The Pneumonia Infection Discussion Paper

The Pneumonia Infection Discussion Paper

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Pneumonia infection causes the inflammation of air sacs of the lungs, either one or both. The sacs could fill with pus or fluid, cause phlegm, and lead to chills, fever, and dyspnea (Lanks et al., 2019). It could be mild to chronic, and it is common in infants, young children, and older people above 65 years and the immunosuppressed (Wunderink & Waterer, 2014). The bacteria that causes the disease is mainly the Streptococcus pneumoniae. Additionally, mycoplasma pneumoniae causa a milder pneumoniae. For fungi like Pneumocystis jirovecii cause pneumonia in immuno-suppressed people or people with chronic body conditions. When pneumonia is suspected, the tests done to confirm include blood tests to identify the causative microorganism, a chest X-ray to determine the location of the infection, and a sputum test to rule out the cause of infection (Prina et al., 2015)The Pneumonia Infection Discussion Paper.

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The treatment of pneumonia requires antibiotics, cough medicine, and analgesics. Antibiotics include a macrolide and a tetracycline. In macrolides, the drug of choice is clarithromycin, while in the tetracycline class of medications, the drug is doxycycline. Clarithromycin is indicated for Mycoplasma pneumoniae, Chlamydophila pneumoniae, or Streptococcus pneumoniae (Lanks et al., 2019). The dosage is 250 mg PO q12hr for 7-14 days (Prina et al., 2015). Tetracycline dosage has initial and maintenance doses. The initial dose of 200 mg IV is administered in one or two infusions, and a maintenance dose of 100 per day IV (Wunderink & Waterer, 2014). Chest medicines are used to calm the cough and ensure rest. The analgesics also act as antipyretics to reduce fever. The drugs include ibuprofen, aspirin, and acetaminophen (Prina et al., 2015)The Pneumonia Infection Discussion Paper. Additionally, one should drink plenty of water or be administered intravenously in order to loosen secretions as well as bring phlegm.

The risk factors include smokers, pregnant women, the immunosuppressed, those with a neurological condition that causes difficulties in swallowing, like strokes, or those living with a heart or lung condition (Lanks et al., 2019). To reduce the risk of pneumonia, one should quit smoking and avoid passive smoking too. Hygiene should be maintained by washing hands before meals and if handling any food, in addition to using alcohol-based hand sanitizer (Wunderink & Waterer, 2014). One should also eat healthily, do exercises, and get enough sleep. Finally, one should be treated for underlying conditions to ensure that they are not immunosuppressed, which makes them susceptible to pneumonia.

 References

Lanks, C. W., Musani, A. I., & Hsia, D. W. (2019). Community-acquired pneumonia and hospital-acquired pneumonia. Medical Clinics, 103(3), 487-501. https://doi.org/10.1016/j.mcna.2018.12.008

Prina, E., Ranzani, O. T., & Torres, A. (2015). Community-acquired pneumonia. The Lancet, 386(9998), 1097-1108. https://doi.org/10.1016/S0140-6736(15)60733-4

Wunderink, R. G., & Waterer, G. W. (2014). Community-acquired pneumonia. New England Journal of Medicine, 370(6), 543-551. DOI: 10.1056/NEJMcp1214869 The Pneumonia Infection Discussion Paper

 Provide recommendations for alternative drug treatments to address the patient’s pathophysiology. Be specific and provide examples. NEED 2 Resources

Discussion Post Response:

CASE STUDY

Mr. HH is 68 years old and was admitted with community-acquired pneumonia; he is being administered empiric antibiotics, including azithromycin 500 mg IV qday and ceftriaxone 1 g IV qday. He has improved clinically and uses less oxygen but cannot tolerate food due to nausea and vomiting. With HH having a medical history of COPD, this places him at greater risk for acquiring pneumonia.

Pneumonia can be caused by bacteria, viruses, fungi, protozoa, or parasites; identification of causes can depend on treatment considerations (McCance & Huether, 2019). To reduce further risk to HH, empiric antibiotics were imperative. When patients have other comorbidities such as hypertension, COPD, asthma, chronic liver disease, diabetes mellitus, or HIV or have a CURB 65 score greater than two, they must be treated with a macrolide and a beta-lactam or fluoroquinolone antibiotic (Regunath & Oba, 2020)The Pneumonia Infection Discussion Paper. However, bloodwork, including a CBC and sputum specimen, should have been collected before initiating antibiotics.

