Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pharm I > Meningitis > Flashcards

Meningitis Flashcards

1
Q

Causes of meningitis

A 
Bacterial
Fungal
Mycobacteral
Viral
Parasitic
Spirochetes
Drug-induced
-Sulfonamides, NSAIDs, IV immunoglobulin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Common bacterial pathogens

A 
Strep pneumoniae
Neisseria meningitidis
Group B Strep
Hemophilus influenzae
Listeria monocytogenes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

To discern what bugs to target, consider…

A 
Environmental exposures (sick contacts, endemic fungi)
Recent infections
Immunosuppression
-HIV/AIDS (Cryptococcus)
-Asplenia
-Cancer
Surgery or trauma
Non-infectious causes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

To discern what drugs to use, consider…

A 
Age
Medication allergies
Medication properties
-CNS penetration
-Spectrum of activity
-Adverse effects
-Resistance patterns
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Tx for CNS infections- characteristics of medications

A 
Microcidal
High-dose
Parenteral
Low molecular weight
Lipophilic
Unionized at physiologic pH
Not highly protein bound
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

First steps of tx

A

Supportive care
LP
-Usually done prior to abx
-Do not delay abx is there is a delay getting LP
High dose, parenteral abx
-Age
-Risk factors for MDR bacterial, fungal, viral, etc infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Lab results in nl pt: CSF

A 
WBC <5
Differential: monocytes
Protein: <50
Glucose: 45-80 (50-60% of the blood glucose)
CSF: BG ratio: 50-60%
CSF stain: Neg
Opening pressure: <20 mm Hg
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Bacterial CSF lab results

A 
WBC: 1,000-5,000
Differential: Neutrophils
Protein: Elevated
Glucose: Low
CSF:BG ratio: Decreased
CSF stain (+) Gm stain
Opening Pressure: >20 mmHg
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Viral CSF lab results

A 
WBC: 5-500
Differential: Lymphocytes
Protein: Mild elevation
Glucose: Normal
CSF: BG ratio: Normal
CSF stain: Neg
Opening pressure: <20 mmHg
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Fungal CSF lab results

A 
WBC: 100-400
Differential: Lymphocytes
Protein: Elevated
Glucose: Low
CSF: BG ratio: Decreased
CSF stain: (+) Indian ink stain (Crytpo)
Opening Pressure: >20 mmHg
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

TB CSF lab results

A 
WBC: 25-50
Differential: Variable
Protein: Elevated
Glucose: Low
CSF:BG ratio: Decreased
CSF stain: Pos AFB
Opening Pressure: >20 mmHg
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Common therapy for bacterial meningitis for < 1 mo

A

Ampicillin + Cefataxime or Ampicillin + aminoglycoside

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Common pathogens for bacterial meningitis <1 mo

A

S. agalactiae
E. coli
L. monocytogenes
Klebsiella species

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Common pathogens for bacterial meningitis 1-23 mos

A 
S. pneumoniae
N. meningitidis
S. agalactiae
H. influenzae
E. coli
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Recommended therapy for bacterial meningitis 1-23 mos

A

Vancomycin
AND
Ceftriaxone OR Cefataxime

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Common pathogens in bacterial meningitis for 2-50 yrs

A

S. pneumoniae

N. meningitidis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Recommended therapy for bacterial meningitis 2-50 yrs

A

Vancomycin
AND
Ceftriaxone OR Cefataxime

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Common pathogens in bacterial meningitis for > 50 yrs

A

S. pneumoniae
N. meningitidis
L. monocytogenes
Aerobic gm-neg bacilli

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Recommended therapy for bacterial meningitis for > 50 yrs

A

Vancomycin AND Ampicillin AND Ceftriaxone OR Cefotaxime

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Ampicillin adult dose in meningitis

A

2 gm IV q4h

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Side effects of ampicillin

A

Hypersensititvity
Rash
Interstitial nephritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Adult dose in ceftriaxone

A

2 gm IV q12H

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Side effects of ceftriaxone

A

Hypersensitivity
Pancreatitis
Gallbladder pseudolithiasis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Adult dose in cefotaxime

