Thursday, March 11, 2010

Novel influenza A

Novel influenza A, H1N1 - Acute
Rahul Soman, M. Pharm


 


 

Definition  

An influenza-like illness caused by a new influenza virus called novel H1N1 (formerly called "swine flu"), that is contagious and is spreading from human to human


 

Medical History  

* Close contact to persons infected with swine-origin influenza A (H1N1) virus

* Close contact with infected swine


 

Findings  

* Fever

* Cough

* Pain in throat

* Nasal congestion

* Nasal discharge

* Dyspnea - Acute

* Fatigue

* Loss of appetite

* Myalgia

* Headache

* Nausea and vomiting - Acute

* Diarrhea

* Decreased skin turgor

* Altered mental status

* Irritability

* Apnea

* Cyanosis

* Tachypnea


 

Tests  


 

Initial testing for identification of influenza A, B, H1, and H3 status at a State Health Department laboratory  

* Polymerase chain reaction analysis


 

Suspected novel influenza A (H1N1) virus infection  

* PCR test for swine influenza A: A positive real time reverse transcription-polymerase chain reaction result indicates presumptive infection with novel influenza A (H1N1) virus .


 

Suspected novel influenza A (H1N1)  

* Rapid influenza test: A positive rapid influenza detection test cannot distinguish between influenza A virus subtypes , and a negative result does not exclude influenza virus infection .


 

Differential Diagnosis  

* Influenza due to Influenza A virus

* Influenza due to Influenza virus, type B

* Influenza due to Influenza virus, type C

* Respiratory syncytial virus infection

* Bronchitis, acute - Acute

* Common cold


 

Treatment  


 

Drug Therapy  


 


 

Novel influenza A (H1N1) virus infection  


 

OSELTAMIVIR PHOSPHATE  

Adults: 75 mg orally twice daily for 5 days

Adults (creatinine clearance 10 to 30 mL/min): 75 mg orally once daily for 5 days

Pediatrics, weight-based dosing preferred (<12 months): 3 mg/kg orally twice daily for 5 days

Pediatrics (?12 months and ?15 kg): 30 mg orally twice daily for 5 days

Pediatrics (?12 months and >15 kg to 23 kg): 45 mg orally twice daily for 5 days

Pediatrics (?12 months and >23 kg to 40 kg): 60 mg orally twice daily for 5 days

Pediatrics (?12 months and >40): 75 mg orally twice daily for 5 days

Pediatrics, age-based dosing if weight unknown (full-term infants <3 months): 12 mg orally twice daily for 5 days

Pediatrics, age-based dosing if weight unknown (full-term infants 3 to 5 months): 20 mg orally twice daily for 5 days

Pediatrics age-based dosing if weight unknown (full-term infants 6 to 11 months): 25 mg orally twice daily for 5 days


 

ZANAMIVIR  

Adults: 10 mg (2 oral inhalations) twice daily for 5 days

Pediatrics (?7 years): 10 mg (2 oral inhalations) twice daily for 5 days


 


 

Novel influenza A (H1N1) virus infection in hospitalized adults and children who meet criteria for emergency use authorization  


 

PERAMIVIR  

Adults: 600 mg IV over 30 min once daily for 5 to 10 days

Pediatrics (birth to 30 days): 6 mg/kg IV over 60 min once daily for 5 to 10 days (maximum 600 mg daily)

Pediatrics (31 days to 90 days): 8 mg/kg IV over 60 min once daily for 5 to 10 days (maximum 600 mg daily)

Pediatrics (91 days to 180 days): 10 mg/kg IV over 60 min once daily for 5 to 10 days (maximum 600 mg daily)

Pediatrics (181 days to 5 years): 12 mg/kg IV over 60 min once daily for 5 to 10 days (maximum 600 mg daily)

Pediatrics (6 to 17 years): 10 mg/kg IV over 60 min once daily for 5 to 10 days (maximum 600 mg daily)


 


 

Fever  


 

