Anti mycobacterial

Question 1

bactericidal

works at the bacterial cell wall inhibiting mycobacterial cell wall by inhibiting mycelia acid production

activated by catalase peroxidase katc

Answer 1

INH

Question 2

resistance due to deletion or down regulation of katc

Answer 2

INH

Question 3

metabolized by liver enzyme N acetyl transferase - slowacetylators have higher risk of SE

Answer 3

INH

Question 4

neuropathy caused by vit b6 excretion promoted by

Answer 4

INH

Question 5

SE: sideroblastic anemia, hepatotoxicity, drug induced lupus, inhibits CYP450, G6PD def hemolysis

Answer 5

INH

Question 6

bactericidal
activated by CYP450

binds to bacterial DNA dependent RNA polymerase

Answer 6

rifampin

Question 7

point mutation in rpoB

Answer 7

resistance of rifampin

Question 8

used in tx of prophylactic mono therapy in close contacts of h flu and n meningitis

Answer 8

rifampin

Question 9

SE: hepatotoxicity and orange urine and body fluids

Answer 9

rifampin

Question 10

Other note: contraceptive failure with oral combined contraceptives; admin with INH to prevent rapid resistance

Answer 10

rifampin

Question 11

blocks arabinosyl transferase

inhibiting carbohydrate formation at the cell wall

bacteriostatic

Answer 11

ethambutol

Question 12

SE: optic neuritis (loss of visual acuity, red and green color blindness)

Answer 12

ethambutol

Question 13

pyrazinamide converted to pyrazinoic acid by

Answer 13

mycobacterial pyrazinamidase

Question 14

distrupts mycobacterial cell membrane metabolism

Answer 14

pyrazinoic acid

Question 15

active at ph 5.5

bactericidal

inhibits bacteria in lysosome of macrophage (intracellular back.)

Answer 15

pyrazinamide

Question 16

bactericidal
crosses BBB

active against extracellular mycobacterium

SE: ototoxicity and nephrotoxicity

Answer 16

streptomycin

Question 17

inhibits bacterial cell wall syndrome (alanine racemes which links 2-D ala residues)

Answer 17

cycloserine

Question 18

SE: peripheral neuropathy, anemia, CNS dysfxn: depression and psychotic rxn; pyridoxine ameliorates neurotoxicity

Answer 18

cycloserine

Question 19

inhibits dihydropteroate synthase and mycobactin synthesis

high [ ] in urine can cause crystalluria

Answer 19

aminosalicyclic acid

Question 20

active against TB, MAC, M fortuitous

less potent inducer of P450

preferred in px with HIV co inf

Answer 20

rifabutin

Question 21

longer half life

should not be used in px with HIV

potent P450 inducer

used after 2 mon of TB tx

Answer 21

rifapentin

Question 22

mycobacterial adenosine

triphosphate synthase inhibitor

Answer 22

bedaquiline - new drug

Question 23

nitroimidazole derivative

mycelia acid synthesis inhibitor

Answer 23

delaminid - new drug

Question 24

temporary exacerbation of sx’s and signs on starting tx

paradoxical rxn in HIV px with active TB

Tx with Prednisone

Answer 24

IRIS - immune reconstitution inflammatory syn

Question 25

15 mm or more

Answer 25

+ test in no risk pop

Question 26

> 5mm

Answer 26

+ in case of HIV, organ transplant; suppressed immune system or steroid therapy

Question 27

> 10 mm

Answer 27

+ in case of health care workers, immigrants who have moved from a country with high TB rate in the past 5 yrs

Question 28

PPD +, but no sx's, no + x ray Tx: INH fro 9 mon (tb prophylaxis) for pregnant women give INH along with pyridoxine

Answer 28

latent TB

Question 29

treatment for MAC infections

Answer 29

azithromycin clarithromycin ethambutol

Question 30

used to help prevent (prophylaxis regimen in MAC) | CD < 100

Answer 30

azithromycin + clarithromycin

Question 31

inhibits folate syn. by dihydropteroate synthase

Answer 31

dapsone

Question 32

SE: hemolytic anemia in G6PD def and drug induced erythema nodosium leprosum

Answer 32

dapsone

Question 33

binds to DNA and inhibits DNA template fxn ADR: distinctive reddish brown discoloration of skin

Answer 33

clofazamine

Question 34

type 2 lepra rxn | - glucocorticoids- no response after 2 courses = thalidomide

Answer 34

erythema nodosum leprosum

Question 35

can cause phocomelia

Answer 35

thalidomide