Should be added to therapy only when ICS use does not provide adequate asthma control.
Have a rapid onset of action across the drug class.
Have a significantly different pharmacodynamic profile.
Are recommended as a first-line therapy in mild persistent asthma.
Indicated in all COPD stages
Goals include improvement in overall well-being
An underused therapeutic option
Components aimed at reducing the deconditioning common in COPD.
Inhalation of contaminated water
Contact with contaminated surface
Systemic antimicrobial therapy in the previous 3 months
Exposure to children in day care
Age older than 65
Use of inhaled corticosteroids
Long-term oral corticosteroid therapy
Indicated in moderate to very severe COPD
Use limited by narrow therapeutic profile and drug-drug interaction potential
A potent bronchodilator
Available only in parenteral form.
Parenteral therapy is preferred over the oral route
Tapering down the dosage is required if used for 5-7 days as is typical in an asthma flare
These medications provide action against the formation of various inflammatory mediators.
The adult dose to treat an asthma flare should not exceed the equivalent of prednisone 40 mg daily.
A recommendation for use with short-acting beta2 agonists in the hospital.
An increase in vagal tone in the airway
Inhibition of muscarinic cholinergic receptors
An increase in salivary and mucous secretions
Routinely in all patients
When attempting to rule out a concomitant pneumonia
If sputum is increased
When work of breathing is increased.
Ability to have entire testing process complete with one clinical visit
Results are available within 24 hours
Interpretation of test is not subject to reader bias
Provides a prediction as to who is at greatest risk for disease development
Antipneumococcal vaccine should be given when antimicrobial therapy has completed.
Antipneumococcal vaccine can be given today, and influenza vaccine can be given in 2 weeks.
Influenza vaccine can be given today and antipneumococcal vaccine can be given in 2 weeks.
Influenza and antipneumococcal vaccines should be given today.
His current plan of care should continue because he is improving by clinical assessment
A CXR should be taken today to confirm resolution of pneumonia
Given the persistence of abnormal thoracic findings, his antimicrobial therapy should be changed.
A computed tomography scan of the thorax is needed today to image better any potential thoracic abnormalities.
She should receive TB chemoprophylaxis if her TST result is 5 mm or more in induration.
Because of her age, TB chemoprophylaxis is contraindicated even in the presence of a positive TST result.
If the TST result is positive, but the CXR is normal, no further evaluation or treatment
Further evaluation is needed only if the TST result is 15 mm or more in induration.
She will always have a positive TST result
Biannual CXR are needed to assess her health status accurately.
A TST finding of 10 mm or more induration should be considered a positive result.
Isoniazid therapy should be given for 6 months before TST is undertaken.
As needed when SOB
Primarily during sleep hours
Preferably during waking hours
For at least 15 hours a day
Chlamydophila (Chlamydia) pneumoniae
LABAs enhance the anti-inflammatory action of the corticosteroids
Use of LABAs is associated with a small increase in risk of asthma-related death.
LABAs reduce asthma exacerbations
LABAs can be tried before ICS to relieve bronchospasm.
Reducer of inflammation
Inhibition of secretions
Modification of leukotrienes
Smooth muscle relaxation
Many squamous epithelial cells and few WBCs
Three or more stained organisms
Few squamous epithelial cells and many WBCs
Motile bacteria with monocytes
Longer course of therapy
Lower antimicrobial dosage
Higher antimicrobial dosage
Prescribing a broader spectrum agent
History of allergy
ABX therapy is usually not indicated