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I was asked to answer this question, but since it is not my field of expertise (I am a dentist not a hematologist), I will link to a webpage on Medscape and quote what is says about ITP. Medscape has excellent information, and is meant for professional use:http://emedicine.medscape.com/article/779545-medication#showallThis answer is meant only as a reference to what Medscape lists as "Medication" for ITP. Please consult you doctor if you want to learn more about this disease.Prehospital CarePrehospital care focuses on the ABCs, which include providing oxygen, controlling severe hemorrhage, and initiating intravenous (IV) fluids to maintain hemodynamic stability.Prehospital airway control may be necessary for a large intracranial hemorrhage.EMS providers should be aware of the potential for serious bleeding complications in patients with idiopathic thrombocytopenic purpura (ITP).Emergency Department CareLife-threatening bleeding requires conventional critical care interventions.In the patient with known ITP, high-dose parenteral glucocorticoids and IV immunoglobulin (IVIg), with or without platelet transfusions, are appropriate.Platelet transfusion is indicated for controlling severe hemorrhage. Send a blood specimen to the lab for type and screen in case platelet transfusion is necessary.Platelet survival is increased if the platelets are transfused immediately after IVIg infusion.A consultation with a hematologist may be required to make a decision regarding the transfusion of platelets.Guidelines for transfusion dosage6-8 U of platelet concentrate, or 1 U/10 kg1 U of platelets to increase count of a 70-kg adult by 5-10,000/mm3 and an 18-kg child by 20,000/mm3Splenectomy is reserved for patients in whom medical therapy fails. Emergent splenectomy is indicated in patients with life-threatening bleeding in whom medical therapy fails.In patients without life-threatening complications, focus ED care on confirming the diagnosis, if possible, and initiating therapy as needed.Most patients with undiagnosed thrombocytopenia and purpura will need admission for further evaluation and treatment, since ITP is a diagnosis of exclusion.ConsultationsConsult a hematologist for assistance in confirming the diagnosis or, in the patient with known ITP, arranging disposition and follow-up care, if appropriate.Consult a neurosurgeon for intracranial hemorrhage. Consultation by other surgical specialists may be required for extensive hemorrhage at other sites.Medication SummaryGlucocorticoids and IVIg are the mainstays of medical therapy. Indications for use, dosage, and route of administration are based on the patient's clinical condition, the absolute platelet count, and the degree of symptoms. Consultation with a hematologist may be needed prior to starting therapy.Children who have platelet counts >30,000/mm3 and are asymptomatic or have only minor purpura do not require routine treatment. Children who have platelet counts < 20,000/mm3 and significant mucous membrane bleeding and those who have platelet counts < 10,000/mm3 and minor purpura should receive specific treatment.Adults with platelet counts >50,000/mm3 do not require treatment. Treatment is indicated for adults with counts < 50,000/mm3 with significant mucous membrane bleeding. Treatment also is indicated for those adults with risk factors for bleeding (eg, hypertension, peptic ulcer disease, vigorous lifestyle) and in patients with a platelet count < 20,000-30,000/mm3.IV anti-(Rh)D, also known as IV Rh immune globulin (IG), was not recommended by the 1996 American Society of Hematology practice guidelines. However, recent studies using higher dosages of IV RhIG in acute ITP in children and adults show platelet count increases at 24 hours faster than medicating with steroids and at 72 hours similar to IVIg. Although generally less toxic than IV steroids, IV RhIG is more expensive than IV steroids. Studies in children with chronic ITP show that escalating or elevated doses of IV RhIG have comparable responses to those of high-dose IVIg therapy in children. This therapy is not appropriate for patients who have undergone splenectomy. Acute intravascular hemolysis after infusing IV RhIG has been reported, with an estimated incidence of 1 in 1115 patients.Steroid use and immunosuppressives and splenectomy may be undesirable because of their associated complications. For long-term steroid use, this includes osteoporosis, glaucoma, cataracts, loss of muscle mass, and an increased risk of infection. For immunosuppressive therapy and splenectomy, risks include worsening immunosuppression and infection or sepsis. Studies of the use of multiagent therapies in refractory patients are ongoing. Some small studies have shown limited success. According to one study[3] , using a combination of weekly vincristine, weekly methylprednisolone, both until platelet counts reached 50,000/mm3, and cyclosporine orally twice daily until the platelet count is normal for 3-6 months seems promising, though larger prospective studies are needed.Other therapies, such as cyclophosphamide, danazol, dapsone, interferon alfa, azathioprine, vinca alkaloids, accessory splenectomy, and splenic radiation have been studied. Many case series discussing these treatments are too small to show sufficient evidence of a clinically significant reduction in bleeding or mortality rate; however, they serve as additional therapeutic measures in ITP refractory-to-primary therapy (eg, glucocorticoids, IVIg immunoglobulin, splenectomy). Newer studies on rituximab suggest that this agent is an effective treatment option in splenectomized refractory or relapsed ITP patients.