In this unit we will discuss the subset of patients with community acquired pneumonia who are at a higher risk for morbidity and mortality. Those patients require a high level of inpatient care and should be admitted directly to intensive care. In the unit Community Acquired Pneumonia: Inpatient Treatment we introduced the CURB 65 score.Continue reading “Community Acquired Pneumonia: When to Admit to ICU and How to Treat”
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Community Acquired Pneumonia: When to Admit and How to Treat
In the unit Respiratory Tract Infections: Pneumonia we covered the assessment of a patient presenting with signs and symptoms of pneumonia including differentiating between the 3 main types. In the unit Community Acquired Pneumonia: Outpatient Treatment we talked about those patients who are stable enough to be treated at home. This unit focuses on theContinue reading “Community Acquired Pneumonia: When to Admit and How to Treat”
How to Manage Pneumonia in the Outpatient
Pneumonia is simply a type of infection of one or both lungs. Community acquired pneumonia (CAP) describes the clinical scenario where signs and symptoms of a lung infection started outside of the hospital OR within 48 hours (2 days) of hospital admission. Within this timeframe, it is likely the patient encountered the bug and itContinue reading “How to Manage Pneumonia in the Outpatient”
Navigating Pneumonia: Where and How to Treat
Pneumonia is an infection of the lower respiratory tract specifically the lungs. You can refer to the introduction of the study unit on SINUSITIS for a detailed discussion of the respiratory system. This study unit is based on the current Clinical Practice Guideline of the American Thoracic Society and Infectious Diseases Society of America (ATS/IDSA)Continue reading “Navigating Pneumonia: Where and How to Treat”
Sinusitis: What You Need to Know to Maximize Patient Outcomes
Respiratory tract infections can affect the upper (sinuses, throat, nasal cavity) and lower (windpipe, lungs) respiratory tract. Sinusitis can be caused by bacteria or viruses, leading to symptoms like runny or stuffy nose and facial pain. Treatment involves antibiotics for bacterial cases, but most viral cases resolve on their own. Symptomatic management includes saline irrigation and analgesics.
Volume of Distribution: Why We Need it and How to Use It
Distribution is the second step in drug pharmacokinetics. Pharmacokinetics refers to how a drug is processed by the body. Volume of distribution is a way to quantify the extent of drug distribution throughout the body. Intravascular & Extravascular Spaces The body can be broadly divided into intravascular and extravascular spaces. Intravascular space refers to anyContinue reading “Volume of Distribution: Why We Need it and How to Use It”
Pharmacokinetics of Absorption: 3 Metabolic Processes that Affect Bioavailability
First Pass Effect, Enterohepatic Recirculation and P glycoproteins Drug absorption is the first important step needed for a drug to impact the body. The first pass effect, enterohepatic recirculation and p glycoproteins determine how much of the absorbed drug gets to the site of action. When we develop a dosing regimen, we consider how muchContinue reading “Pharmacokinetics of Absorption: 3 Metabolic Processes that Affect Bioavailability”
What You Need to Know: Hemostasis
Hemostasis is achieved through primary and secondary stages. The coagulation cascade, part of secondary hemostasis, stabilizes the platelet plug. It consists of extrinsic, intrinsic, and common pathways, involving multiple clotting factors and calcium ions. Vitamin K is essential for the synthesis of some clotting factors. Each pathway is triggered by specific factors and leads to the activation of the common pathway, ultimately resulting in the formation of a stabilizing fibrin complex.
Warfarin: The Fundamentals
Warfarin, a groundbreaking oral anticoagulant, has a narrow therapeutic index and requires careful management. Its mechanism of action, drug interactions, and effects on vitamin K, platelet function, and absorption are crucial to consider. Individual dosing and patient education are essential, and its benefits make it a preferred choice in specific cases despite its challenges.
Cytochrome Enzymes and Glycoproteins: What You need to Know
Cytochrome P450 (CYP) enzymes play a crucial role in metabolizing over 70% of clinical drugs, primarily in the liver. P-Glycoproteins (PGP) help pump foreign substances out of cells. Drug interactions with these proteins can lead to toxicity or reduced efficacy. Clinically significant drugs may induce or inhibit these proteins, requiring careful monitoring for interactions.