LRTIVI 2

Question 1

List corticosteroids for patients who are on supplemental oxygen or mechanically ventilated

Answer 1

• Dexamethasone 6mg daily for 10 days
• OR
• Betamethasone 6mg (po/iv) for 10 days
• OR
• Prednisone 40mg PO daily for 10 days
• WHO recommended equivalents
• OR
• Hydrocortisone 50 mg IV TDS
• OR
• Methylprednisolone 8 mg QID or 16 mg BD PO or IV

Question 2

List drug for thromboprophylaxis and explain that drug. List SEs, MOA

Answer 2

Heparins
Low molecular weight heparins (enoxaparin, dalteparin)
Unfractionated heparin
MOA
Inactivates thrombin & factor Xa through antithrombin III activation
SEs
Bleeding, heparin induced thrombocytopenia (HIT)

Question 3

what to give hospitalised patients for thromboprophylaxis

Answer 3

For all hospitalised patients:
* Enoxaparin 40mg SC daily
* Unfractionated heparin 5000 units SC 12 hourly

Question 4

What is Baricitinib?

Answer 4

Baricitinib is a Janus kinase inhibitor that has anti-inflammatory
properties.

Question 5

Baricitinib is registered for what?

Answer 5

Registered for the treatment of several dermatological conditions and
rheumatoid arthritis.

Question 6

Explain the findings of baracitinib by RCS and OB

Answer 6

• Several observational studies of hospitalised patients with COVID-19
  showed evidence of clinical improvement with baricitinib. It reduces levels
  of multiple cytokines associated with the pathophysiology of COVID-19
  disease, as well as having anti-viral activity.
• One randomised controlled study of baricitinib in hospitalised patients,
  most of whom required oxygen, demonstrated that the risk of 28-day allcause
  mortality was reduced with baricitinib by 43% (HR 0·57; 95% CI
  0·41–0·78], equivalent to 54 fewer deaths per 1000 (95% CI from 27 fewer
  to 75 fewer) (Marconi et al., 2021)

Question 7

Vaccine: Caution

Answer 7

• Thrombocytopenia
• Bleeding disorders
• On coagulation therapy

Question 8

Vaccine: common side-effects

Answer 8

• Start 6 hours after vaccination and lasts for 1-2 days
• Rarely anaphylaxis (within minutes to hours)
• Myocarditis & pericarditis after mRNA vaccination
• Rare form of blood clots (between 4 days and 3 weeks)
  Fatigue, nausea, Muscle aches, Headaches, fever, chills, Arm is sore or red at the injection site

Question 9

Pre-vaccination questions list them

Answer 9

• Are you sick today? (Postpone vaccination is patients with acute
  severe febrile illness)
• Have you received any vaccination in the past 2 weeks? .
• Have you been diagnosed with COVID-19 infection in the last 30
  days?

Question 10

Explain inactivated antigen vaccines

Answer 10

• 19nCoV-CDC-Tan-HB02 strain inoculated on vero cells
• Inactivated SARS-Co V2 antigen (MC PHARMA)
• 2 doses at least 2-4 weeks apart

Question 11

mRNA vaccines EXAPLAIN
WHAT LIPID NANOPARTICLES USED FOR?
The host uses nucleaside?
Doses?

Answer 11

• Lipid nanoparticles are used to protect the prefusion-stabilized S
  protein–encoding mRNA en route to the intracellular space.
• The host uses nucleoside-modified mRNA to make the target spike
  glycoprotein (full length S-protein with proline substitutions), which
  induces a coordinated immune response. (Pfizer-BioNTech)
• 2 doses at least 3 weeks apart (+ booster after at least 6 months

Question 12

What viral vector vaccines?

Answer 12

• Use replication-deficient viruses engineered to express the genetic
  sequence of the antigen of interest in host cells.
• Recombinant, replication-incompetent human adenovirus serotype
  26 vector encoding a full-length, stabilized SARS-CoV-2 S protein
  (Ad26.CoV2.S; Johnson & Johnson)
• Single dose (+ booster after at least 2 months)