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Therapeutics of the flu
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Ph
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Influenza
Anas Bahnassi PhD
Pharmacotherapy of Infectious Diseases
Anas Bahnassi 2014
A Case-Based Approach
Ph
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• Influenza – An acute viral illness of the respiratory tract
caused by influenza A &B virus.
– Influenza-like illness is defined as an acute onset of respiratory illness with fever, cough, and one or more of the followings: • Sore throat.
• Arthralgia.
• Myalgia.
• Prostration.
Anas Bahnassi 2014
• Gastrointestinal symptoms may be present in children <5yrs.
• Fever may not show in children <5yrs or eldery >65yrs.
Ph
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Prevention Goals of Therapy
• Prevent influenza illness from occurring, especially in individuals at high risk of developing serious influenza-related symptoms.
• Decrease influenza-related hospitalizations and deaths.
Anas Bahnassi 2014
Ph
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• History:
– With particular attention to symptoms and onset of symptoms, the key to appropriate use antiviral agents:
• When flu is circulating in the community, abrupt onset of fever ≥38.5ºC, and dry cough is likely to be the flu. Value of these symptoms is less in the very young and elderly.
• Young children may present with either nonsymptomatic febrile illness or with a respiratory illness resembling croup, bronchitis, broncholitis.
• Fever may not be prominent in elderly, if flu is circulating: suspect the flu with ≥ 2 symptoms: Sore throat, arthralgia, myalgia, or prostration.
Anas Bahnassi 2014
Ph
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• Laboratory Testing: – Beyond formal surveillance programs, widespread
laboratory testing in the community is not necessarily or practical.
– As a general rule, nasopharyngeal swabs from ill long-term residents should be sent for lab test if ≥2 or more cases of ILI in ≤72 hrs.
– To decrease the potential of false negative results, swabs are best collected within 24hr of symptom onset and no later than 48 hrs.
Anas Bahnassi 2014
Ph
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Prevention Choices Nonpharmacologic
• Wash hands often, use sensitizers.
• Cough/sneeze into tissues and throw used tissues in garbage, use sleeve if tissues are not available.
• Stay home.
Pharmacologic
• Flu Vaccine
Anas Bahnassi 2014
Ph
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• Patients at high risk for influenza-related complications: – Chronic cardiac or respiratory disorder. – Residents of nursing homes. – >65 yrs old. – Patients of DM, Cancer, Immunodeficiency,
Immunosuppression, Renal disease, Anemia, hemoglobinopathies, Chronic ASA therapy.
• Persons able of transmitting influenza to high risk patients: – Healthcare workers. – People with direct contact to high risk patients. – Childcare workers.
• Others: – People who provide essential community services. (police, fire..)
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Criteria for prophylactic use of antiviral agents:
• Administer to all residents of a LTC facility who are not currently ill.
• Duration of prophylaxis is 8 days after the onset of symptoms of the last case.
• Administer for the duration of outbreak to healthcare provider in the LTC facility who refuse immunization.
• Continue prophylaxis to high risk patients for the duration of the outbreak when
Anas Bahnassi 2014
Ph
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Infectious Diseases:
Anas Bahnassi PhD
http://www.twitter.com/abpharm
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http://www.linkedin.com/in/abahnassi Anas Bahnassi 2014
