An older adult with a history of asthma, rhinitis, and no known ...

[OSWALD]

An older adult with a history of asthma, rhinitis, and no known drug allergies has been admitted to receive IV antimicrobial therapy for bronchitis. The patient has received the oral form of the antimicrobial agent in the past.
 
  Which factors increase the risk for an allergic reaction? (Select all that apply.)
  a. Medical history of asthma
  b. The patient's age
  c. IV antimicrobial therapy
  d. Medical history of rhinitis
  e. Subsequent use of the same antimicrobial therapy

Question 2

Which patient can safely be treated with a fluoroquinolone medication?
 
  a. A 40 year old on steroid therapy
  b. A 15 year old with a sore throat
  c. A 70 year old with a gait abnormality
  d. A 30 year old with a fractured tibia

[alvinum]

Answer to Question 1

ANS: A, D, E
Patients with a history of asthma, allergies, or rhinitis should be closely monitored for possible allergic reaction. Subsequent use of the same antimicrobial therapy may only pose a risk if a reaction occurred with the first administration of the drug; in this case, repeat exposures to a previously sensitized substance can be fatal. Older adults, because of physiologic changes of aging, require close observation for therapeutic response and drug toxicity, but not necessarily for allergic reaction. The route of administration does not increase the risk of an allergic reaction.

Answer to Question 2

ANS: D
Fluoroquinolones are safe to prescribe for a 30 year old with a fractured tibia. Fluoroquinolones should not be prescribed for patients taking corticosteroids, patients younger than 18 years, or patients older than 60 years.