Pharmacological Treatment for CAP Essay
Pharmacological Treatment for CAP Essay
Community-Acquired Pneumonia
Provide recommendations for alternative drug treatments to address the patient’s pathophysiology. Be specific and provide examples. Pharmacological Treatment for CAP Essay
Community-acquired pneumonia is a respiratory tract infection caused by bacteria streptococcus pneumonia or Hemophilus influenza. It is common in patients with other illnesses such as diabetes mellitus and chronic obstructive pulmonary disease. According to Metlay, et al, (2019), mortalities and morbidities associated with CAP are among elderly patients. This paper is a response post for an elderly patient diagnosed with CAP and has other co-morbidities; COPD, hypertension, diabetes, and hyperlipidemia. I agree with the patient’s initial treatment of CAP with ceftriaxone 1gm IV Daily and Azithromycin 500 mg IV Daily for three days because he is allergic to penicillin. According to Metlay, et al, (2019), the first-line treatment for CAP involves giving penicillin and macrolides, for example, amoxicillin and gentamycin. Patients with chronic obstructive pulmonary disease are at risk of being colonized by pseudomonas bacteria. Therefore, I would change the treatment regimen from ceftriaxone 1gm IV Daily and Azithromycin 500 mg IV daily for three days to ceftazidime 2gm IV three times a day for five days. Pharmacological Treatment for CAP Essay
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Ceftazidime is a 3rd generation cephalosporin with broad-spectrum gram-negative and pseudomonas activities (Van Duin, et al, 2018). It would be more effective for this patient because it has tolerable but rare adverse effects such as skin rash and itchiness. Ceftriaxone causes nausea and vomiting which may predispose the patient to acute kidney injury because of dehydration, diabetes, and hypertension (Eyre, et al, 2018). Ceftazidime is a single therapy that is specific for pseudomonas infection thus reducing the risk of killing the normal bacteria in the gut. It is also important to monitor the patient’s oxygen circulation, random and fasting blood sugar, and blood pressure. The patient should avoid extreme body exercise because of COPD. The patient should take a healthy diet to control sugars and reduce hyperlipidemia.
CASE STUDY
Provide recommendations for alternative drug treatments to address the patient’s pathophysiology. Be specific and provide examples.
Post a brief description of your patient’s health needs from the patient case study you assigned. Be specific. Pharmacological Treatment for CAP Essay
We are treating 68-year-old male patient with community-acquired pneumonia (CAP) with empiric antibiotics (ceftriaxone 1g gm IV Daily and Azithromycin 500 mg IV Daily) for three days. During his stay at the hospital, his symptoms has improved requiring less oxygen, but is currently not tolerating his diet due to nausea and vomiting. He has a history of COPD, Hypertension, Hyperlipidemia, and Diabetes and has allergies to penicillin (PCN). The empiric antibiotics he is currently taking for the treatment of his CAP are effective and will need to be continued until the course of treatment is completed to prevent any antibiotic resistant microorganisms (Rosenthal, and Burchum, 2020). This combination of antibiotics may also be killing the patient’s healthy microbes in his gut. His current healthcare needs are to continue the current treatment of empiric antibiotics for his CAP and treat his nausea, vomiting, and restore his normal gut flora to help him tolerate his diet and maintain adequate national intake that is essential to his recovery process.
Then, explain the type of treatment regimen you would recommend for treating your patient, including the choice or pharmacotherapeutics you would recommend and explain why. Be sure to justify your response. Explain a patient education strategy you might recommend for assisting your patient with the management of their health needs. Be specific and provide examples.
