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Sketchy Medical > Antimicrobials: Antimycobacterials > Flashcards

Antimicrobials: Antimycobacterials Flashcards

1
Q

What combination is used to prevent the development of resistant strains of Mycobacterium tuberculosis

A

combination of rifampin, isoniazid, pyrazinamide, and ethambutol used to prevent development of resistant strains of Mycobacterium tuberculosis

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2
Q

What is the mnemonic for the combination of drugs used to prevent the development of resistant strains of Mycobacterium tuberculosis

A

RIPE (rifampin, isoniazid, pyrazinamide, and ethambutol)

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3
Q

What are the 2 phases of treatment for tuberculosis

A

4 drug combination (rifampin, isoniazid, pyrazinamide, and ethambutol) for 2 months followed by 2 drugs (iosinazid and rifampin) for 4 months

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4
Q

Primary TB often presents as

A

middle lobe cavity

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5
Q

______ can be used alone for latent TB therapy

A

Isoniazid

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6
Q

mycolic acids are

A

essential components of the mycobacterial cell wall

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7
Q

How does Isoniazid work

A

INH acts on the mycobacterial cell wall by inhibiting mycolic acid production

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8
Q

How is isoniazid activated

A

INH is activated by a catalase-peroxidase (KatG)

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9
Q

mycobacteria develop resistance to isoniazid by

A

mycobacteria develop resistance to INH by downregulating Kat G

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10
Q

isoniazid side effects include

A
  1. peripheral neuropathy
  2. seizures
  3. hepatotoxicity
  4. asymptomatic rise in aminotransferases
  5. Drug induced lupus
  6. Anion gap metabolic acidosis
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11
Q

How is isoniazid metabolized

A

INH metabolized by the liver enzyme N-acetyltransferase (slow acetylators have higher risk of side effects)

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12
Q

How does isoniazid cause peripheral neuropathy

A

INH promotes excretion pyridoxine (vitamin B6) –> peripheral neuropathy

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13
Q

How is peripheral neuropathy from isoniazied prevented

A

coadministration of INH and pyridoxine prevents peripheral neuropathy

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14
Q

What side effect is associated with all “RIPE” therapy drugs

A

hepatotoxicity

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15
Q

Isoniazid inhibits

A

cytochrome P450

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16
Q

Rifampain activates

A

cytochrome P450

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17
Q

Which RIPE therapy drug activates cytochrome P450

A

Rifampin

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18
Q

Which RIPE therapy drug inhibits cytochrome P450

19
Q

What does rifampin bind to

A

rifampin binds bacterial DNA dependent RNA polymerase

20
Q

Rifampin monotherapy is used as?

A

rifampin monotherapy is used as prophylaxis in close contacts exposed to Haemophilus influenzae or Neisseria meningitidis

21
Q

Rifampin may produce _____ body fluids

A

rifampin may produce orange body fluids

22
Q

What does ethambutol block

A

ethambutol blocks arabinosyl transferase, inhibiting carbohydrate formation at the cell wall

23
Q

True or false ethambutol is bacteriostatic?

A

True: ethambutol is bacteriostatic

24
Q

What are the side effects of ethambutol

A
  1. Optic neuritis with loss of visual acuity and/or red green color blindness
  2. hepatotoxicity
25
Q

Pyrazinamide can cause

A

pyrazinamide can cause hyperuricemia and needle-shaped uric acid crystal formation

26
Q

pyrazinamide may precipitate _____ attacks

A

pyrazinamide may precipitate gout attacks

27
Q

Mycobacterium avium complex (MAC) includes

A

Mycobacterium avium, and Mycobacterium intracellulare

28
Q

Mycobacterium avium complex (MAC) infections are treated with

A

a macrolide (azithromycin or clarithromycin) combined with ethambutol

29
Q

Mycobacterium avium complex (MAC) infections are a common cause of _______ in aids patients

A

MAC is a common cause of disseminated disease in AIDS patients

30
Q

Macrolide prophylaxis is used for Mycobacterium avium complex (MAC) infection when

A

macrolide prophylaxis for MAC when CD4 < 50

31
Q

What may be added as a third agent in the treatment of Mycobacterium avium complex (MAC) infections

32
Q

____ and ______ activate cytochrome P450

A

rifampin and rifabutin

33
Q

_____ _____ is the causative agent of leprosy

A

Mycobacterium leprae

34
Q

What drug is used to treat leprosy

35
Q

Dapsone is used to treat

36
Q

Dapsone can cause

A
  1. agranulocytosis

2. hemolytic anemia in G6PD deficiency

37
Q

In patients with leprosy bite cells and Heinz bodies are seen in

A

bite cells and Heinz bodies seen in RBCs

38
Q

dapsone can cause ______ in G6PD deficiency

A

hemolytic anemia

39
Q

Clofazimine treats

A

lepromatous leprosy

40
Q

What drug is used for lepromatous leprosy

A

Clofazimine

41
Q

______ is seen in lepromatous leprosy

A

leonine facies

42
Q

Rifampin is used to treat

A
  1. Leprosy

2. TB

43
Q

What are the 3 uses of rifampin

A
  1. To treat leprosy
  2. To treat TB
  3. Prophylaxis for exposure N. Meningitidis or H. Influenzae

Sketchy Medical (46 decks)

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