Antimycobacterial (Lec 18) Flashcards
TB Disease sxs?
cough > 3wks fever no appetite night sweats exhaustion
TB spreads?
droplet
Mycobacterium tuberculosis characteristics?
acid-fast
facultative intracellular paracite (U macrophages)
15-20 hrs generation time
1st line AntiTB drugs for active dx:
Isoniazid* Rifampin* Pyrazinamide* Ethambutol * * use all 4 in combo
Streptomycin
Rifabutin
Isoniazid (INH) mechanism?
inhibits mycolic acid prdxn in memb,
reaches intracellular bacilli
Isoniazid (INH) used how?
alone for TB prophylaxis
active TB in combo
Isoniazid (INH) administered?
oral
Isoniazid (INH) side-effects?
hepatitis
CNS issues
hemolysis (6GPD pts)
Rifampin (Rif) mechanism?
inhibits RNA polymerase
Rif DOC for?
TB active (in combo)
TB latent (+ isoniazid)
Leprosy (+ dapsone)
Legionella (+ azythro or quinolone)
(closest in activity to INH)
Rif side-effects?
metabolizes hormones faster =
decreases effectiveness of birth control
Ethambutol mechanism?
inhibits production of arabinogalactin in memb
Ethambutol active against?
active TB in combo
Ethambutol side-effects?
decreased visual acuity and red/green perception
Pyrazinamide mechanism?
unknown
Pyrazinamide active against?
in acidic pH
against dormant organisms
in combo for active TB
Pyrazinamide side-effects?
hyperuricemia
hepatic dysfxn
Streptomycin mechanism?
30S ribosome inhibitor
Aminoglycoside
Streptomycin active against?
extracellular TB
Rifabutin mechanism?
RNA polymerase inhibition
Rifabutin first line drug for?
TB pts w/ HIV
replaces rifampin in combo
Mycobactim Avium Complex (MAC)
m. avium + m. intracellulare
MAC tx combo made of?
clarithromycin or azithromycin
+ ethambutol
+ Rif or cipro or clofazimine
(P) IV amikacin
Mycobacterium leprae tx?
PB leprosy (1-5 patches)
MB leprosy (>5 patches)
ALWAYS combo or creates resistance
dapsone + rifampin
dapsone + rifampin + clofazimine
Clofazimine mechanism?
phenazine dye that binds DNA
Clofazimine active against?
Mechanism?
Mycobacter: tb, marinum, leprae
Binds DNA
Clofazimine administration?
oral
Clofazimine side-effects?
GI
skin discoloration
hepatitis
Thalidomide is DOC for?
erythema nodosum leprosum in adults
Thalidomide also treats?
brain malignancies
Kaposi’s Sarcoma
graft-vs-host
other myco