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Pharmacology > Anti-Mycobacterial Agents > Flashcards

Anti-Mycobacterial Agents Flashcards

1
Q

Treatment for rapidly growing tuberculosis with high bacillary load (cavitary)

A

Isoniazid

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2
Q

Treatment for spurters within the caseous material (caseous)

A

Rifampicin

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3
Q

Slow growing tuberculosis located intracellularly in macrophages and inflamed site

A

Pyrazinamide

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4
Q

Treatment for dormant tuberculous bacilli

A

Not susceptible

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5
Q

Symptoms of TB

A

chronic cough, fever, and weight loss

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6
Q

Drug with the strongest/most potent sterilizing activity that covers all subpopulations

A

Rifampicin

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7
Q

First line anti-TB drug that prevents relapse

A

Pyrazinamide

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8
Q

First line anti-TB drug that prevents resistance

A

Ethambutol

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9
Q

MOA of Rifampicin

A

RNA synthesis inhibitor

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10
Q

MOA of Isoniazid

A

Mycolic acid (Cell wall) synthesis inhibitor)

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11
Q

MOA of Pyrazinamide

A

Disruption of membrane energy metabolism

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12
Q

MOA of Ethambutol

A

Cell wall synthesis inhibition (Arabinoglycan)

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13
Q

DME inducer of the first line anti-TB drugs

A

Rifampicin

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14
Q

DME inhibitor of the first line anti-TB drugs

A

Isoniazid

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15
Q

Rifampicin’s adverse effect

A

Red orange secretions and urine

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16
Q

Isoniazid’s adverse effect

A

Peripheral neuritis

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17
Q

Pyrazinamide’s adverse effect

A

Hyperuricemia

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18
Q

Ethambutol’s adverse effect

A

Optic neuritis and impaired red-green color discrimination

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19
Q

Mechanism of resistance against Isoniazid

A

Mutation in Kat G and Inh A

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20
Q

First line drug used for latent TB infection; bactericidal after 24 hours

A

Isoniazid

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21
Q

Adverse effects of Isoniazid

A

Peripheral neuropathy (Vit B6 deficiency), Hepatitis, elevated ALT

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22
Q

Co-administration of this drug inactivates isoniazid

A

Vitamin C

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23
Q

Isoniazid increases toxicity of these drugs:

A

Phenytoin and Theophylline

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24
Q

Isoniazid increases its hepatotoxicity with:

A

Rifampicin and alcohol

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25
Q

Mechanism of resistance to Rifampicin

A

Mutation in rpo gene

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26
Q

Alternative to Isoniazid for latent TB infection, to Isoniazid resistant organisms, or to MOTT

A

Rifampicin

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27
Q

Drug given as an alternative to Rifampicin in HIV and TB patients

A

Rifabutin

28
Q

This first line anti-TB drug is inactive at neutral pH

A

Pyrazinamide

29
Q

Mechanism of resistance to Pyrazinamide

A

Mutation in pncA gene

30
Q

Dosage effects of Ethambutol

A

Bacteriostatic at usual dose (15mg/kg/day)

Bactericidal at high dose (>25mg/kg/day)

31
Q

Mechanism of resistance to Ethambutol

A

Mutation in emb B gene

32
Q

Clinical use of Ethambutol

A

Intermittent therapy for drug resistant TB, prevent emergence of resistance, treatment of NMTB

33
Q

First of the 2 phases of DOTS

A

Intensive or bactericidal phase: First 2 months, at least 4 drugs

34
Q

Second of the 2 phases of DOTS

A

Continuation or sterilizing phase: 3rd to 6th months, uses Isoniazid and Rifampicin

35
Q

Advantages of Fixed Dose Combination

A

Simplicity, monotherapy is avoided (less drug resistance), and improve patient compliance

36
Q

Resistance to a drug without prior treatment

A

Primary drug resistance

37
Q

Resistance to a drug developed during the treatment

A

Secondary drug resistance

38
Q

MDR plus resistance to fluoroquinolones and 1 injectable drug

A

Extensive drug resistance

39
Q

Presence of at least 1% of mycobacterium strains resistant to both isoniazid and rifampicin

A

Multi-drug resistance

40
Q

Indicated for TB meningitis and pericarditis

A

Steroids

41
Q

Mechanism of resistance to Streptomycin

A

Mutation in S12 protein encoded by rpsl and 16s rRNA encoded by rss gene

42
Q

Clinical indication for Streptomycin

A

Serious forms of TB (Disseminated TB and TB meningitis), and MDR-TB susceptible to streptomycin

43
Q

Drugs used for streptomycin resistant strains

A

Amikacin and Kanamycin

44
Q

Drugs used for streptomycin and kanamycin resistant strains

A

Capreomycin

45
Q

This hepatotoxic drug has an obnoxious taste and blocks mycolic acid synthesis similar to isoniazid

A

Ethionamide

46
Q

Mechanism of resistance to Ethionamide

A

Mutation in inhA

47
Q

Folic acid synthesis inhibitor used in patients with extended spectrum of drug resistance (XDR)

A

PAS (Para-amino salicylic acid)

48
Q

Drugs with flu-like syndrome

A

PAS and Rifampicin

49
Q

This drug is used in combination regimen for MDR-TB and is the last resort drug for MDR-TB resistant to first and second line drugs

A

Linezolid

50
Q

Adverse effect of Linezolid

A

Bone marrow suppression

51
Q

Respiratory fluoroquinolones having better activity than ciprofloxacin against TB Bacilli

A

Gatifloxacin and Moxifloxacin

52
Q

Potent analog of Rifamycins with a longer half life

A

Rifapenine

53
Q

Newly repurposed anti-tuberculosis drugs

A

Bedaquiline and Delamanid

54
Q

MOA of Fluoroquinolones

A

DNA gyrase inhibition

55
Q

Booster for BCG Vaccine

A

MYA85A

56
Q

MOA of Dapsone

A

Dihydropteroate synthase inhibitor (inhibiting folic acid synthesis)

57
Q

Used for all forms of leprosy, dermatitis herpetiformis and prophylaxis and treatment of Pneumocystis jirovecii

A

Dapsone

58
Q

Adverse effects of Dapsone

A

Steven-Johnson syndrome and Sulfone Syndrome

59
Q

Fastest bactericidal for Mycobacterium leprae

A

Rifamycin

60
Q

Greatest limiting factor for Rifamycin usage

A

Cost

61
Q

This drug accumulates in tissues for prolonged periods making possible discontinuous treatment separated by 4 weeks

A

Clofazimine

62
Q

Drug used for Erythema Nodosum Leprosum and M. avium intracellulare infection

A

Clofazimine

63
Q

Long acting tetracycline that has ototoxic effects

A

Minocycline

64
Q

Drug of choice for treatment of Erythema Nodosum Leprosum

A

Thalidomide

65
Q

Alternative treatment for Erythema Nodosum Leprosum

A

Corticosteroid

Pharmacology (4 decks)

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