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A-CNS Pharma > Treatment of meningitis > Flashcards

Treatment of meningitis Flashcards

1
Q

بسم الله الرحمن الرحيم
___________________
the cranial nerve affected in bacterial meningitis is ?

A

CN 8 vestibulochoclear

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2
Q

بسم الله الرحمن الرحيم
___________________
the cranial nerve affected in bacterial meningitis is ?

A

CN 8 vestibulochoclear hearing loss

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3
Q

Durg induced meingitis
by ?

A

NTI
-NSAIDS
-Trimethoprims / Sulfamethaxazole
-IV immungoglobulin G
_______________________-
As hypersnensitvity in SLE and RA
SO cessation !

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4
Q

Triad of baterical meningits ?

A

1-High Fever!
2-Headache Or altered Conscousness
3-Neck rigidity or stifness

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5
Q

How to mangae bacterial meningiits

A

acmd 1-Antibiotic for bcateria
2-Corticosteroids for inflammation
3-Mannito decrearsing ICP
-Diazpam for seizures

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6
Q

Increased ICP in bacterial menignitsi is due to ?

A

CIV 1-Vasgoenic edema increased peramibility Of BBB due to endothelis damage
2-Interstitial edema due to Obstruction of CSF Flow due to neutrophils in subarachanoid space producing inflammatory excudate obstruvting the CSF!
3-Cytotoxic edema in brain tissue
________________
Vascultitis = ischemia due to cytokines INTERPETING BLOOD FLOW increasing ICP
_____________________________
Neuronal damage and CN8 seizures

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7
Q

Intersitial edema in bacterial menigitis is due to ?

A

Interstitial edema due to Obstruction of CSF Flow due to neutrophils in subarachanoid space producing inflammatory excudate obstruvting the CSF!

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8
Q

Managemetn of Bacteial meningiits?

A

Initial Dexa + empriric antibiotic
Pathogen specific antibiotic
Shemopropylaxix to contacts

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8
Q

Managemetn of Bacteial meningiits?

A

Initial Dexa + empriric antibiotic
Pathogen specific antibiotic
Shemopropylaxix to contacts

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9
Q

INtital magmetn of bacterial menigits

A

Dexa 10/20 minuts before the empric antibiotic ! or concomitanntly
for 2-4 days

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10
Q

Dexa dose in bacterial menigits

A

0,15mg/kg/6hours IV!

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11
Q

Dexa imp in bacterial meigits

A

Decreasing Inflammaroty cells and cytokines and the inflmmatory reacgtion and vascultits
decresaing brain edema and neurotoxicity

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12
Q

Empric antibiotic is ABCDEF

A

Antibiotic Broad Parentral Cidal Combination 2-4days Epmprical Full dose
intavenous

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13
Q

When intrathecal injection of Emprici antibiotic

A

Nosocomial menigits
Non responsing IV ANTIBIOIT

Hydrophilic = gentamycin - vancomycin
Never pecellin and cephalosprins intrathecally = neruotoxic and seizure

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14
Q

Population below 1 month tha pathogen is ,,,,,,,,,, &,,,,,,,&,,,,,,,,&othe gram - bacilli
Emprical is ……….+………
or …….+………
_________________________
1-23 months
2-50 years the pathogen …………..&,,,,,,,,,,,&,,,,,,,,,,,,,,,&,,,,,,,,,,,,,,
empric is ……..+……
or…..+……..
______________________________
>50years or imuuno comprismed or alcholo
………………&,,,,,,,,&,,,,,,,,,,
AND aeerobic geam-bacilli
Empric is ?
,,,,,,,AND,,,,,,AND,,,,,,,,,,,
OR
,,,,,,,,,AND ,,,,,,,,,

A

=Streoptcoccus aglactiae - Listera -E COLI SLE
Ampicclin + cefotaxime
Ampicllim+ gentamycin
___________________
=S,peunonaie , N.meingiitds , S,agalcite , H,inglezuae
Vanocmycin +ceftriaxone
Vancomycin + meropenem….
____________________________
=S.pnemuona + listera + N,meidigits
Vancomycin + Ceftirzxone + Ampicllin
Vanocmycin + meropenem

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15
Q

Penterating trauma
Neurosurgery
CSF shunt
Bactrial meinigits pathogen is ?
emprical antibiotics is ?

A

Coagulae - staphs MRSA
Aerobic gram - bacilli pseudomonas
___________________________
Vancomycin + cefepime
Vancomycin + meropenem

16
Q

To increase it csf permeability Ceftriaxone is given with ?

