Sun21November0420PM 1

You are asked to review a patient with acute respiratory failure due to H1N1 influenza virus infection.

She is intubated and ventilated. She has large volumes of gastric fluid aspirated from her nasogastric tube. She currently only has peripheral intravenous access.

Which of the following treatment options is most appropriate?

(Please select 1 option)

Zanamivir 300 mg IV for 10 days Correct

Zanamivir 300 mg orally for 10 days

Oseltamivir 75 mg orally bd for 10 days

Oseltamivir 150 mg orally bd for 10 days

Oseltamivir 150 mg orally bd for 5 days

Explanation

For critically ill patients with confirmed or suspected H1N1, oseltamivir 150 mg bd for ten days is the recommended treatment.

However, in this case, the large volumes of gastric aspirate suggest that enteral absorption may not be effective. The only parenteral alternative is zanamivir.

This can be safely given using peripheral venous access.

For hospitalized influenza patients with suspected or known gastric statis, gastric malabsorption, gastrointestinal bleeding, or for patients suspected or confirmed with oseltamivir-resistant influenza virus infection, intravenous zanamivir should be considered.

There are currently two ways to obtain IV zanamivir: enrollment in a clinical trial through a clinical site, or through a compassionate use request through GlaxoSmithKline with FDA approval.

Reference:

Centers for Disease Control and Prevention. Antiviral Agents for Influenza.

Answer Statistics

1

72%

2

1%

3

15%

4

7%

5

8%

Times answered: 278