2/14/17 SMITH antibiotics 5 TEST #2 Flashcards
What type of bacterium have nearly impermeable cell walls?
-Mycobacterium
What shields and prevents many drugs from accessing the cell membrane of mycobacterium?
-Mycolic acids
What are three way that mycobacterial defenses make it exceptionally difficult for antimicrobials to do their jobs?
- Thick hydrophobic cell wall
- Efflux pumps
- Some species can hide inside patients cells
What area of the body does Mycobacterium tuberculosis primarily effect?
-Lung, but can cause disease in almost any tissue
What conditions do Mycobacterium leprae grow better in?
-Cooler body temps closer to skin surface
What are other names for a TB test?
- TST
- PPD
If a person has a TST greater than 5 mm who is that indicative of a positive TB test in?
- HIV patients
- Close contacts of active cases
- Have fibrotic chest x-ray films
What is the prophylactic treatment of choice for some who has latent/asymptomatic infections of primary tuberculosis?
-Isoniazid for 9 months
What is the treatment of choice for over/active infection of primary tuberculosis?
-(RIPE) Rifampin + Isoniazid + Pyrazinamide
+ Ethambutol
When you are treating the overt/active infection of Primary TB after you do a 2 month treatment with what do you do?
-Do a 4 month treatment of Rifampin + Isoniazid
If there is an intracellulare organism in the overt/active infection of primary TB how do you treat?
-RIPE for 12 months + azithromycin
How long is the longest you should use the Pyrazinamide in a TB treatment?
-2 months because of hepatotoxicicity
Healthy patients infected with TB have a ____ % risk of reactivation in the first ____ years and then a ____ % lifetime risk of reactivation?
- 5
- 2
- 5
What is the treatment of choice for secondary TB?
- (RIPES)
- Rifampin + isoniazid + pyrazinamide +Ethambutol + streptomycin (2 months)
- 4 months treatment with isoniazid and rifampin
What is an aminoglycoside drug that can be used in TB?
-Streptomycin
What is a macrolide drug that can be used in TB?
-Azithromycin
What is a nucleic acid synthesis inhibitor drug that can be used in TB?
-Rifampin
What is the Drug of choice for a prophylaxis treatment of Mycobacterium tubercuosis?
-Isoniazid (INH)
What is the mechanism of Isoniazid?
-Decreases Mycolic acid synthesis
T/F Isoniazid is a prodrug
True
Where is Isoniazid activated?
-Bacterial enzyme KatG
Whenever you give a patient Isoniazid what do you always want to administer with it?
-Vitamin B6
What is the purpose of administering vitamin B6 with Isoniazid?
- Maintain heme synthesis
- Prevent neurotoxicity
What are the adverse effects of Isoniazid?
- Hepatotoxicity
- Disulfuram-Like reaction (Hangover feeling)