[4, 5]Clinical trials have shown promise for agents that directly stimulate platelet production, such as thrombopoietin (TPO) receptor-binding agents. Two new agents, eltrombopag and romiplostim, are available to patients with chronic ITP who have failed other therapies.[6, 7] Both of these agents require registration in a database. While they show promise for raising platelet counts, there are potential safety concerns such as thrombocytosis and rebound thrombocytopenia. It is unlikely that emergency physicians should be prescribing these agents without being under the recommendation of a hematologist.GlucocorticoidsClass SummaryThese agents are used to treat idiopathic and acquired autoimmune disorders. They have been shown to increase platelet count in ITP.View full drug informationPrednisone (Deltasone, Orasone, Sterapred)Useful in treating inflammatory and allergic reactions; may decrease inflammation by reversing increased capillary permeability and suppressing PMN activity. DOC for all adult patients with platelet counts < 50,000/mm3. Asymptomatic patients with platelet counts >20,000/mm3, or patients with counts 30,000-50,000/mm3 with only minor purpura, may not need therapy; withholding medical therapy may be appropriate for asymptomatic patients, regardless of count.Methylprednisolone (Solu-Medrol, Depo-Medrol)Decreases inflammation by suppressing migration of polymorphonuclear leukocytes and reversing increased permeability. Used as alternative glucocorticoid of choice for all patients with severe, life-threatening bleeding or children with platelet counts < 30,000/mm3. Careful observation without medical treatment may be appropriate in some asymptomatic children.Blood productsClass SummaryAdministration of IVIg may temporarily increase platelet counts in some children and adults with ITP. Consider IVIg if the situation requires a rapid, temporary rise in platelet count.Intravenous immune globulin (IVIg)DOC for severe, life-threatening bleeding or for children with platelet counts < 20,000/mm3 with minor purpura; can be used alone or in addition to glucocorticoid therapy.Thrombopoietic AgentClass SummaryThese agents directly stimulates bone marrow platelet production.[8]Eltrombopag (Promacta)Oral thrombopoietin (TPO) receptor agonist. Interacts with transmembrane domain of human TPO receptor and induces megakaryocyte proliferation and differentiation from bone marrow progenitor cells. Indicated for thrombocytopenia associated with chronic idiopathic thrombocytopenic purpura in patients experiencing inadequate response to corticosteroids, immunoglobulins, or splenectomy. Not for use to normalize platelet counts but used when clinical condition increases bleeding risk.Prescribers must enroll in Promacta Cares program. Only available through restricted distribution program. Program phone number is (877) 9-PROMACTA (877-977-6622).Romiplostim (Nplate)An Fc-peptide fusion protein (peptibody) that increases platelet production through binding and activation of the thrombopoietin (TPO) receptor, a mechanism similar to endogenous TPO. Indicated for chronic immune (idiopathic) thrombocytopenic purpura in patients who have had an insufficient response to corticosteroids, immunoglobulins, or splenectomy.Only available through the Nplate NEXUS (Network of Experts Understanding and Supporting Nplate) program, a program designed to promote informed risk-benefit decisions before initiating treatment. For more information, see www.nplate.com or call (877) NPLATE1 (877-675-2831).

Great question!The usual answer is that fevers should be treated - especially high ones, especially in seriously ill patients. All of my professional life, I have followed this dictum, especially since my patients usually have brain disease and are especially sensitive to it (PLENTY of clinical and experimental evidence to show that!), as have the vast majority of my colleagues.No - not minor fevers in people with minor ailments. But certainly in those with major body system disease.The problem is that the other usual answer, when asked why we have fever at all, is that it enhances the immune system. And it is a very phylogenetically ancient response, seen in animals as distant from us as fish and reptiles, so it must surely have some important and useful function!So many have silently wondered how treating fever could be a good thing ...Fever in the critically ill medical patient.Crit Care Med 37(7 Suppl):S273-8 (2009 Jul)There is a small - but growing - minority of clinician-scientists who are asking exactly this question. The New Scientist had an interesting review of this in August, 2010, and I have drawn some of my comments from their information.Fever has, in fact, been associated with things like:- far lower bacterial counts in the blood of patients with meningitis- higher survival in patients with pneumoniaThese were observational studies, and could have lots of explanations (e.g. older, weaker patients may have a harder time both mounting a fever and fighting infection).However, there has been one randomized trial. In patients in ICU for all kinds of reasons EXCEPT brain problems, patients randomized to be treated for fevers at 38.5℃ (101.3℉) did so much more poorly than those treated only when they reached 40℃ (104℉) that the trial was interrupted prematurely:The effect of antipyretic therapy upon outcomes in critically ill patients: a randomized, prospective study.Surg Infect 6(4):369-75 (2005)Further randomized trials have been discussed and may be undertaken soon.What about the run-of-the-mill cold- or flu-related fever?I cannot - and would not want to - advise anyone about treating or not treating their fever, unless I have seen them in a clinical setting and had an opportunity to fully evaluate them.But the growing consensus is that while in the past, the advice has been to treat all fevers, this has now changed to the milder advice to treat only those fevers that cause a patient distress in some way.PLEASE NOTE: THE ABOVE IS OFFERED AS MEDICAL INFORMATION AND NOT AS MEDICAL ADVICEHOT OFF THE PRESS:This month's Pediatrics has a report from the American Academy of Pediatrics offering new guidelines for treating fever in kids. The bottom lines:"Fever ... is not the primary illness but is a physiologic mechanism that has beneficial effects in fighting infection""There is no evidence that fever itself worsens the course of an illness or that it causes long-term neurologic complications""antipyretic use [i.e. giving drugs to lower fever] does not prevent febrile seizures""the real goal of antipyretic therapy is ... to improve the overall comfort and well-being of the child"Clinical report - Fever and antipyetic use in children.Pediatrics 127(3):580-587 (2011 Feb)http://pediatrics.aappublications.org/cgi/reprint/peds.2010-3852v1

