Tags: Rimantadine

Influenza

 Essentials of Diagnosis • Acute onset of fever, chills, myalgia, headache, sore throat, nonproductive cough, and severe malaise • Winter or epidemic setting • Variable white blood cell counts • Nasopharyngeal specimen ideally collected within 2-3 days of illness; placed into viral transport media; virus usually isolated within 2-6 days of inoculation into tissue culture • Direct antigen assay positive on nasopharyngeal specimens for influenza A • Increased school absenteeism or emergency room visits signal outbreak General Considerations Influenza is a highly contagious, acute, febrile respiratory illness caused by influenza A and B viruses. The hallmark of these viruses is their ability to undergo rapid ongoing antigenic change and to cause …

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Influenza Infection

Clinical Findings The spectrum of influenza infection ranges from subclinical cases to fulminating viral pneumonia. A. Signs and Symptoms (Box 1). There are no specific physical examination findings associated with influenza. The patient usually appears ill and has fever. A clear nasal discharge is common. A typical uncomplicated case of influenza illness begins abruptly and is manifested by sore throat, headache, fever, chills, myalgias, anorexia, and extreme fatigue. Fever is usually between 38 and 40 °C but may be higher and usually lasts for ~3 days (but = 5 days). Other respiratory tract manifestations include cough, which is usually nonproductive, and a runny or stuffy nose. Substernal tenderness, photophobia, abdominal pain, …

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Order Zithromax Online No Prescription 250/500mg

Azithromycin: Organs and Systems Cardiovascular Torsade de pointes and cardiorespiratory arrest have been reported in a patient with congenital long QT syndrome who took azithromycin. In a prospective study of 47 previously healthy people, there was a modest statistically insignificant prolongation of the QTC interval without clinical consequences after the end of a course of azithromycin 3 g/day for 5 days. Sensory systems Ears Azithromycin can cause ototoxicity. In one study, 8 (17%) of 46 HIV-positive patients had probable (n = 6) or possible (n = 2) ototoxicity with azithromycin. The effects were hearing loss (88%), tinnitus (37%), plugged ears (37%), and vertigo (25%), developing at a mean of 7.6 weeks …

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Specific Causes Of Acute Community-Acquired Pneumonia

Great overlap occurs among the clinical manifestations of the pathogens associated with acute community-acquired pneumonia. However, constellations of symptoms, signs, and laboratory findings serve to narrow the possibilities. By developing an ability to focus on a few pathogens or to identify a specific pathogen, clinicians can better predict the clinical course of pneumonia and can narrow antibiotic coverage. Streptococcus pneumoniae Pathogenesis Pathogenic strains of S. pneumoniae have a thick capsule that prevents PMN binding and that blocks phagocytosis. Certain capsular types (1, 3, 4, 7, 8, and 12 in adults, and 3, 6, 14, 18, 19, and 23 in children) account for most pneumonia cases. Type 3 has the thickest polysaccharide …

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Anti-Infective Therapy

Despite dire warnings that we are approaching the end of the antibiotic era, the incidence of antibiotic-resistant bacteria continues to rise. The proportions of penicillin-resistant Streptococcus pneumoniae, hospital-acquired methicillin-resistant Staphylococcus aureus, and vancomycin-resistant Enterococcus strains continue to increase. Community-acquired methicillin-resistant Staphylococcus aureus is now common throughout the world. Multiresistant Acinetobacter and Pseudomonas are everyday realities in many of our hospitals. The press is now warning the lay public of the existence of “dirty hospitals.” As never before, it is critical that health care providers understand the principles of proper anti-infective therapy and use anti-infective agents judiciously. These agents need to be reserved for treatable infections — not used to calm the …

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Respiratory Tract Infections, Lower

Lower respiratory tract infections include infectious processes of the lungs and bronchi, pneumonia, bronchitis, bronchiolitis, and lung abscess. Bronchitis Acute bronchitis Bronchitis refers to an inflammatory condition of the large elements of the tracheobronchial tree that is usually associated with a generalized respiratory infection. The inflammatory process does not extend to include the alveoli. The disease entity is frequently classified as either acute or chronic. Acute bronchitis most commonly occurs during the winter months. Cold, damp climates and/or the presence of high concentrations of irritating substances such as air pollution or cigarette smoke may precipitate attacks. Pathophysiology Respiratory viruses are by far the most common infectious agents associated with acute bronchitis. …

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Antimicrobial therapy: general principles

A wide variety of antimicrobial agents is available to treat established infections caused by bacteria, fungi, viruses, or parasites. This section will cover the general principles of antimicrobial therapy and will also include illustrative clinical problems to emphasize proper decision-making in using antimicrobials. Determinants of Antimicrobial Efficacy Measurement of antimicrobial activity in vitro Susceptibility testing is indicated for any bacterial pathogen warranting chemotherapy. Drugs that irreversibly destroy the ability of an organism to replicate, and perhaps in the process destroy the structural integrity of the organism, are microbicidal. Drugs that reversibly impair replicating ability, with this function being restored when drug concentrations fall below critical inhibitory levels, are microbiostatic. In quantitative …

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Toxicity of Antimicrobial Therapy

Mechanisms of toxicity The mechanisms associated with common adverse reactions to antimicrobials include dose-related toxicity that occurs in a certain fraction of patients when a critical plasma concentration or total dose is exceeded, and toxicity that is unpredictable and mediated through allergic or idiosyncratic mechanisms. For example, certain classes of drugs such as the aminoglycosides are associated with dose-related toxicity. In contrast, the major toxicity of the penicillins and cephalosporins is due to allergic reactions. These differences are explained in part by the relative ability of specific drugs to inhibit enzymatic pathways in the host versus their stimulation of specific immune response. Not included in these lists is mention of the …

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Management of Sepsis

Definition and prognosis Sepsis, sepsis syndrome, septic shock, and multiorgan dysfunction are all part of a continuum of infection-related systemic illness. Table Definitions for Sepsis, Sepsis Syndrome, Septic Shock and Multiorgan Dysfunction Syndrome gives definitions for each of these entities. The pathogenesis of sepsis is very complex, involving a large number of mediators. A cascade is started when endotoxin or other products of microorganisms enter the circulation, resulting in the release of a variety of mediators from mononuclear phagocytes, endothelial cells and other cells. Initially the proinflammatory cytokines (tumor necrosis factor, IL-1β, IL-6, and IL-8) are elevated, although there are large individual variations. The anti-inflammatory cytokines (IL-10) and soluble cytokine receptors …

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Rimantadine Hydrochloride

C12H21N•HCl • Rimantadine hydrochloride is a synthetic antiviral agent that is structurally related to amantadine and active against influenza A virus. Uses • Influenza Virus Infection Rimantadine is used for the prophylaxis of infection caused by various human and animal strains of influenza A virus in adults and children and for the treatment of these infections in adults.While the optimum dose and duration of therapy have not been established, rimantadine also has been used for the treatment of influenza A virus infection in children. While chemoprophylaxis with the drug should not be considered a substitute for annual vaccination with influenza virus vaccine, antiviral agents are an important adjunct to influenza vaccine …

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