Evaluation and Management of Pneumonia in Older Adults |
Certified
for 1 AMA PRA Category 1 Credit™
Co-Sponsored
by
the
University of Alabama
School
of Medicine
Division of Continuing Medical Education,
Division of Gerontology, Geriatrics, and
Palliative Care, and
The Center for Aging
| Release
Date: May 3, 2007 |
Expiration
Date: May 3, 2010 |
| TARGET
AUDIENCE: |
| Primary
care physicians |
| OBJECTIVES: |
| Upon
completion of this CME activity,
physicians and other healthcare professionals
should be able to: |
- Discuss the benefits of immunization with the pneumococcal and influenze vaccines and how to address barriers to immunization.
- Describe a technique to identify low-risk patients with community-acquired pneumonia (CAP) to distinguish between persons who may be safely treated as outpatients and those who require hospital admission.
- Appreciate the most recent guidelines for the treatment of CAP.
- Discuss the management of infections due to drug-resistant Streptococcus pneumoniae and the indications for switching to oral therapy in CAP patients.
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| Top of Page |
| SOURCE: |
| EDITOR
AND CONTRIBUTING AUTHOR: |
Angela
R. Curtis, PhD
Managing Editor
Assistant Professor, Geriatric Education
Manager
Richard V. Sims, MD
Associate Professor of Medicine, Division of Gerontology
Geriatrics, and Palliative Care
Chief, Geriatrics Section, Birmingham VA Medical Center
Division
of Gerontology, Geriatrics and
Palliative Care
University of Alabama at Birmingham
Birmingham, Alabama |
| Top of Page |
| |
| DISCLOSURE: |
The
faculty has no commercial affiliations
to disclose.
Because of the nature of preliminary
studies, some products mentioned are
unlabeled and investigational. Dosages,
indications, and methods of use of
drugs mentioned in this publication
may reflect the experience of the authors,
clinical literature, or other resources.
Therefore, please see the full prescribing
information before using any licensed
product mentioned. |
| CME
PARTICIPATION: |
| To
participate in this online course
for CME credit, please review the
objectives before beginning the program.
Complete the course and the self-assessment
test before May 3, 2010 to receive
CME credit. Your certificate will
then be available online. This process
should take approximately 1 hour. |
| ACCREDITATION: |
The
University of Alabama School of
Medicine is accredited by the Accreditation
Council for Continuing Medical
Education to provide continuing
medical education for physicians.
The
University of Alabama School of
Medicine designates this educational
activity for a maximum of 1 AMA
PRA Category 1 Credit™.
Physicians should only claim credit
commensurate with the extent of
their participation in the activity.
The
boards of nursing in many states,
including Alabama, recognize Category
1 continuing medical education
courses as acceptable activities
for the renewal of license to practice
nursing. |
| DISCLAIMER: |
| Dosages,
indications, and methods of use of
any drug referred to in this publication
may reflect the clinical experience
of the authors, clinical literature,
or other clinical resources. Therefore,
please see the full prescribing information
before using any product mentioned.
UAB is an equal opportunity/affirmative
action institution. |
| INTRODUCTION: |
Pneumonia is common and associated with significant comorbidity and mortality among older adults. Recent literature estimates that more than 900,000 cases of CAP occur annually among patients 65 years and older. In part because of the greater prevalence of elders with predisposing comorbidity conditions, hospitalization rates for CAP among US adults aged 65 to 84 years increased 20% between 1988-1990 and 2000-2002, and 1 in 20 persons 85-years-old and older were admitted to the hospital with CAP each year. |
| CASE: |
Ms. A, a 73-year-old widow with a history of osteoarthritis, New York Heart Association class II heart failure, hypertension, osteoporosis, and non-insulin dependent diabetes comes into the office for routine follow-up visit. She lives alone, is generally healthy, and is able to do all of her self-care and instrumental (i.e., bill paying, shopping, using the telephone, cooking, cleaning and self-administration of medications) activities of daily living independently. She is assisted by her children with transportation and heavy housework and does not use alcohol or tobacco. There are no known allergies. Ms. A’s medication list includes acetaminophen 650 mg pot id prn pain, lisinopril 20 mg po qd, carvedilol 12.5 mg po bid, HCTZ 12.5 mg po qd, alendronate 70 mg po qwk, multiple vitamins, caltrate plus D, and glipizide XL 2.5 mg po qd. Her physical examination is remarkable only for minimal spinal kyphosis. A hemoglobin A1c from the last appointment was 7.0%. The patient has typically refused all immunizations because of concerns about side-effects, but because it is the fall of the year, you recommend that she receive immunizations against influenza and Streptococcus pneumoniae.
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