[4] Drugs for Respiratory Infections - Antibiotics and Anti-TB Flashcards
Color of M. Tuberculosis in Gram Staining
Neutral, but once stained cannot be decolorized by acid alcohol
First Line Anti-TB Drugs
Pyrazinamide
Ethambutol
Rifampicin
Isoniazid
When do you use second-line drugs?
MDR-TB
Mode of Action of Isoniazid
Inhibits cell wall synthesis
Effect of food on Isoniazid absorption
Decreases
Take on an empty stomach
[Excretion]
Isoniazid
Excreted as unchanged drug and metabolites
Isoniazid toxicity can cause seizures, what can you give to counter this?
Vitamin B6
What should you supplement with Isoniazid in patients with diabetes, uremia, HIV infection, alcohol abuse, pregnant and postpartum women?
Pyridoxine
Mode of Action of Rifampicin
Inhibits nucleic acid protein synthesis
Can you use Rifampicin along as monotherapy for bacterial infections?
No, never ever ever ever ever ever ever ever ever ever ever ever ever ever use alone because you will cause resistance, although you can use it as a prophylaxis in certain cases
This Rifampicin adverse effect is also called Redman Syndrome
Hypersensitivity Reactions
Mode of Action of Pyrazinamide
Inhibits fatty acid synthetase 1 (FAS1)
Inhibits mycolic acid synthesis
What is the most hepatotoxic Anti-TB Drug?
Pyrazinamide
How can pyrazinamide cause pain and swelling in the joints?
Can cause gout
Mode of Action of Ethambutol
Alters the cell barrier: Inhibits synthesis of arabinoglycan by inhibiting arabinosyl transferase
First anti-TB drug to be discovered
Streptomycin
Mode of Action of Streptomycin
Inhibits protein synthesis
Adverse effects of Streptomycin causes?
Nephrotoxicity (not Hepato!)
Ototoxicity
Neuromuscular Blockade
Treatment Guideline for TB for Adults
2 HRZE 4 HR
Optimal Dosing Frequency
Daily
WHO Treatment for Children with suspected/confirmed TB Meningitis
2HRZE 10HR
What other aminoglycosides can be used for the treatment of TB?
A) Ciprofloxacin and neomycin
B) Clarithromycin and azithromycin
C) Amikacin and kanamycin
D) Netilmycin and paramomycin
C
Most toxic of all aminoglycosides
Kanamycin
Which Quinolone has the best Anti-TB activity?
Levofloxacin
What does DOTS mean
Directly Observed Therapy Short Course
