Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pharmacology 2 > Antimycobacterial Drugs > Flashcards

Antimycobacterial Drugs Flashcards

1
Q

what is the most common site of mycobacterial infection?

A

lungs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

in which patients is multi-drug resistance TB seen?

A

HIV/AIDS +

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

asymptomatic, no radiographic abnormalities, and all bacteriological studies are negative

A

latent TB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what is the cell wall of mycobacteria made of? (3)

A

peptidoglycan
arabinogalactan
mycolic acid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

single most important anti-T drug that inhibits synthesis of mycolic acid, destroying the cell wall

A

isoniazid (INH)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

when is isoniazid the most potent?

A

during initial 2-5 days of therapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

6 ADRs of isoniazid?

A

“the sons are so neurotoxic (muscle twitching, insomnia), that they cause hepatotoxicity and hemolysis”

neurotoxic
muscle twitching
insomnia
hepatotoxicity
hemolysis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what enzyme does isoniazid induce in alcoholics?

A

CYP2E1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

in which patients is hemolysis to occur when taking isoniazid?

A

those with G6PD deficiency (protects RBCs from damage)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what should be added when a patient is taking isoniazid? why?

A

vit B6
INH blocks metabolic activation of pyridoxine (vit B6)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

which enzyme does isoniazid INHIBIT?

A

CYP450

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

which 4 drugs have increased side effects in patients who are slow acetylators (AKA have an absence or deficiency in the N-acetyltransferase 2 enzyme)? why?

A

Sulfapyridine
Hydralazine
Isoniazid
Procainamide

they all go through N-acetyltransferase 2 pathway

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what effect does sulfapyridine have on slow acetylators?

A

liver damage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what effect do hydralazine and procainamide have on slow acetylators?

A

lupus-syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what effect does isoniazid have on slow acetylators?

A

peripheral neuropathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Rifa-

A

rifamycins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

block RNA polymerase from initiating transcription by binding to and inhibiting it

A

rifamycins (rifa-)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

4 ADRs of rifamycins?

A

“Rifa has alot of HOGS”

Hepatotoxicity
Orange
GI
Skin rash

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

ADR from weekly high doses of a rifamycin?

A

flu-like syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

which enzyme do rifamycins INDUCE?

A

CYP450

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

which rifamycin should be used in a patient with TB + co-infection with HIV? why?

A

rifabutin
less DDI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

since rifamycin have biliary excretion and enterohepatic recirculation, which drug’s effectiveness will be decreased?

A

oral contraceptives

23
Q

bacteriostatic agent that inhibits arabinosyl transferase (who is required for synthesis of arabinogalacatan, which links mycolic acid to mycobacterial cell wall)

A

ethambutol

24
Q

what is a dose dependent ADR of ethambutol?

A

visual disturbances

25
Q

ADR d/t prolonged high dose of ethambutol?

A

retinal damage

26
Q

6 ADRs of ethambutol?

A

optic neuritis
red-green colorblindness
headache
confusion
peripheral neuropathy
hyperuricemia

27
Q

bactericidal agent against semi-dormant form of TB in macrophage

A

pyrazinamide

28
Q

4 ADRs of pyrazinamide?

A

“the pyraz’s want to HASH it out”

Hepatotoxicity
Arthralgia
Skin rash
Hyperuricemia

29
Q

name the most frequently used 2nd line Rx for TB

A

IM streptomycin
amikacin/kanamycin

30
Q

aminoglycosides that inhibit protein synthesis

A

streptomycin
amikacin/kanamycin

31
Q

ADR of streptomycin + amikacin?

A

nephrotoxicity
ototoxicity

32
Q

in which patients should streptomycin and amikacin be avoided in?

A

pregnant patients

33
Q

which 3 fluoroquinolones can be used to treat TB?

A

“Moxi and Levo need their Cipro to treat their TB”

Moxi-
Levo-
Cipro-

34
Q

7 ADRs of fluoroquinolones?

A

Skin rash/sun sensitivity
Prolonged QT/Peripheral neuropathy
Ruptured tendon
Increased risk of C. diff
Neurotoxic
GI intolerance

+Weak cartilage

35
Q

2nd line tx for TB that inhibits mycolic acid synthesis

A

ethionamide

36
Q

2nd line tx for TB that inhibits protein synthesis

A

capreomycin

37
Q

2nd line treatment for TB that interferes with proton pump for ATP synthase

A

bedaquiline

38
Q

2nd line tx for TB that inhibits mycobacterial cell wall synthesis; similar to INH

A

delamanid

39
Q

2 ADRs for bedaquiline and delamanid?

A

increased QT
CYP3A4

40
Q

used to treat persistent and latent TB

A

pretomanid

41
Q

what should pretomanid be used with to treat extensively drug-resistant TB? (2)

A

bedaquiline + linezolid x 6mo

42
Q

8 ADRs for combination treatment: pretomanid + bedaquiline + linezolid

A

nerve damage
hepatotoxicity
prolonged QT
lactic acidosis
myelosuppression
acne
headache
N/V/D

43
Q

what drugs should be used during the first 2 months of tx for TB? AKA the intensive phase

A

Rifamycins
Isoniazid
Pyrazinamide
Ethambutol

44
Q

what drugs should be used for the 2nd phase of TB? AKA the continuation phase

A

Rifamycin
Isoniazid

45
Q

what is the monotherapy #1 for TB prophylaxis?

A

isoniazid daily x 6 months

46
Q

what is the monotherapy #2 for TB prophylaxis?

A

isoniazid x 9 months

47
Q

what is the monotherapy #3 for TB prophylaxis?

A

rifampin daily x 4 months

48
Q

what is the monotherapy #4 for TB prophylaxis, especially for latent TB with HIV?

A

isoniazid daily + weekly rifapentine x 3 months

49
Q

vaccine for TB that protects children but not adults

A

bacile calmette guerin

50
Q

what is the most common pattern of resistance in TB treatment?

A

isoniazid resistance

51
Q

treatment for resistant TB disease?
what is an alt?
what is added in severe disease?

A

rifampin + pyrazinamide + ethambutol

alt: streptomycin in place of etham.

quinolone for severe

52
Q

what is the treatment rule for multi-drug resistant TB?

A

at least 4 drugs x 18-24 months

3 PO, 1 injection

53
Q

what should be included for treatment of mycobacterium avium complex?

A

azithromycin OR clarithromycin

Pharmacology 2 (22 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions