Pharm - CNS Infections

Question 1

Most important characteristic for CNS distribution

Answer 1

Large volume of distribution
More drug available to cross BBB

Question 2

Route of admin with highest CNS concentrations

Answer 2

Intravenous - most common
Intrathecal - subarachnoid space(drug dependent)
Constant rate infusion - also IV

Question 3

Ideal characteristics of drugs that cross the bbb

Answer 3

Lipophilic
Protein unbound
MW<500
Unionized

Question 4

Drugs that are considered hydrophilic

Answer 4

Aminoglycosides
Betalactam - cephalosporins, penicillins

Question 5

Which tetracycline reaches the highest concentrations of CSF

Answer 5

Doxy & - most lipophilic, high protein binding
Minocycline - lipophilic, Low protein binding

Question 6

Significance of inflammation in treating infections of protected sites

Answer 6

Initial therapy may be effective, but efficacy will decrease as inflammation resolves

Question 7

Drugs that are effective to reduce CNS inflammation

Answer 7

Dexamethasone - steroid
Can cause immune suppression

Question 8

Drugs good against protozoal infectious agents

Answer 8

Nitroimidazoles
Potentiated sulfonamides

Question 9

Specific drugs to treat EPM

Answer 9

Pyrimethamine/sulfadiazine
Ponazuril or Diclazuril - admin w corn oil /loading dose