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Antibiotx > Anti-mycobacterial > Flashcards

Anti-mycobacterial Flashcards

1
Q

First line TB

A 
Streptomycin
Pyrazinamide
Isoniazid
Rifampin
Ethambutol
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2
Q

2nd line TB

A 
Fluoroquinolone
Amikacin
Aminosalicylic acid
Capreomycin
Cycloserine
Ethionamide
Kanamycin
Linezolid
Rifabutin
Rifapentine
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3
Q

Leprosy

A

Clofazimine

Dapsone

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4
Q

Latent TB Infx (LTBI)

A

Isoniazid (INH) 9 months
INH + rifapentine weekly 12 weeks
Rifampin 4 months

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5
Q

Active TB Infx

A

Initial-INH Rifampin, pyrazinamide, ethambutol
(RIPE)
Continued-INH, Rifampin 4-7mos (cavitary/sputum cult 2 mo)

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6
Q

TB osteomyelitis

A

6-9 mos

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7
Q

TB meningitis

A

9-12 mos

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8
Q

TB Pericarditis

A

+CS 1-2 mos

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9
Q

SEs

A

Hepatotoxicity
Ocular tox
rash
fever

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10
Q

INH MOA/Resistance

A

inhibits synth of mycolic acids (cell wall)

R: inhA, katG, KasA. ahpC

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11
Q

INH SE

A

hepatitis
peripheral neuropathy (peroxidine supp)
CNS toxicity (peroxdine supp)
fever, skin rashes, lupus

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12
Q

INH important

A

no renal dosing

acetylated (slow/fast polymorhpisms)

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13
Q

Rifampin MOA/Resistance

A

binds b subunit RNA polymerase (inhibits RNA synth)

R: rpoB, cross resistance to rifamycins

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14
Q

Rifampin other uses

A

meningococcal carriage
h. influenza B prophylaxis
staph carriage
serious staph infx

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15
Q

Rifampin SE

A 
red color to urine/feces/saliva/sweat
rashes
GI
nephritis
thrombocytopenia
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16
Q

Rifampin important

A

CYP450 inducer-dig, propran, ketoconazole, metop, verap, methadone, CS, oral contraceptives, warfarin
If given <2x/wk flu illness

17
Q

Pyrazinamide MOA/R

A

unknown but disrupts cell memb synth, taken up by macros

R:pncA, no cross resistance, impaired uptake pyrazinamide

18
Q

Pyrazinamide SE

A

Hepatotox (mostcommon agent to cause)
GI
Hyperuricemia
DRUG RASH (most common agent to cause)

19
Q

Ethambutol MOA/R

A

inhibits arabinosyl transferases (cell wall)

R: embB, emb

20
Q

Ethambutol SE

A

retrobulbar neuritis (red/green color blindness)

21
Q

Streptomycin MOA/R

A

irreversible inhibitor protein synthsis, exact mech unknown

R: rpsL, rrs, everything other than TB, MAI, kansasii resistant

22
Q

Streptomycin SE

A

Ototox, nephrotox

23
Q

All drugs dosing

A

ALL PO except streptomycin-IV/IM

24
Q

Related second line drugs

A

INH-ethianomide
streptomycin-capreomycin, amikacin, kanamycin
rifampin-rifabutin, rifapentine

25
Q

Other second line drugs

A

Cycloserine-
Aminosalicylic acid
FQs-
linezolid-

26
Q

LTBI trx

A

INH-9 months
INH +rifapentine-12 wks
Rifampin-4 mo (intol INH)

27
Q

Active TB trx

A

INH, rifampine, pyrazinamide, ethambutol

intol to pyrazinamide-can not take

28
Q

Continuation trx

A

Risk factors: cavitary lesions, pos sputum culture @ 2mo
0-1=INH, rifampin 4 mo
2=7 mos

29
Q

TB osteomyelitits

A

6-9 mo

30
Q

Tb meningitis

A

9-12 mo

31
Q

Resistance to INH trx

A

rifampin, pyraz., ethambutol= 6 mo

(intol to pyraz)=rifampin, ethambutol +/- FQ 12 mo

32
Q

Resistance to rifamycins

A

INH, ethambutol, FQ=12mo

pyraz for first 2 mo

33
Q

MDR

A

INH, rifampin

-all five first line, FQ, injectable

34
Q

XDR

A

INH, rifampin, FQ AND 1+ of injectables

-susceptible drugs

35
Q

HIV trx LTBI

A

INH 9 mo

36
Q

HIV trx active

A

4 first line
ART-rifamycin (p450 inducer) can reduce effectivity of NNRTIs and PIs (rifampine avoided with PIs)
need to dose adjust rifabutin too (CYP3A4)

37
Q

Immunomodulating drugs TB trx

A 
TNFa inhibitor (highest risk fr LTBI-> active
usually stopped
38
Q

Pregnancys trx

A

INH, rifampin, ethambutol 2mo
INH, rifampin 7 mos
should take pyroxidine
Don’t use pyrazinamide/streptomycin

Antibiotx (3 decks)

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