Advanced Pharmacology Pharmacological Management of Respiratory Illness
Pharmacological Management of Respiratory Illness
JD presents with signs and symptoms suggesting an upper airway tract infection. However, there is a productive cough with greenish sputum suggesting a lower respiratory tract infection as well. The frontal headache, sinus tenderness, and nasal congestion are classical sinus presentations in acute rhinosinusitis. He thought that these symptoms would subside on their own but progressed instead.
Missing Information and Need for Treatment
Chest examination revealed bilaterally clear lungs but this does not rule out concurrent pneumonia. A piece of subjective information ruling out chest pain with difficulty in breathing would be needed. A chest plain radiograph finding would be required to rule out lung consolidation as the source of the productive cough. JD’s immune status and presence of comorbidities such as diabetes and hypertension are missing and would be used to rule out the possibility of fungal sinusitis (Husain et al., 2018) in the patient. Information about recent antibiotics use would also be essential (American Academy of Family Physicians, 2020). Nevertheless, JD would require treatment because his symptoms had lasted more than 10 days with postnasal discharge.
JD has had severe sinusitis symptoms for more than 10 days (NICE, 2018) and this warrants medical treatment. The ideal prescription would be Augmentin 875 mg PO TID. Augmentin prevents cell wall synthesis in bacteria while inhibiting beta-lactamase enzymes. Its excretion is predominantly renal with hepatic components for the clavulanic acid. This mediation may cause fatal anaphylactic reactions in those allergic to penicillin (Food and Drug Administration, n.d.).
If JD were a child, say 10 years old and weighing 78lbs, the medication would not change but alterations would be made to the dosage quantities. It would be essential to monitor the patient for allergy symptoms and educate him properly regarding medication adherence. Monitoring his response to antibiotic treatment would be essential in his further treatment.
JD most likely has acute bacterial rhinosinusitis requiring antibiotic treatment due to the severity of his symptoms lasting more than 10 days. The best choice of antibiotics would be Augmentin since he has reported no known food or drug allergies. This medication choice would be maintained even if JD were a child weighing 78 pounds. However, monitoring for possible allergic reaction would be necessary.
- American Academy of Family Physicians. (2020). Adult Sinusitis. Aafp.Org. https://www.aafp.org/family-physician/patient-care/clinical-recommendations/all-clinical-recommendations/adult-sinusitis.html
- Food and Drug Administration. (n.d.). Augmentin Label – FDA. Fda.Gov. www.accessdata.fda.gov
- Husain, S., Amilia, H. H., Rosli, M. N., Zahedi, F. D., Sachlin, I. S., & Development Group Clinical Practice Guidelines Management of Rhinosinusitis in Adolescents & Adults. (2018). Management of rhinosinusitis in adults in primary care. Malaysian Family Physician: The Official Journal of the Academy of Family Physicians of Malaysia, 13(1), 28–33. https://www.ncbi.nlm.nih.gov/pubmed/29796207
- NICE. (2018, April 3). NICE sinusitis (acute): antimicrobial prescribing. Guidelines.Co.Uk; Guidelines. https://www.guidelines.co.uk/infection/nice-sinusitis-acute-antimicrobial-prescribing/454117.article