Jawaharlal Nehru Technological University Hyderabad Pharm. D III Year PHARMACOTHERAPEUTICS - II Previous Question Paper (June/July - 2022 - R08)

Lower respiratory tract infections (LRTIs) primarily include pneumonia and acute bronchitis. Pneumonia is an infection of the lung parenchyma, classified as Community-Acquired (CAP) or Hospital-Acquired (HAP). Clinical presentation includes fever, productive cough, dyspnea, and pleuritic chest pain. Diagnosis is confirmed via chest X-ray showing infiltrates and sputum culture.

Management involves empirical antibiotic therapy based on severity and patient risk factors:

• For healthy outpatients with CAP: Macrolides (e.g., Azithromycin) or Doxycycline.
• For patients with comorbidities: Respiratory fluoroquinolones (e.g., Levofloxacin) or a combination of beta-lactam plus a macrolide.
• For HAP: Broad-spectrum coverage including anti-pseudomonal agents like Piperacillin-Tazobactam or Carbapenems.

Supportive care includes oxygen therapy for hypoxemia, adequate hydration, antipyretics, and bronchodilators if bronchospasm is present.

Gastroenteritis is characterized by inflammation of the stomach and intestines, typically caused by viral (e.g., Rotavirus, Norovirus), bacterial (e.g., E. coli, Salmonella), or parasitic pathogens. The primary goal of pharmacotherapy is the prevention and treatment of dehydration and electrolyte imbalance.

Management strategies include:

• Oral Rehydration Therapy (ORT): The cornerstone of treatment using Oral Rehydration Salts (ORS) to replace lost water and electrolytes.
• Antimotility Agents: Loperamide may be used in adults to reduce stool frequency, but it is generally contraindicated in cases of bloody diarrhea or suspected invasive bacterial infection.
• Antiemetics: Ondansetron may be administered to control severe vomiting, facilitating oral rehydration.
• Antibiotics: Not routinely indicated for viral gastroenteritis. They are reserved for specific severe bacterial infections (e.g., Ciprofloxacin or Azithromycin for severe shigellosis or traveler's diarrhea).
• Probiotics: May be used as an adjunct to shorten the duration of diarrhea.