Anti-Tuberculosis Agents

Question 1

what is the action of rifampicin?

Answer 1

inhibits RNA polymerase

Question 2

rifampicin - revamp the hose. What does this mean?

Answer 2

hepatoxic
hypersensitivity reactions
orange bodily fluids
severe skin reaction - DRESS, SJS/TEN

Question 3

rifampicin is known to have quite a lot of colour. Where else do you see this?

Answer 3

Yellow - Jaundice (Contraindication)

Question 4

Iso rhymes with myco. Finish this off.

Answer 4

isoniazid inhibits mycolic acid synthesis

Question 5

Isoniazid has toxic hands as adverse effects. What are they?

Answer 5

Hepatotoxic
Anemia - sideroblastic
Neurotoxicity - give pyridoxine to prevent (25mg)
Drug induced
SLE

Question 6

Now when a drug is hepatotoxic, where do you think it will be most contraindicated? and which drug would do this?

Answer 6

hepatits. Rifampicin, ISONIAZID, pyrazinamide

Question 7

How much pyridoxine would you give to treat neuropathy?

Answer 7

100mg

Question 8

what are good replacements for isoniazid?

Answer 8

moxifloxacin, levofloxacin

Question 9

difference between CNS penetration in the 1st line drugs

Answer 9

rifampicin - poor because highly protein bound

isoniazid - good CNS penetration

Question 10

Ethambutol is not only the last drug added, but it is special in its indications. What can it do that the other drugs cannot?

Answer 10

Bacteriostatic.

Question 11

How does EMB do its special trick? What wall did it have to come over?

Answer 11

inhibits bacterial cell wall formation

Question 12

Ethambutol sounds like Ethanol. What part of the body does alcohol affect?

Answer 12

brain - neurotoxic. also the eyes - retro bulbar optic neuritis

Question 13

when you drink a lot, you need to pee. Ethambutol also affects?

Answer 13

precipitates gout because hyperuicemia occurs

Question 14

If Ethambutol is affecting not only your brain and eyes, but causing an increase in uric acid, what would be contraindicated?

Answer 14

renal failure

Question 15

Name the 3 drugs in Group A of drug resistant drugs

Answer 15

levofloxacin, bedaquilline, linezolid

Question 16

Adverse effects of fluroquinolones are almost opposites. List them.

Answer 16

N&V, diarrhoea, abdominal pain, headache, tremors, dizziness, depression, agitation, athralgia, QT prolongation

Question 17

you need to avoid the use of bedaquilline with specific enzymes. Which are they?

Answer 17

CYP3A induces ie. rifampicin, efivarenz

Question 18

clawfazimine - name this side effect of this group B DRTB

Answer 18

ichthysosis - derm reaction and discololuration