Term
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Definition
A: outbreaks, 2 surface antignes (H & N)
B: sporadic cases;
3 known subtypes: H1N1, H1N2, H3N2;
Transmitted by aeroslization/inhalation;
Sx start 1-4 days after virus enters body;
Contagious up to 1 day prior to Sx developing & for 3-7 days after Sx start; |
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Term
| Influenza A & B Clinical Presentation |
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Definition
Generally self-limiting, last ~2 wks;
Fever, HA, tiredness, dry cough, sore throat, nasal congestion, body aches; |
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Term
| Complications of Influenza |
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Definition
Who has them??
- People >=65 yrs;
- Chronic medical conditions;
- very young children;
What are they??
- pneumonia
- bronchitis
- ear infections
- sinus infections |
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Term
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Definition
Hx & physical exam;
Isolation of virus;
Detection of antigen; |
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Term
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Definition
Wash hands frequently;
Flu vaccine yearly - activated (Live Attenuated) & inactivated vaccines; |
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Term
| Activated Influenza vaccine (Live-attenuated) |
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Definition
Give in Oct or Nov.;
reduces flu-related respiratory illness & physician visits among ALL age groups;
Reduces rates of otitis media in children;
Decreases work absenteeism among adults;
Indications:
- healthy persons between 2-49 yrs old |
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Term
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Definition
Give in Oct. or Nov;
Reduces influenza-related respiratory illness & physician visits among all age groups;
Reduces hospitalization & death among persons at high risk;
Reduces rates of otitis media among children;
Decreases work absenteeism among adults;
Indications:
- persons >6 months old |
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Term
| Flu Shot Contraindications |
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Definition
egg allergy;
previous severe reaction to flu shot;
People who previously developed Guillain-Barre Syndrome in 6 wks after flu shot; |
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Term
| Non-Pharm Tx of Influenza |
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Definition
| rest, drink plenty of liquids, avoid using EtOH & tobacco |
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Term
| Pharmacological Tx of Influenza |
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Definition
OTC meds to relieve symptoms;
Avoid ASA in children (Reyes Syndrome);
Antivirals:
- Adamantanes (CDC does not recommend): amantidine, rimantidine;
- Neuraminidase inhibitors: zanamivir (Relenza), oseltamivir (Tamiflu); |
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Term
| Notes about Antiviral Agents (amantidine, rimantidine, zanamivir, oseltamivir) |
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Definition
Must be started within 48 hrs of Sx onset;
Recommended for severely ill regardless of timing of Sx onset or underlying comorbidities; |
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Term
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Definition
- used to help treat Influenza infection;
Tx Recommended in pts >=7 yrs & older;
Chemoprophylaxis recommended in pts >=5 yrs old;
NOT Recommended in people w/ underlying respiratory disease (astham, COPD);
Dosing:
- Treatment (Children & Adults): 10 mg (2 inhalations) BID x 5 days;
Chemoprophylaxis:
- Children & Adults: 10 mg (2 inhalations) ONCE daily x 7 days after exposure
ADRs: allergic rxns, diarrhea, nausea, sinusitis, bronchitis, cough, HA, dizziness, ear/nose/throat infections |
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Term
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Definition
- used to help treat Influenza infection;
Tx Recommended in >=1 yr old;
Chemoprophylaxis Recommended in >=1 yr old;
Dosing:
- Children: 30 mg to 75 mg PO BID x 5 days (weight dependent);
- Adults: 75 mg PO BID x 5 days;
Chemoprophylaxis:
- Children: 30 mg to 75 mg ONCE daily x 7 days after exposure (weight dependent);
- Adults: 75 mg PO once daily x 7 days after exposure;
ADRs: N/V, transient neuropsychiatric events (self-injury or delirium in Japanese teens & adults0; |
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Term
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Definition
1 is more common than 2;
Transmitted via close contact w/ infected pt (peripheral site, mucosal surface, oral or genital secretion);
Found worldwide |