ACETAMINOPHEN (Related toxicological information in ACETAMINOPHEN-ACUTE, ACETAMINOPHEN-REPEATED SUPRATHERAPEUTIC)  

Adults: 650 mg (2 regular-strength tablets) orally every 4 to 6 hours (maximum, 12 tablets in 24 hours) or 2 suppositories (325 mg/suppository) every 4 to 6 hours (maximum, 12 suppositories in 24 hours)

Pediatrics (2 to 3 years): (2 to 3 years; 24 to 35 pounds) 5 mL liquid (160 mg/5 mL) orally every 4 hours (maximum 5 doses in 24 hours) or (3 years) 1 pediatric suppository (120 mg/suppository) every 4 to 6 hours (maximum, 6 suppositories in 24 hours)

Pediatrics (4 to 5 years; 36 to 47 pounds): 7.5 mL liquid (160 mg/5 mL) orally every 4 hours (maximum 5 doses in 24 hours) or 1 pediatric suppository (120 mg/suppository) every 4 to 6 hours (maximum, 6 suppositories in 24 hours)

Pediatrics (6 to 11 years): 325 mg (1 regular-strength tablet) orally every 4 to 6 hours (maximum, 5 tablets in 24 hours) or 1 suppository (325 mg/suppository) every 4 to 6 hours (maximum, 6 suppositories in 24 hours) or (6 to 8 years; 48 to 59 pounds) 10 mL liquid (160 mg/5 mL) orally every 4 hours (maximum 5 doses in 24 hours) or (9 to 10 years; 60 to 71 pounds) 12.5 mL liquid (160 mg/5 mL) orally every 4 hours (maximum 5 doses in 24 hours) or (11 years; 72 to 95 pounds) 15 mL liquid (160 mg/5 mL) orally every 4 hours (maximum 5 doses in 24 hours)

Pediatrics (12 years and older): 650 mg (2 regular-strength tablets) orally every 4 to 6 hours (maximum, 12 tablets in 24 hours) or 2 suppositories (325 mg/suppository) every 4 to 6 hours (maximum, 12 suppositories in 24 hours)


 

IBUPROFEN (Related toxicological information in IBUPROFEN)  

Adults: 1 or 2 tablets (200 mg/tablet) orally every 4 to 6 hours (maximum, 6 tablets in 24 hours)

Pediatrics (6 months to 12 years): 5 mg/kg oral suspension (100 mg/5 mL) for baseline temperature <102.5°F; 10 mg/kg for baseline temperature ?102.5°F (maximum daily dose, 40 mg/kg)


 

NAPROXEN (Related toxicological information in NAPROXEN)  


 


 


 

Prevention of pneumococcal pneumonia in persons ?65 years, high-risk persons aged 2 to 64 years, persons with asthma, and current smokers  


 

PNEUMOCOCCAL VACCINE POLYVALENT  

Adults (primary vaccination): 0.5 mL IM x one dose given to all adults 65 years of age and older

Adults (revaccination): 0.5 mL IM x one dose given to all adults 65 years of age and older who were vaccinated before the age of 65 and at least 5 years prior

Adults (at high-risk): 0.5 mL IM x one or 2 doses, at least 5 years apart, for adults less than 65 years of age who have medical indications for vaccination or are part of high risk populations

Pediatrics (2 to 18 years): 0.5 mL IM or subQ as a single dose; may be repeated once after 5 years in selected cases


 

Procedural Therapy  


 

Suspected, probable, or known novel influenza A (H1N1) virus infection in a healthcare setting  

* Infection control procedure: Standard and contact precautions plus eye protection should be used by all personnel entering the patient's room for 7 days after illness onset or until symptoms have resolved, whichever is longer .


