CC Jan 2016 Influenza treatment and prevention

echoecho's version from 2016-01-01 17:59


Question Answer
Three agents are approved for use during the 2015-2016 influenza season, name these three medications?1) oral oseltamivir (Tamiflu) 2) inhaled zanamivir (Relenza) 3)IV peramivir (Rapivab)
Which two of the three medications mentioned above are relevant to outpatient practice for treatment and chemoprophylaxis?1) oral oseltamivir (Tamiflu) 2) inhaled zanamivir (Relenza)
Why are Amantadine (Symmetrel) and rimantadine (Flumadine) not recommended during the 2015-2016 influenza season?because they have high levels of resistance and efficacy only against influenza A
According to a 2013 Cochrane review, Oseltamivir and Zanamivir have small, non-specific effects on reducing the time to alleviation of influenza symptoms in adults, but not in what set of patients?asthmatic children
Treatment reduces symptom duration by less than ___ day and earlier treatment (within ____ hours of symptom onset) is more effective?1; 48
Treatment of hospitalized patients can reduce what?morbidity
Early treatment of hospitalized children can shorten what?hospital stays
Treatment should be limited to a ____ of patients?subset
Widespread use of medication may encourage the development of what?resistance
*** Early antiviral treatment is recommended for what patients?1) hospitalized patients 2) individuals with severe, complicated, or progressive illnesses 3) those at high risk for complications
*** List 10 patients types at increased risk for complications of influenza and treatment should not be delayed while awaiting confirmational test results?1) children < 2 y.o. 2) adults > 65 y.o. 3) persons with chronic pulmonary (including asthma); cardiovascular (except HTN alone); renal, hepatic, hematological (including sickle cell disease),and metabolic disorders (including DM); or neurologica and neurodevelopment conditions (including disorders of the brain, spinal cord, peripheral nerve and muscle, such as cerebral palsy, epilepsy (seizure disorders), stroke, intellectual disability (mental retardation), moderate to severe developmental delay, muscular dystrophy or spinal cord injury 4) persons with immunosuppression, iincluding that caused by medications or by HIV infection 6) pts with cancer 7) women who are pregnant or postpartum (within 2 weeks after delivery) 7) persons < 19 years of age who are receiving long-term aspirin therapy 8) American Indians / Alaska natives 9) persons who are morbidly obses (BMI > 40) 10) residents of nursing homes or other chronic care facilities
*** Vaccination is the primary intervention for preventing influenza. Medications are effective for chemoprophylaxis, reducing the risk of symptomatic illness by ___% to ___%? Duration of therapy is ____ days after LAST known exposure. It is not recommended if ____ hours have past since first exposure to an infectious person?70-90%; 7; 48
Although the CDC states that "while widespread use of chemoprophylaxis is NOT recommended, it may be a consideration in 7 situations, list these?1) prevention of influenza in persons at high risk of influenza complications after exposure to an infectious person during the first 2 weeks following vaccination 2) prevention of influenza in persons at high risk fo complications from influenza who have NOT yet received vaccine; administion of vaccine is recommended as well 3) prevention for people with severe immune deficiencies or others who might nOT respond to influenza vaccination, such as persons receiving immunosuppressive medications, after exposure to an infectious persons 4) prevention after exposure to an infectious person for people at high risk for complications from influenza who cannot receive influenza vaccine dur to contraindication or lack of vaccine availability 4) prevention of influenza in persons in close contact with individuals at high risk for developing complications from influenza 6) prevention of inkfluenza among all residents (vaccinated or unvaccinated) of institutions, such as long-term care facilities, during influenza outbreaks in the institution 7) prevention of influenza in individuals at highest risk for complications (severely immunocompromised age > 85 y.o.)
Annual vaccination is recommended for individuals > ___ months of age?6
Children ___ months to ___ years require 2 doses of vaccine during their first season of influenza vaccination?6; ; 8
Inactvated and live (______ adminstered) vaccines are available?nasally
List the 8 individuals who should NOT receive live influenza vaccines?1) persons < 2 years of age or > 49 years of age 2) children 2-17 years of age receiving ASA or ASA-containing products 3) pregnant women 4) immunocompromised inidividuals 5) persons with hx of egg allergy 6) children 2-4 years of age with hx of asthma or wheezing (including parental report) in the last 12 months, older children may be at increased risk for wheezing following administration 6) individuals who have taken influenza antiviral medication in the past 48 hours 7) persons who care for severely immunosuppressed persons who require a protective environment
*** SUMMARY = What 2 medications have small, nonspecific effects on reducing the time to alleviation of influenza symptoms in adults, but not in asthmatic children?1) oral oseltamivir (Tamiflu) 2) inhaled zanamivir (Relenza)
*** SUMMARY = Earlier treatment within ___ hours of symptom onset is more effective?48
*** SUMMARY = Treatment with antivirals is recommended for certain subgroups of _____-risk patients?high
*** SUMMARY = Chemoprophylaxis is recommended for certain subgroups of individiuals, list two subgroups?1) those at high risk of acquiring the disease 2) those at high risk of complications from the disease