The latest evidenced-based practice for treating CAP without suspicion of MRSA or Pseudomonas while having a PCN allergy is to start a 2nd or 3rd generation cephalosporin paired with a macrolide (ceftriaxone and azithromycin) (File, Ramirez, and Bond, 2020). Our patient’s decreased oxygen requirement makes it evident that his current empiric antibiotic treatment is effective, therefore there is no need for changing this drug regimen at the moment. I will continue the course of the patient’s current empiric antibiotic treatment with Ceftriaxone and Azithromycin. Ceftriaxone (cephalosporin) and Azithromycin (macrolide) are both a broad-spectrum antibiotic that is effective in combating microorganisms associated with CAP (File, Ramirez, and Bond, 2020). Broad-spectrum antibiotics are effective against a wide range of microorganism, which can result in killing healthy microorganisms that is naturally present in our gut (Rosenthal, and Burchum, 2020). These microorganisms’ aids in our digestion processes, but when a disruption in their equilibrium occurs, this can lead to food intolerance, nausea, and vomiting (Jandhyala, Talukdar, Subramanyam, Sasikala and Nageshwar Reddy, 2015). Using antiemetics agents such as Zofran 4mg IV PRN and probiotics such as Acidophilus PO Daily can help with our patient’s nausea, vomiting, and food intolerance. Also, modifying our patient’s diet to bland type food and advancing as tolerated can also help him improve his nutrition. The probiotics may not work immediately, but can eventually help restore the patient’s gut flora equilibrium. Pharmacological Treatment for CAP Essay
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Education must be centered around the prevention of developing drug resistant microorganisms and the expected side effects and impacts of taking broad spectrum antibiotics. Teaching our patient, the importance of completing and adhering to his current antibiotic regimen to prevent the development of drug-resistant microorganisms is key (Rosenthal, and Burchum, 2020). Discussing how the use of Ceftriaxone and Azithromycin can disrupt our normal gut flora can potentially result in diet intolerance, nausea, and vomiting will help our patient become aware of the risks that may be associated with taking broad spectrum antibiotics. Educating them about the interventions we can take to help manage these risks such as use of anti-emetics and probiotics can encourage them to adhere to their current antibiotic regimen. We must ensure that they understand how the benefits of taking the proper empiric antibiotics outweighs the risks of a poorly managed CAP which can lead to death.
Reference
File, T. M., Ramirez, J. A., & Bond, S. (2020, December 28). Treatment of community-acquired
pneumonia in adults who require hospitalization. UpToDate. https://www.uptodate.com/contents/treatment-of-community-acquired-pneumonia-in-adults-who-require-hospitalization
Jandhyala, S. M., Talukdar, R., Subramanyam, C., Vuyyuru, H., Sasikala, M., & Nageshwar
Reddy, D. (2015). Role of the normal gut microbiota. World journal of gastroenterology, 21(29), 8787–8803.https://doi.org/10.3748/wjg.v21.i29.8787
Rosenthal, L. D., & Burchum, J. R. (2021). Lehne’s pharmacotherapeutics for advanced practice
nurses and physician assistants (2nd ed.). St. Louis, MO: Elsevier.
RUBRIC
Response exhibits synthesis, critical thinking, and application to practice settings.
Responds fully to questions posed by faculty.
Provides clear, concise opinions and ideas that are supported by at least two scholarly sources.
Demonstrates synthesis and understanding of learning objectives.
Communication is professional and respectful to colleagues. .
Responses to faculty questions are fully answered, if posed.
Response is effectively written in standard, edited English.
References
Eyre, D. W., Sanderson, N. D., Lord, E., Regisford-Reimmer, N., Chau, K., Barker, L., … & Andersson, M. I. (2018). Gonorrhea treatment failure caused by Neisseria gonorrhoeae strains with combined ceftriaxone and high-level azithromycin resistance, England, February 2018. Eurosurveillance, 23(27), 1800323.
Metlay, J. P., Waterer, G. W., Long, A. C., Anzueto, A., Brozek, J., Crothers, K., … & Whitney, C. G. (2019). Diagnosis and treatment of adults with community-acquired pneumonia. An official clinical practice guideline of the American Thoracic Society and Infectious Diseases Society of America. American journal of respiratory and critical care medicine, 200(7), e45-e67.
Van Duin, D., Lok, J. J., Earley, M., Cober, E., Richter, S. S., Perez, F., … & Antibacterial Resistance Leadership Group. (2018). Colistin versus ceftazidime-avibactam in the treatment of infections due to carbapenem-resistant Enterobacteriaceae. Clinical Infectious Diseases, 66(2), 163-171. Pharmacological Treatment for CAP Essay
