Anti-mycobacterial

Question 1

4 drugs against active TB

Answer 1

Isoniazid
Rifampin
Ethambutol
Pyrazinamide

Question 2

Most effective agent against active and latent TB, both extra- and intracellular (mfgs)

Answer 2

Isoniazid

Question 3

1) Inhibits synthesis of mycolic acid
2) Prodrug, activated by Kat G (mycobacterial catalase-peroxidase enzyme
3) Forms covalent bond with at least two proteins involved in mycolic acid synthesis

Answer 3

Isoniazid

Question 4

Adverse effects of isoniazid (2)

Answer 4

1) Hepatitis

2) Peripheral neuropathy

Question 5

Binds with high affinity to bacterial DNA-dependent RNA pol, inhibits RNA synthesis

Answer 5

Rifampin

Question 6

Alternative to INH in treatment of latent TB

Answer 6

Rifampin

Question 7

Adverse effects of rifampin (4)

Answer 7

1) GI
2) Hepatitis
3) Nervous system
4) Red-orange of all things liquidity (urine, sweat, etc)

Question 8

Rifampin and antiretroviral drugs

Answer 8

Must switch to rifabutin if using anti-retroviral drugs bc rifampin is a strong inducer of cytochrome p450 and has drug to drug interaction with anti-retroviral drugs

Question 9

1) Synthetic analogue of nicotinamide
2) Inhibits mycolic acid synthesis
3) Prodrug
4) Requires acidic environment

Answer 9

Pyrazinamide

Question 10

Adverse effects of pyrazinamide

Answer 10

Liver toxicity and hyperuricemia (gout)

Question 11

1) Inhibits arabinosyl transferase - interrupts mycobacterial cell wall biosynthesis
2) Used in combo for treatment of TB and MAC

Answer 11

Ethambutol

Question 12

Adverse effects of ethambutol

Answer 12

retrobulbar neuritis

• vision impairment
• reversible after discontinuation

Question 13

Used in resistance to first line treatment of TB

Answer 13

streptomycin

Question 14

Adverse effects of streptomycin

Answer 14

ear and kidney toxicity

ototoxicity and nephrotoxicity

Question 15

MAC treatment regiment (3)

Answer 15

1) Macrolide
2) Rifampin - if HIV+ sub for rifabutin
3) Ethambutol

Question 16

Treatment regiment for leprosy (3)

Answer 16

1) Dapsone
2) Clofazimine
3) Rifampin

Question 17

1) PABA analogue
2) Competitive inhibitor of folic acid synthesis
3) Long half-life in skin, muscle and kidney (up to 3 weeks)

Answer 17

Dapsone

Question 18

Bactericidal dye

Answer 18

clofazimine