6521 Wk4 Discussion Pharm for Respiratory Disorders

Pharmacotherapy for Respiratory Disorders

A review of symptoms of pneumonia, including a productive cough, fever, chills, shortness of breath and chest pain provide the practitioner with a basis for completing a focused health history and physical exam to prescribe appropriate drug therapy. Because individual patient factors can impact the effects of prescribed drugs, these factors must be considered when making decisions about drug therapy and following up. The purpose of this discussion post is to present a description of community-acquired pneumonia, individual patient factor and its effect on prescribed drugs, and a SOAPE note presenting a patient case.

Community-Acquired Pneumonia

Patients with community-acquired pneumonia (CAP) often present for health care provider evaluation with fever, cough, pleuritic pain, shortness of breath, and general malaise. These symptoms alone do not provide adequate information for a diagnosis, although they do suggest the possibility (Arcangelo, Peterson, Wilbur, & Reinhold, (Eds.), 2017). CAP is a leading cause of death in the elderly and patients with multiple comorbid factors. Confirming the diagnosis of CAP requires a chest x-ray or ultrasound. Most outpatients do not require a sputum culture and sensitivity for diagnosis or for initiating antibiotic drug therapy, although they are helpful for guiding the use of appropriate agents. Symptoms and a positive CXR, i.e., consolidation or infiltrates, warrant empiric treatment with macrolide, doxycycline, or a respiratory fluoroquinolone. Patients with severe pneumonia and requiring hospital admission should be treated with a fluoroquinolone or beta-lactam plus a macrolide (Kaysin & Viera, 2016). A diagnosis of CAP warrants the initiation of drug therapy.

In addition to an antibiotic prescription to eliminate the offending organism in CAP, consideration of other treatments and drug therapy begins. Goals for additional drug therapy