 

Non-Procedural Therapy  


 

Novel influenza A, H1N1  

* Home Care of a Patient with Novel Influenza A (H1N1) Virus Infection

* Facemask and Respirator Recommendations in Occupational (Non-Healthcare) Settings

* Facemask and Respirator Recommendations in Community Settings

2 comments:

  1. Am Richard, I am here to testify about a great herbalist  man who cured my wife of breast cancer. His name is Dr Imoloa. My wife went through this pain for 3 years, i almost spent all i had, until i saw some testimonies online on how Dr. Imoloa cure them from their diseases, immediately i contacted him through. then he told me the necessary things to do before he will send  the herbal medicine. Wish he did through DHL courier service, And he instructed us on how to apply or drink the medicine for good two weeks. and to greatest surprise before the upper third week my wife was relief from all the pains, Believe me, that was how my wife was cured from breast cancer by this great man. He also have powerful herbal medicine to cure diseases like: Alzheimer's disease, parkinson's disease, vaginal cancer, epilepsy Anxiety Disorders, Autoimmune Disease, Back Pain, Back Sprain, Bipolar Disorder, Brain Tumor, Malignant, Bruxism, Bulimia, Cervical Disc Disease, Cardiovascular Disease, Neoplasms , chronic respiratory disease, mental and behavioral disorder, Cystic Fibrosis, Hypertension, Diabetes, Asthma, Autoimmune inflammatory media arthritis ed. chronic kidney disease, inflammatory joint disease, impotence, alcohol spectrum feta, dysthymic disorder, eczema, tuberculosis, chronic fatigue syndrome, constipation, inflammatory bowel disease, lupus disease, mouth ulcer, mouth cancer, body pain, fever, hepatitis ABC, syphilis, diarrhea, HIV / AIDS, Huntington's disease, back acne, chronic kidney failure, addison's disease, chronic pain, Crohn's pain, cystic fibrosis, fibromyalgia, inflammatory Bowel disease, fungal nail disease, Lyme disease, Celia disease, Lymphoma, Major depression, Malignant melanoma, Mania, Melorheostosis, Meniere's disease, Mucopolysaccharidosis, Multiple sclerosis, Muscular dystrophy, Rheumatoid arthritis. You can reach him Email Via drimolaherbalmademedicine@gmail.com / whatsapp +2347081986098    Website/ www.drimolaherbalmademedicine.wordpress.com

    ReplyDelete
  2. I''m Charlotte Johnson,65  years old, Here in Edmonton, Canada. With the new herbal mix medicine I purchased from Dr James herbal mix medicine West Africa  was my only way to get rid of my Alzheimer's, the herbal  mix medicine effectively reversed my condition and alleviate all symptoms.  I was initially very hesitant to discuss my Alzheimer but I just hope it can still help someone. I feel this will be very important information for all Alzheimer patients, because the most violent element in society today is ignorance. Be it any condition, a healthy diet and natural herbs and roots medicine from Dr. James is the road to fast recovery. I had suffered Alzheimer for many years, I fought for proper medical recommendation, care  and all form of humane treatment with little improvement I went through many sleepless nights and periods of intense grief, as do most families. I was recommended by a friend to use Dr. James herbal mix medicine for my Alzheimer with high hope and assurance. I never doubted my friend but to contact Dr. James. And purchased His herbal mix medicine which was effective and I finally feel my Alzheimer is gone with no more symptoms. He also told me that he cures diseases such as  Lungs diseases, kidney diseases, Warts, Bipolar disorder, Shingles,  HPV, ALS, CANCER, NEPHROTIC SYNDROME, HIV / AIDS, Herpes virus, Ovarian Cancer, Pancreatic cancers, bladder cancer, prostate cancer, Glaucoma., Cataracts, Macular degeneration, Cardiovascular disease, Autism. Enlarged prostate, Osteoporosis. Alzheimer's disease, psoriasis, Tach Diseases, Lupus, Backache, dementia, skin cancer,.testicular Cancer, Leukemia, HEPATITIS A, B, C, Contact  the great one on his email    greatcureman@gmail.com
    Info @ drjamesherbalmix@gmail.com

    ReplyDelete