Empiric treatment for bacterial meningitis?
Ceftatriaxone and Vancomycin
Definitive and prophylactic treatment of neisseria meningitis?
Ceftatriaxone
If a 20 year old patient is being treated for meningitis, but has a beta-lactam allergy. What should you treat them with?
Aztreonam and Vancomycin
Why can Rifampin sometimes interfere with other drugs?
Inhibits DNA-dependent RNA polymerase increase P-450 levels.
Can decrease activity of other drugs
What do you treat listeria monocytogenes meningitis with?
Gentamicin and Ampicillin
(unless you’re pregnant
How does Gentamicin work?
aminoglycosides
30S protein synthesis inhibitor
What kinds of drugs can lead to increase risk of seizures due to binding of GABA receptors?
Penicillin (beta lactam antibiotics)
What is acyclovir’s mechanism of action?
Inhibits viral DNA polymerase through chain termination
What is gancyclovir’s mechanism of action?
Inhibits viral DNA polymerase through chain termination
Penicillin treats gram + or gram - ?
Gram + only
What is used to treat intrapartum streptococcus agalactiae prophylactically?(Group B Strep)
Penicillin
How would you treat viral meningitis of CMV?
Gancyclovir
How would you treat viral meningitis of HSV-1?
Acyclovir
How would you treat latent HSV-1 infection?
You can’t treat it until it is active
How would you treat viral meningitis of HSV-2?
Acyclovir
How do you empirically treat bacterial brain abscess infections?
Ceftatriaxone and metronidazole
If you are treating an ear or sinus infection with amoxicillin and you suspect the pathogen has beta lactamase, what should you do?
Add clavulanate to inactivate degradation by beta lactamases
How do you treat Neisseria Gonorrhea conjunctivitis?
Ceftatriaxone
Best treatment for otitis media and sinusitis?
Amoxicillin
What medication is great for gram + bacteria, including MRSA?
Vancomycin
What drug would you use topically for HSV keratoconjunctivitis?
Trifluridine
Vancomycin Mechanism of action?
Cell wall inhibitor.
bloacks trans-peptidation rxn
What drug would you prophylactically use against Hemophilus Influenza Type B?
(meningococcal)
Rifampin
Aminoglycoside (like Gentamicin) adverse effect?
ototoxicity
What drugs would you use for mycobacterium tuberculosis meningitis?
Their mechanisms?
Why a cocktail?
Rifampin - inhibits DNA/RNA polymerases
Isoniazid - Mycolic Acid Inhibitor
Pyrazinamide - unknown
Ethambutol - Cell wall inhibitor (thru arabiosyl transferase)
Lots of problems with MDR-Tb
What kind of drug is Foscarnet?
What can you use it against?
- Antiviral - binds to viral polymerases
- Use on CMV
Candida otitis externa can be treated by?
fluconazole
How does fluconazole work?
Decreases ergosterol synthesis in fungi
How does amphotericin B work?
Pokes holes in plasma membrane of fungi
How does Flucytosine work?
DNA synthesis inhibitor of fungi
How would you treat any of these infections?
Taenia solium- cysticercosis, Echinococcus granulosis, Toxocara cati
Use abendazole
these are round worms and tape worms
How would you treat a cryptococcus infection?
Combine flucytosine and amphotericin B
Possible adverse effect of amphotericin B?
Nephrotixicity
What medications can you use to treat stage 2 Trypanosoma brucei infection?
Melarsaprol and eflornithine
What medications would you use on stage 1 trypanosoma brucei infection?
Pantamidine
OR
Suramin (very toxic)
Mechanism of Pentamidine
Binds to minor groove of DNA
How does eflornithine work?
Ornithine carboxylase inhibitor
Mechanism of nifurtimox?
Oxidative stress
What do you treat tryapnosoma cruzei with?
Nifurtimox
How do you treat toxoplasmosis?
Sulfatiazine and Pyrimethamine combo
What two options can you use to treat leishmania?
Sodium stibogluconate & Meglumine antimoniate
OR
Miltefosine