Question

A. Mark is 17 years old who presents to the clinic with a 4-day history of cough and fever. He feels much worse today and got short of breath during the walk into the clinic. He is otherwise healthy and is worried that he will not be able to play varsity basketball this week. He has been consuming fluids fairly well and has not had any nausea or vomiting with this illness. Upon examination, he is noted to appear tired, pale, and ill. His temperature is 101°F. His breath sounds are decreased in the right lower lobe and there are faint crackles noted in the right lower lobe. His oxygen saturation (SaO2) is 95% and his respiratory rate is 24. His chest x-ray indicates a right lower lobe consolidation 1. What is the treatment for Mark's pneumonia? Discuss how you made this decision. 2. What education does he need?

patho of the disease, drug od choice and dosages!

patho of the drug

drug side effects and education to be given to the patient

drug side effects and education

Answer 1

Pneumonia is defined as an inflammation or infection of the alveoli that can occur in one or both lung and can be filled with fluid or pus.

Pathophysiology of pneumonia includes:

Because of inflammatory response such as:

- attraction of neutrophils

- release of inflammatory mediators

- accumulation if fibrinous exudates, red blood cells, and bacteria

This will lead to

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Alveoli filled with fluid increased production of

and debris(consolidation). mucus ( airway obstruction)

This will lead to

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Decreased gas exchange

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Resolution of infection

- macrophages in the alveoli ingest and removes debris

- normal lung tissue restored

- gas exchange returns to normal

The drug of choice for pneumonia are:

Antibiotics

- macrolides: erythromycin

- fluoroquinolones: levofloxacin

- beta- lactams: ceftriaxone

- antipneumococcal: meropenem

Erythromycin

Pathological function of the drug:

Erythromycin acts as the inhibitor of protein synthesis in the bacteria. It goes and binds in the 23S ribosomal molecule in 50S ribosomal subunits in various susceptible bacterias. It inhibits the synthesis of the protein by interfering in the transpeptidation of the protein during its synthesis. It also interferes in the pattern of the 50S subunits of the protein molecule.

Dose: 1-2 GM daily in divided doses

Side effects of erythromycin:

- unusual tiredness

- muscle weakness

- slurred speech

- blurred vision

- drooping eyelids and

- hearing loss

Health education to patient or patient teaching:

- erythromycin does not effect the pregnant lady but should be taken under the complete supervision of the physician.

- take the medication on time

- if the dose is missed do skip the medication and follow the same pattern

- keep the medicine away from the reach of the young children