I would continue with azithromycin and ceftriaxone are broad-spectrum antibiotics clinically indicated for lower respiratory tract infections, including pneumonia (Vallerand & Sanoski, 2019). With HH having an allergy to penicillin, monitoring him while receiving ceftriaxone is vital. Macrolides can cause gastrointestinal disturbances such as epigastric pain, nausea, vomiting, and diarrhea (Rosenthal & Burchum, 2021). As the provider, I would ensure the patient receives an antiemetic such as Zofran ODT 4 mg, a clear liquid diet, and advance as tolerated, along with IV fluids to provide hydration. Involving others from the interdisciplinary treatment team, such as physical therapy and respiratory therapy, would be clinically indicated.

HH would be educated on using the incentive spirometer and the importance of ambulation while hospitalized. I would also discuss with the patient the importance of not smoking, avoiding alcohol, and ensuring flu shots, and if he has not received a pneumonia vaccine, inquire about getting that administered (Lanks et al., 2019). HH could benefit from the pneumonia vaccine due to multiple risk factors for acquiring pneumonia. Risk factors include advanced age, compromised immunity, COPD, alcoholism, smoking, endotracheal intubation, and underlying cardiac diseases or liver diseases (McCance & Huether, 2019)The Pneumonia Infection Discussion Paper.

 References

Lanks, C. W., Musani, A. I., & Hsia, D. W. (2019). Community-acquired Pneumonia and Hospital-acquired Pneumonia. Medical Clinics of North America, 103(3), 487–501. https://doi.org/10.1016/j.mcna.2018.12.008Links to an external site.

Mccance, K. L., & Huether, S. E. (2019). Pathophysiology : the biologic basis for disease in adults and children (8th ed.). Elsevier.

Regunath, H., & Oba, Y. (2020). Community-Acquired Pneumonia. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK430749/Links to an external site.

Rosenthal, L., & Burchum, J. (2021). Lehne’s pharmacotherapeutics for advanced practice nurses and physician assistants (2nd ed.). Saunders.

Vallerand, A. H., & Sanoski, C. A. (2019). Davis’s Drug Guide for Nurses (16th ed.). F.A Davis Company The Pneumonia Infection Discussion Paper.

Class Resources:

• Rosenthal, L. D., & Burchum, J. R. (2021). Lehne’s pharmacotherapeutics for advanced practice nurses and physician assistants(2nd ed.) St. Louis, MO: Elsevier.
  • Chapter 46, “Anticoagulant and Antiplatelet Drugs” (pp. 364–371)
  • Chapter 47, “Drugs for Deficiency Anemias” (pp. 389–396)
  • Chapter 50, “Estrogens and Progestins: Basic Pharmacology and Noncontraceptive Applications” (pp. 425–436)
  • Chapter 51, “Birth Control” (pp. 437–446)
  • Chapter 52, “Androgens” (pp. 447–453)
  • Chapter 53, “Male Sexual Dysfunction and Benign Prostatic Hyperplasia” (pp. 454–466)
  • Chapter 70, “Basic Principles of Antimicrobial Therapy” (pp. 651–661)
  • Chapter 71, “Drugs That Weaken the Bacterial Cell Wall I: Penicillins” (pp. 662–668)
  • Chapter 75, “Sulfonamides Antibiotics and Trimethoprim” (pp. 688–694)
  • Chapter 76, “Drug Therapy of Urinary Tract Infections” (pp. 695–699)
  • Chapter 78, “Miscellaneous Antibacterial Drugs” (pp. 711–714)
  • Chapter 79, “Antifungal Agents” (pp. 715–722)
  • Chapter 80, “Antiviral Agents I: Drugs for Non-HIV Viral Infections” (pp. 723–743)
  • Chapter 82, “Drug Therapy of Sexually Transmitted Diseases” (pp. 763–770)
    

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• Roberts, H., & Hickey, M. (2016). Managing the menopause: An updateLinks to an external site.. Maturitas, 86(2016), 53–58. https://doi.org/10.1016/j.maturitas.2016.01.007

This article provides an update on treatments on Vasomotor symptoms (VMS), genito-urinary syndrome of menopause (GSM), sleep disturbance, sexual dysfunction, and mood disturbance that are common during the menopause transition. The Pneumonia Infection Discussion Paper