CNS Infections

Question 0

Acyclovir

Answer 0

-anti-viral
-used for encephalitis, herpes simplex type 1&2, VZV
MOA
-blocks nucleic acid synthesis thus inhibiting viral DNA synthesis
-*requires 3 phosphorylation steps, which inc safety of drug
ADE
-IV my cause reversible renal (crystalline nephropathy or interstitial nephrities) or neurologic (tremors, delirium, seizures) toxicity

Question 1

Tetracyclines
Doxycycline
Tigecycline

Answer 1

-"cyline"
MOA
-binds to 30s ribosomal subunit inhibiting bacterial protein metabolism
-tige- overcomes 2 most common bacterial resistance mechanism (efflux pumps and ribosomal protection) via side chain
Diseases
-drug of choice form Lyme and RMSF
ADE
-photosensitivity
-phototoxicity
-photoallergy
-photoonycholyisis
-tige- increase in all cause mortality
Contraindications
-kidst eat dairy products either

Question 2

Flucyctosine

Answer 2

-common cancer chemotherapy agent
-given w/ other anti-fungals to prevent resistance
MOA
-disrupts RNA and DNA synthesis
ADE
-bone marrow and GI toxicity
Contraindications
-impaired renal function

Question 3

Echinocandins
caspofungin
micafungin

Answer 3

-“fungin”
-affects Cadida and Aspergillus
MOA
-inhibits beta-glucan synthase which inhibits cell wall synthesis

Question 4

Fluconazole

Voriconazole

Answer 4

-“-conazole”
-anti-fungal
MOA
-reduces ergosterol synthesis by inhibition of fungal cytochrome enzyme which disrupts cell membrane bilayer
Contraindications
-over 30+ drug interactions

Question 5

Amphotericin B deoxycholate

Answer 5

MOA
-forms aggregates in cell membrane with ergosterol, leading to pores in cell wall
ADE
-"ampho-TERRIBLE"
-fever, chills
-phlebitis
-nephrotoxicity
-renal loss of K and Mg
-anemia

Question 6

Amphotericin B lipid associated meds

Answer 6

• less side effects than deoxycholate
• more expensive
• efficacy data lacking to compare w/ OG