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Term
| Clinical Presentation of Genital Herpes |
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Definition
initial infections do not usually cause clinically apparent lesions;
Most common cause: HSV-2;
Fever, HA, myalgias, malaise, pain, itching, dysuria, vaginal & urethral discharge, tender inguinal lymphadenopathy; |
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Term
| Clinical Presentation of Oral-Facial Herpes |
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Definition
initial infections do not usually cause clinically apparent lesions;
Most common cause: HSV-1;
Most common primary infection: pharyngitis & gingivostomatitis;
Reactivation --> herpes labialis;
Fever, malaise, myalgias, inability to eat, irritability, cervical adenopathy;
Bell's palsy |
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Term
| Clincal Presentation of Herpes Encephalitis |
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Definition
Initial infections do not usually cause clinically apparent lesions;
Most common cause: HSV-1;
Acute onset of fever;
Focal neurologic symptoms; |
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Term
| Diagnosis of Herpes Simplex Infections |
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Definition
History & Physical Exam;
Tzanck stain for giant cell sor intranuclear inclusions of HSV;
Isolation of virus in tissue culture;
Detection of HSV antigen or DNA; |
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Term
| Treatment of Genital Herpes |
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Definition
Acyclovir 5 mg/kg (IBW) IV q8 hr x 5-10 days;
Valacyclovir:
- Initial: 1 g PO BID x 10 days;
- Recurrent: 500 mg PO BID x 3 days;
Famciclovir:
- Initial: 250 mg PO TID x 7-10 days;
- Recurrent: 125 mg PO BID x 5 days; |
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Term
| Treatment of Oral-Facial Herpes |
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Definition
Acyclovir 5 mg/kg (IBW) IV q8 hr x 5-10 days;
Valacyclovir:
- Severe: 1 g PO BID;
- Mild-Moderate: 500-1000 mg PO BID;
- Cold Sores: 2 g PO BID x 1 day;
Famciclovir |
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Term
| Suppressive Treatment of Genital Herpes |
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Definition
Valacyclovir:
- Immunocompetent: 500-1000 mg PO q24 hr
- HIV CD4 <100: 500 mg PO BID |
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Term
| Treatment of Herpes Encephalitis |
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Definition
| Acyclovir 10 mg/kg (IBW) IV q8 hr x 10 days |
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Term
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Definition
| virus that causes Chicken Pox & Shingles; |
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Term
| Clinical Presentaiton of Chicken Pox |
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Definition
ubiquitous extremely contagious virus (Varicell-Zoster Virus);
Prodrome: rash, low-grade fever, malaise;
Rash appears 10-21 days after exposure;
Vesicles develop & become crusted over; |
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Term
| Complications of Chicken Pox |
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Definition
2ndary bacterial infection;
Pneuomonia;
Encephalitis; |
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Term
| Clinical Presentation of Shingles |
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Definition
recurrent varicella-zoster infection known as herpes zoster;
Unilateral vesicular eruptions w/ dermatomal distribution;
Pain associated with affected dermatome; |
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Term
| Complications of Shingles |
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Definition
keratitis;
post herpetic neuralgia --> severe pain & sensitivity to temperature changes;
Encephalitis; |
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Term
| Non-pharm Tx of Chicken Pox |
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Definition
warm baths with emulsified oatmeal;
calamine lotion |
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Term
| Pharmacologic Tx of Chicken Pox |
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Definition
Avoid ASA (esp. in children - Reyes Syndrome);
APAP --> fever;
Diphenhydramine or hydroxyzine --> itching;
Pt >12 yrs old OR Immunocompromised:
- acyclovir 20 mg/kg PO 5x/day x 5 days;
- acyclovir 10 mg/kg IV (IBW) q8 hr x 7 days; |
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Term
| Pharmacologic Tx of Shingles |
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Definition
acyclovir 800 mg PO 5x/day x 7-10 days;
acyclovir 10 mg/kg (IBW) IV q8 hr;
famciclovir 500 mg PO q8 hr x 7 days; |
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