• Mary Mays CNM, FNP, MS,

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    • Mart; Mays completed her midwifery and family nurse practitioner training in 1985 at the Frontier School of Midwifery and Family Nursing in Hyden, Kentucky, and received her masters degree in 1992 from the University of California, San Francisco. She works as a nurse practitioner with Health Care for the Homeless in San Francisco, and provides prenatal care in the midwifery service at San Francisco General Hospital.

  • Steven Leiner MS, FNP, PA-C

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    • Steven Leiner completed his masters degree and nurse practitioner training at Pace University, Pleasantville, New York, in 1980. He is employed at Mission Neighborhood Health Center, San Francisco, California.

Mary Mays, CNM, FNP, MS, 815-A 26th Avenue, San Francisco, CA 94121.


In a primary care setting, nurse-midwives will collaboratively manage common lower respiratory conditions that require pharmacologic therapy. As such, they must maintain up-to-date knowledge about the indications, use, and potential side effects of these medications. This article reviews the drugs most commonly used for the out-patient treatment of pneumonia, asthma, tuberculosis, and bronchitis (both acute and chronic). Differences among common oral antibiotics recommended by the American Thoracic Society are described. Inhaled bron-chodilator and anti-inflammatory medications are covered, as well as systemic corticosteroids. The use of isoniazid preventive therapy for latent tuberculous infection is described in detail, with brief mention made of other drugs used for active tuberculosis. Adjunct treatments including immunotherapy, vaccines, oxygen supplementation, and nicotine replacement for smoking cessation also are discussed.