Treatment Recommendations of swine flu

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Treatment Recommendations of swine flu

• By

Nesrien Mohammed Shalabi Ass. Prof of Thoracic
Medicine 5/5/2009
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The CDC recommends

• Patients should seek immediate medical care.
• Self isolation in their home.
• Patients must use face mask.
• Other household members should be given infection
  control instruction.
• Supportive treatment including- bed rest,
  increased fluid consumption, cough suppressants,
  antipyretics and analgesics.

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Hospitalized Patients

• Place patients in a single patient room with door
  kept closed.
• An airborne-infection isolation room can be used.
• Suctioning, bronchoscopy, or intubation.
• Patient should wear a surgical mask when outside
  their room.
• Encourage patients to wash their hand frequently.

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Severely ill patients

• Signs of severe disease include-
• Cyanosis, dehydration, altered mental status
• Apnea, tachypnea, dyspnea.
• Need Mechanical ventilation

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Antiviral Drugs Empiric

• Should be considered for-
• Confirmed, probable or suspected cases of swine
  influenza.
• Treatment of hospitalized patients and patients
  at higher risk for influenza complication.
• Initiation of antiviral agents within 48 hours of
  symptom onset the recommended duration of
  treatment is 5 days.

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Prophylaxis antiviral agents

• Should be considered in the following individuals
  (pre-exposure or post-exposure)-
• Close household contacts of a confirmed or
  suspected case who are at risk.
• School children at high risk of complications or
  have been in close contact with confirmed or
  suspected case.
• Travelers to Mexico who are at high risk for
  complications.
• Health care providers or public health workers.

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Pre exposure prophylaxis

• Any health care provider who is at high risk for
  complication.
• Individuals not considered to be at high risk but
  who are nonetheless traveling to Mexico or
  working in areas with confirmed cases.

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Antiviral Drugs

• There are four influenza antiviral drugs-
• Oseltamivir (brand name Tamiflu)
• Zanamivir (brand name Relenza)
• Amantadine (brand name Lysovir)
• Rimantadine (brand name Symmetrel)
• The swine influenza A(H1N1) viruses in humans
• Resistant to amantadine and rimantadine.
• Sensitive to oseltamivir and zanamivir.

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Benefits of Antiviral Drugs

• Antiviral can make illness milder with faster
  improvement.
• Prevent serious influenza complications

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Oseltamivir (Tamiflue)

• It inhibits neuraminidase which is a glycoprotein
  on the surface of influenza virus that destroys
  an infected cells receptor viral hemagglutinin.
• Forms
• Oral capsules 30mg, 45mg and 75mg.
• Powder for suspension that contain 12mg/ml after
  reconstitution.
• Adult dose
• Treatment of acute illness 75 mg /12 hours for 5
  days
• Prophylaxis 75 mg once daily for 10 days.

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Zanamivir (Relenza)

• Forms
• Powder form for inhalation via Diskhaler. The
  circular foil discs contain 5mg blisters. Disks
  contain 4 blisters.
• Adult dose
• Treatment of acute illness 10mg twice daily for
  10 days.
• Prophylaxis of household contact 10mg once daily
  for 10 days.
• Prophylaxis of community contact 10mg once daily
  for 28 days.

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Thank You