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Cephalosporins (cephalosporins, ceftidar; cefepime and sulfonate) are the first-line therapy for prevention and control of hospital-acquired pneumonia. If resistant organisms are responsible for the hospital-acquired pneumonia, fluoroquinolones are only appropriate agents for treatment. Fluoroquinolones have several disadvantages, including their cost, long duration of therapy, Clonazepam .5 mg vs. xanax and the fact that patients may develop resistance to these drugs and some additional agents used in combination with such drugs. It is therefore recommended that only limited combinations of drugs be used in the management of hospital-acquired pneumonia.
Fever and other signs
The patient's temperature (tachycardia) should be stable. The usual temperature is 98.4–100 °F (37.5–38.6 °C), but patients who are immunocompromised (see Immunosuppressive Chemotherapy and Pneumonia, above) or who have had recent febrile seizures (see Immunosuppressive Drug Interactions) are more likely to be euthyroid and may more likely to develop fever, even at normal temperatures. Tachycardia may be a sign of acute infection (see General Recommendations, Illness), but patients who are at risk for disseminated infection with pneumonia and can be isolated at that time should be kept in the warm.
Auscultation
The standard and preferred way to evaluate the status of lungs is by auscultation. The bronchial discharge, appearance of fine alveolar debris, and the presence of white or black streaks (or, occasionally, a combination of these) are indications bronchospasm. Although alveolar debris is often easily differentiated, it can contain various forms of bacteria. The presence white or black streaks indicates that the alveoli contain organisms causing infection, whereas the presence of white or red streaks indicates that no organisms may be present. White streaks are generally of short duration and fade to gray or red, indicating that no active infection occurs (see Special Infection).
Alveolar streaks may be due to granuloma, bronchitis, or pneumonia. In many situations, alveolar streaks may fade spontaneously into normal alveolarized cells within a few weeks when the bronchial debris resolves. Other situations in which streaks may persist include bronchiolitis, bronchitis with bronchopneumonia, and pneumococcal bronchiolitis.
The presence of small-vessel alveolar inflammation in an asthmatic can be differentiated from pneumonitis. Some patients with an underlying medical disorder may respond to bronchodilator therapy even when they have bronchopneumonia. Although it is possible to make such clinical determinations only in patients who do not respond to bronchodilator treatment, the presence of small-vessel alveolar inflammation does not indicate a clinical difference from other conditions. All cases of asthmatic bronchoconstriction in which there is bronchiolitis, bronchopneumonia, or pneumonia should be evaluated.
The respiratory rate should be normal in asthmatic patients. Patients who are at risk for acute exacerbations of asthma should be kept cool and isolated from other patients (see General Recommendations, Acute Illness, below).
The patient should be monitored by an adequate respiratory rate for at least 3 hours; in the absence of respiratory arrest, patient's vital signs cost of generic adderall xr 10mg and pulse rate should both be maintained for at least 30 minutes. If, after a careful evaluation, it is determined that a patient at risk for respiratory distress due to influenza infection, the patient should be isolated until symptoms subside.
General recommendations
General Considerations for Treatment of Asthma
The patient's asthma treatment should be individualized to address her individual needs for management and to maintain a high degree of quality in her lungs. There is no uniform standard or protocol for the management of asthma in adults (the only exceptions are patients aged ≥18 years and adolescents 14–18 years). A variety of medications and agents to correct individual respiratory problems may be used. The use of certain medications, especially corticosteroids, must be considered when there is an increased risk of respiratory depression in the setting of systemic inflammatory responses.
General Recommendations for Medications
Medications should be used sparingly (typically once per week) and under a physician's supervision in the treatment of asthma (see below). Medications should not be administered to the asthmatic on their own without a prescription.
In addition to the agents listed in following list, there are a range of other agents with a spectrum of effects that may be appropriate for the management of asthma symptoms (see Table)
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