Most bronchitis episodes don't need antibiotics, chest X-rays and the like, about 5% will develop a pneumonia, and since 90% of the causative micro-organisms are virussen, although the period of coughing can last up to 2-3 weeks, usually nothing medical needs to be done.From Medscape:Medical CareTherapy is generally focused on alleviation of symptoms.Toward this goal, a doctor may prescribe a combination of medications that open obstructed bronchial airways and thin obstructive mucus so that it can be coughed up more easily. Care for acute bronchitis is primarily supportive and should ensure that the patient is oxygenating adequately. Bed rest is recommended.The most effective means for controlling cough and sputum production in patients with chronic bronchitis is the avoidance of environmental irritants, especially cigarette smoke.Symptomatic TreatmentBased on 2006 American College of Chest Physicians (ACCP) guidelines,[9, 10] central cough suppressants such as codeine and dextromethorphan are recommended for short-term symptomatic relief of coughing in patients with acute and chronic bronchitis.[11]Also based on 2006 ACCP guidelines, therapy with short-acting beta-agonists ipratropium bromide and theophylline can be used to control symptoms such as bronchospasm, dyspnea, and chronic cough in stable patients with chronic bronchitis. For this group, treatment with a long-acting beta-agonist, when coupled with an inhaled corticosteroid, can be offered to control chronic cough.For details on these guidelines, see Chronic cough due to chronic bronchitis: ACCP evidence-based clinical practice guidelines and Chronic cough due to acute bronchitis: ACCP evidence-based clinical practice guidelines.For patients with an acute exacerbation of chronic bronchitis, therapy with short-acting agonists or anticholinergic bronchodilators should be administered during the acute exacerbation. In addition, a short course of systemic corticosteroid therapy may be given and has been proven to be effective.In acute bronchitis, treatment with beta2-agonist bronchodilators may be useful in patients who have associated wheezing with cough and underlying lung disease. Little evidence indicates that the routine use of beta2-agonists is otherwise helpful in adults with acute cough.[12]Nonsteroidal anti-inflammatory drugs are helpful in treating constitutional symptoms of acute bronchitis, including mild-to-moderate pain. Albuterol and guaifenesin products treat cough, dyspnea, and wheezing.In patients with chronic bronchitis or chronic obstructive pulmonary disease (COPD), treatment with mucolytics has been associated with a small reduction in acute exacerbations and a reduction in the total number of days of disability. This benefit may be greater in individuals who have frequent or prolonged exacerbations.[13] Mucolytics should be considered in patients with moderate-to-severe COPD, especially in the winter months.[3]Antibiotic TherapyAmong otherwise healthy individuals, antibiotics have not demonstrated any consistent benefit in the symptomatology or natural history of acute bronchitis.[14, 15] Most reports have shown that 65-80% of patients with acute bronchitis receive an antibiotic despite evidence indicating that, with few exceptions, they are ineffective. An exception is with cases of acute bronchitis caused by suspected or confirmed pertussis infection.The most recent recommendations on whether to treat patients with acute bronchitis with antibiotics are from the National Institute for Health and Clinical Excellence in the United Kingdom. They recommend not treating acute bronchitis with antibiotics unless a risk of serious complications exists because of comorbid conditions. Antibiotics, however, are recommended in patients older than 65 years with acute cough if they have had a hospitalization in the past year, have diabetes mellitus or congestive heart failure, or are on steroids.[16]In patients with acute exacerbations of chronic bronchitis, the use of antibiotics is recommended. Trials have shown that antibiotics improve clinical outcomes in such cases, including a reduction in mortality.[17, 18]A meta-analysis found no difference in treatment success for acute exacerbations of chronic bronchitis with macrolides, quinolones, or amoxicillin/clavulanate.[19] Another meta-analysis comparing the effectiveness of semisynthetic penicillins to trimethoprim-based regimens found no difference in treatment success or toxicity.[20] These findings support earlier studies that have shown antibiotics to be useful in exacerbations of chronic bronchitis, regardless of the agent used.In addition, a short course of antibiotics (5 d) is as effective as the traditional longer treatments (>5 d) in these patients.[21] Patients with severe exacerbations and those with more severe airflow obstruction at baseline are the most likely to benefit. In stable patients with chronic bronchitis, long-term prophylactic therapy with antibiotics is not indicated.