Question

What medication would you prescribe for a 72y old female who has Community acquired pneumonia. Symptoms are cough, chest pain, fever, nasal congestion. Sputum is rust colored and mucus/phlegm is yellow and green. She has a history of Hypertension and Chronic kidney disease. She takes trandolapril/verapamil combo for the HTN and CKD, chlorothiazide for HTN, vitamin D and calcium supplements for the CKD. What is you first drug of choice and why? What adverse reaction would cause you to change your first medication therapy? What would be your second drug choice?

Answer 1

Amoxycilline cannot be given in this case because verapamil which she is taking decreases excretion rate of Amoxycilline and the later decreases efficacy of the former.

So azithromycin will be my first choice and it even increases the efficacy of verapamil.

Adverse effects of azithromycin:-diarrhea, stomach upset, constipation, abdominal pain, nausea, vomiting.If these effects stay uncontrollable then we will have to change the drug.

Doxycycline will be my second drug choice.