening when an allergen binds to IgE
Propellants in aerosols may aggravate CAD & dysrhythmias
Timing of Corticosteroid Use & Timing with Meals
When is 6am-9am? Taken with meals?
Greatest Risks with Status Asthmaticus
What are non-compliance and infection?
Normal WBC & Culture and Sensitivity Considerations
Normal WBC: 4.5-11 10x9/L
Culture: type of bacteria
Sensitivity: which antibiotics affect it
48-72 hours
Reservoirs (Examples, Prevention)
people, equipment, water / employee health, environmental sanitation, disinfection/sterilization
Leukotriene Inhibitor (Use, Med, Consideration, Black Box Warning)
used for long-term asthma, Montelukast (Singulair), take at bedtime, depression & suicidal thoughts
Reasoning for Steroid Tapering
What is HPA Axis needs time to recover fully?
Exercise Induced Asthma Treatments
What are SABA, SAMA, Leukotriene Inhibitors?
Dry Powder Inhaler Advantages
What are more drug is delivered to the drug, use of a spacer is not necessary, less hand-mouth coordination is required?
Susceptible Host (Examples, Prevention)
immunosuppression, elderly, diabetes, surgery, burns / recognition of high-risk patients, treatment of underlying disease
Xanthines (Med, Warning, Considerations, Patient Teaching)
Theophylline, Medication has a narrow therapeutic index, Smokers & children need higher dose, Instruct the patient to notify they stop smoking (because dosage need to be reduced), Instruct the patient to limit xanthine containing foods (coffee, cola & chocolate)
Corticosteroid Adverse Effects
DECREASED WOUND HEALING, Cushingoid Appearance ("moon face"), HTN, Osteoporosis, DM, Immunologic: Immunosuppression, Lymphocytopenia, False-negative skin test, Narrow-angle glaucoma, Cataracts
Leukotriene Inhibitors (Med & Considerations)
What are Montelukast (Singulair): Take at night/bedtime and need to report mood changes immediately?
Xanthines Normal Drug Range
What is 5-15 mcg?
Means of Transmission (Examples, Prevention)
direct contact, ingestion, fomites, airborne / isolation, food handling, airflow control, standard precautions, sterilization, hand hygiene
Inhaled Corticosteroids (Use, Med, MOA, Education)
beclomethasone (QVAR), budesonide (Pulmicort), fluticasone (Flovent)
(needs to take on a daily basis) long term control for asthma
MOA: suppress the immune system, Increase number and sensitivity of beta2-receptors
Inhalation route for chronic asthma
IV route for acute exacerbation when other measures fail
Educate to rinse the mouth and throat after use to prevent fungal infections
Glucocorticoids (Meds & Uses)
Hydrocortisone (adrenal insufficiency), Prednisone (Non-endocrine disorders), Methylprednisone (Arthritis), Dexamethasone (Cerebral Edema/Mx of chemotherapy induced N/V)
Advantages of Combination Regimens
Smaller dose of each agent can be given
Reduces adverse effects
Can reduce the corticosteroid use by 50%
Can reduce the non-compliance risk
Amphotericin B Deoxycholate (Use & Adverse Effects)
use: only used in serious, progressive, and potentially fatal fungal infections
adverse effects: multiple organ failure, respiratory arrest, cardiac arrest, renal failure, GI effects, leukopenia (decreased WBC), thrombocytopenia (decreased platelets)
contraindications: renal, cardiac, and respiratory failure