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30 Cards in this Set
- Front
- Back
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valacyclovir special structure
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Prodrug of acyclovir – rapidly converted to acyclovir, plasma acyclovir concentrations 3-5x higher compared to oral acyclovir
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valacyclovir renal adjustment?
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dose adjust in renal insufficiency
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valacyclovir- with or without food?
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May administer without regard to food
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HSV- valacyclovir dosing
tx suppression zoster |
Herpes simplex 1g BID treatment; 500-1g QD for suppression
Herpes zoster 1g TID |
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age less than 1 month- meningitis bugs (4)
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Streptococcus agalactiae, (vagina bacteria), Escherichia coli, Listeriamonocytogenes, Klebsiella species
*organisms acquired during birth that’s why they are different |
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tx age less than 1 month meningitis (2 options)
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Ampicillin plus cefotaxime or ampicillin plus an aminoglycoside
For gram (-) coverage + ampicillin (for listeriamonocytogenes) |
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1-23 months bugs for meningitis (5)
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Streptococcus pneumoniae, Neisseria meningitidis,S. agalactiae, Haemophilus influenzae, E. coli
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1-23 months tx for meningitis
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Vancomycin plus a third-generation cephalosporin (why vanco?)
Vancomycin will cover penicillin resistant strep pneumo |
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2-50 years tx for meningitis
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same as 1-23 mo
Vancomycin plus a third-generation cephalosporin |
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2 bugs in 2-50 years meninigitis
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n. meningitidtis
h. flu |
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meningitis in > 50 years (4 bugs)
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S. pneumoniae, N. meningitidis, L. monocytogenes,
aerobic gram-negative bacilli *revert back to…baby…bugs |
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meningitis in > 50 years tx
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Vancomycin plus ampicillin (for listeria) plus a third-generation
Cephalosporin |
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pneumovax not effective in what pop
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not effective in children <2 yr. old
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pneumococcal vaccine for kids 6 weeks to 6 years
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Prevnar 13
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2 meningococcal vaccines available in US
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Meningococcal polysaccharide vaccine (MPSV4)
Meningococcal conjugate vaccine (MCV4 |
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meningococcal vaccine conditionally indicated for pt with what? (5)
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pts. exposed to disease
pts. traveling to epidemic areas pts. with terminal complement deficiencies pts. with asplenia adolescents with HIV |
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meningococcal vaccine routinely rec'd in what age group
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Routinely recommended for adolescents (11-12 yrs) with a booster
dose at age 16 yrs. |
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H. flu ppx and dose
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Rifampin 20 mg/kg po (Not to exceed 600 mg) Q24 x 4 doses;
Adults 600 mg Q24 x4 doses |
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n meningiditis- what is "close contact"
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close contact for at least 4 hrs during
week before illness; exposure to secretions |
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ppx for n meningitiditis- 2 options for adults
didn't talk about dosing what to give adolescents and those younger than 15 yo |
Cipro 500 mg x1 (no kids); Ceftriaxone 250 mg IM X1 (adolescent)
ceftriaxone 125 mg IM x1 (less than 15 yrs) OR Rifampin 600 mg PO Q12 x 4 doses (adult) |
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contact time for ppx for h flu
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residing with index case for greater than 4 hrs (has to be 4 hours of contact time not just like
I passed someone in the hall) or at same day care as infected person for 5-7 days before sx and unvaccinated |
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3 labs to order to dx viral meninigitis and what they will show
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CBC with differential, LP (reveals abnormal CSF with slightly increased glucose and increased protein + lymphocytes eventually), blood cultures
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viruses assoc with encephalitis (7)
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arboviruses, varicella zoster, herpes simplex, measles, mumps, cytomegalovirus, HIV, and rabies.
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how does virus enter CNS for encephalitis (3)
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The organism may enter the bloodstream through the respiratory or GI tract or may be introduced through an insect or animal bite.
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clinical presentation and course of viral enceph (3)
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prodrome for several days
Following the prodromal period, headache, drowsiness, mental status changes, and meningismus signify the development of encephalitis. as it progresses may lapse into coma |
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common s/sx of viral enceph (3)
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Seizures are common and focal signs associated with the area of the brain where the infection is concentrated may appear.
increased ICP |
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dx procedure for viral enceph (5)
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Peripheral blood smear, blood cultures, LP, EEG, and CT Scan or MRI.
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CSF in viral enceph will show...
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leukocytosis, predominately lymphocytes (but PMNs may be present in early stages).
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EEG in viral enceph will show...
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EEG may exhibit temporal spikes (seizure type activity)
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4 things that may provide clues as to how pt got encephalitis
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age of the patient, travel history, season, or evidence/history of an insect or animal bite
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