Sheehy Drugs

Question 1

Empiric treatment bacterial meningitis

Answer 1

Cefotoxime/ceftriazone and vancomycin

Question 2

What drug added in pts >50 w/ bacterial meningitis?

Answer 2

Ampicillin

Question 3

Immunocompromised pts w/ bacterial meningitis get what?

Answer 3

Vancomycin + ampicillin + either cefepime or meropenem

Question 4

Bacterial meningitis and beta-lactam allergy?

Answer 4

Vancomycin + moxiloxacin + trimethoprim-sulfamethoxazole

Question 5

Main pathogens in brain abscess

Answer 5

Viridans strep and staph aureus

Question 6

Treatment for brain abscess

Answer 6

Penicillin G

Methronidazole

Ceftriaxone

Ceftazidime, cefepime or meropenem

Vancomycin

Question 7

Penicillin G and brain abscess

Answer 7

Covers mouth flora that can go to brain

Question 8

Methronidazole and brain abscess

Answer 8

Selectively absorbed by anerobic bacteria

Toxic products taken into bacterial DNA

Readily penetrates brain abscess, but recommended to treat in combo with another agent

Question 9

Adverse effects of metronidazole

Answer 9

Disulfiram-like effect (avoid alcohol)

Metallic taste

Question 10

Ceftriaxone and brain abscess

Answer 10

Covers most aerobic and microaerobic strep (in place penicillin G)

Question 11

Ceftazidime, cefepime, or metipenem and brain abscess

Answer 11

Used when brain abscess complicates neurosurgical procedure

Covers pseudomona aeruginosa

Question 12

Vancomycin and brain abscess

Answer 12

Use until you rule out MRSA, then stop and use nafcillin or oxacillin instead

Question 13

Subdural empyema-community acquired treatment

Answer 13

Cefotaxime or ceftriaxone, vancomycin, methronidazole

Question 14

Subdural empyema- hospital acquired treatment

Answer 14

Meropenem, vancomycin

Question 15

Cryptococcal meningoencephalitis treatment

Answer 15

Amphotericin B- membrane function

Flucytosine (5-fluocouracil)- nucleic acid synthesis

Fluconazole- ergosterol synthesis