A

Rifampin

17
Q

Sterptococcus pnemnoia duration of treatment +
recommednded and alternative antibiotics

A

10-14 days
Penicllin MIC < 0.1
penecillin G or Ampicllin
Penecillin MIC 0.1-1
Ceftriaxone
Ceftriaxone mic >2
Ceftiraxone + vanomycin
Cef + Rifampin
_____________________
alterntaic CMM
Meropenem
Moxifloxcain
Cholramhpenicol

18
Q

N,meingitids duration of treatment +
recommednded and alternative antibiotics

A

7 days
Penecillin mic <0.1
penicclin G or ampicllin
Pencelin mic > 0.1
ceftiaxone
_______________
Alternative
Meropemen
Moxifloxacin
Choramhenicol

19
Q

H.infleuze duration of treatment +
recommednded and alternative antibiotics

A

7-10D
B lactamase + = ampicllin
B lactamase - = Ceftrizxone
_________________
Alternative
Meropenem
Moxifloxacin
Cholramphenicol

20
Q

Streptococus aglactiae duration of treatment +
recommednded and alternative antibiotics

A

21 days
Penicillin G ampicllin
_____________
Vanocmycin + cefotaxime

21
Q

Listera duration of treatment +
recommednded and alternative antibiotics

A

21 days
Ampicclin + gentamycin for synergism
_______________
Trimethoprim / sulfmethaxazole

22
Q

Enterobacteria :duration of treatment +
recommednded and alternative antibiotics

A

21 days
Ceftriaxone
Gentamycin
_________
meropenem
Moxifloxacin

23
Q

[pSUDOMONAS S duration of treatment +
recommednded and alternative antibiotics

A

21 D
_____
Cefepim
______
Meropenem
Ciprofloxacin

24
Q

Stap aerues duration of treatment +
recommednded and alternative antibiotics

A

14 days
____________
Methecillin sensitive = Naficllin
Resistant = Vancomycin
_____________
alternativesss:-
Daptomycin
Liezolid

25
Q

شفا الله كل مريض يتجرع نغب الآلام أنفاسا كأسا تلو كأس نفس تلو نفس !

A
26
Q

In adult
Ampicllin 2g q4h
ceftriaxone 2g q12h
Vanocmycin 15mg/kg q8h
_________________

A

In childrem
ampicllin
50-100mg/kg q6h
ceftrizaxone 12 -24
cefotaxime 6-8 h
(75-100 mg /kg)
Aminoglycoside :- Gentamycin or tobramycin 2.5 mg/kg q8h
Vancomycin :- 15 mg /kg q6h
Cholreamphenicol : 25 mg/kg orally or intravenous q 12h

27
Q

Chloramphenicol is last choice why?

A

Fatal aplastic amemia
Grey baby sndomre in neonate

28
Q

Chemoprphylaxis :-
H.Influenza : indications 1-2
antibiotis is ……… for……. dose………..up to,…….
=N,mengitidis :1-2-
no need contact >14 days
antiviotic ?,m,,,,,,,,,, for……
alternatices ………. IMand……… only adult
________________________
S.aglacitae
1-
2-
3-
antivioticm,,,,,,,,,,,,,,,,,IV
allergy ?,,,,,,,,or,,,,,,,,,,,,,,,,,,,,,,,,,

A

Household contacts
Unvcaiinate or incompletely vaccinate children
Rifampin for 4 days
_____________________
1-close contact for 8 hours
2-Contact with oral secretions
Rifampin for 2 days
Ceftriaxone
Cefofloxacin

____________________________
Prevous birh with infected child
Colonization
Baturia during pregnancy
Fever + amionitc fluid rubture
labor < 37 weeks
=Pencillin G or
Cefazolin and CLINDAMYCIN

29
Q

vIRAL menigits by herpes simplex giving ?

A

Acyclovir

30
Q

candidal menigits ?
Aspergillius menigitis?

A

candia = liposomal ampotrecin B
lESS NEPHROTOXIC + Higher CNS CONC + 5 fluocytosine

Aspergillus = Voriconazole

31
Q

TB meingitis

A

Combination of first line anti tb drugs
for 9 -12 months

Isoniazid -pyraziamide - fifamon -ethabutlo -streptomycin

32
Q

الحمدلله رب العالمين

A

A-CNS Pharma (11 decks)

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