A

2 gm IV q4-6h

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Side effects of cefotaxime

A

Hypersensitivty

Rash

26
Q

Clinical pearls of ampicillin

A

Renal elimination

27
Q

Clinical pearls of ceftriaxone

A

Avoid in neonates
Avoid use with Ca containing IV fluids
Hepatic elimination

28
Q

Clinical pearls of cefotaxime

A

Preferred in neonates

Renal elimination

29
Q

Adult dose for vancomycin

A

15-20 mg/kg IV q8-12h

Goal trough = 15-20 mg/dL

30
Q

Side effects of vancomycin

A

Neurotoxicity
Infusion reactions
Nephrotoxicity
Ototoxicity

31
Q

Clinical pearls for vancomycin

A

DTM required

Renal elmination

32
Q

Adult dose for gentamicin, tobramycin

A

2-2.5 mg/kg IV q8h OR 5-7 mg/kg IV qday

33
Q

Side effects of gentamicin, tobramycin

A

Nephrotoxicity
Neurotoxicity
Ototoxicity

34
Q

Clinical pearls for gentamicin, tobramycin

A

DTM required

Renal elimination

35
Q

Gm positive cocci

A

Group B streptococcus
Strep pneumoniae
Staph aureus

36
Q

Gram positive rod

A

Listeria monocytogenes

37
Q

Gram neg cocci

A

Neisseria meningitidis

38
Q

Gm neg rod

A

E. coli
Klebsiella species
H. influenza
P. aeruginosa

39
Q

Recommended therapy for S. pneumoniae

A

Vancomycin plus a third-generation cephalosporin

40
Q

Alternative therapy for S. pneumoniae

A

Meropenem, fluoroquinolone

41
Q

Recommended therapy for N. meningitidis

A

Third-gen cephalosporin

42
Q

Alternative therapies for N. meningitidis

A

Pen G, Ampicillin, chloramphenicol, fluoroquinolone, aztreonam

43
Q

Recommended therapy for L. monocytogenes

A

Ampicillin or Pen G

44
Q

Alternative therapies for L. monocytogenes

A

Trimethoprim-sulfamethoxazole, meropenem

45
Q

Recommended therapy for S. agalactiae

A

Ampicillin or Pen G

46
Q

Alternative therapies for S. agalactiae

A

Third-gen cephalosporin

47
Q

Recommended therapy for H. influenzae

A

Third-gen cephalosporin

48
Q

Alternative therapies for H. influenzae

A

Chloramphenicol, cefepime, meropenem, fq

49
Q

Recommended therapy for E. coli

A

Third-gen cephalosporin

50
Q

Alternative therapies for E. coli

A

Cefepime, meropenem, aztreonam, fq, trimethoprim-sulamethoxazole

51
Q

Dexamethasone guidelines

A

Neonates- insufficient evidence to recommend use
Infants and children- H. influenza meningitis, consider in S. pneumoniae
Adults- S. pneumoniae
Dosing: Dexamethosone 0.15 mg/kg (10 mg in adults) IV q6h x 2-4 days
Give with or before 1st dose of antibiotic

52
Q

Duration of therapy for N. meningitidis

A

7 days

53
Q

Duration of therapy for H. influenzae

A

7 days

54
Q

Duration of therapy for S. pneumoniae

A

10-14 days

55
Q

Duration of therapy for S. agalactiae

A

14-21 days

56
Q

Duration of therapy for gram-neg bacilli

A

21 days

57
Q

Duration of therapy for L. monocytogenes

A

Greater than or equal to 21 days

58
Q

Who do you give prophylaxis to?

A

Household/daycare/close contacts, shared sleeping quarters, direct exposure to secretions

59
Q

Prophylaxis tx

A 
N. meningitidis
-Rifampin 600 mg PO BID x 4 doses
-Ciprofloxacin 500 mg PO x 1 dose
-Ceftriaxone 250 mg IM x 1 dose
H. influenzae
-Indicated if not received full Hib vaccine series
-Rifampin 600 mg daily PO x 4 days
60
Q

Common viral pathogens

A 
Enteroviruses (85%)
Arboviruses
HSV
Cytomegalovirus
Varicella-zoster
Rotavirus
Coronavirus
Influenza A and B
West Nile
Epstein-Barr
61
Q

Treatment for viral

A 
HSV or VZV suspected
-Acyclovir 10 mg/kg IV q8h x 14 days
--21 days if immunosuppressed
--Use IBW to calculate dose
--Continuous IV fluids to avoid AKI crystal nephropathy
Supportive care
-Seizure control
-Lower ICP if necessary
62
Q

Adverse effects of acyclovir

A 
Nephrotoxicity
TTP/ HUS
Rash
N/V
Phlebitis

Pharm I (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions