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Pharmacology 2nd Sem Prelim > Antimycobacterials > Flashcards

Antimycobacterials Flashcards

1
Q

Isoniazid is less effective in

A

Atypical mycobacteria

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2
Q

Isoniazid

If used as a single drug

A

10-20% prevalence

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3
Q

Isoniazid

As a single agent in cases of

A

Recent converters
Immunocompromised individuals
Close contacts
Abnormal chest x ray but activity has been R/O

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4
Q

Complex semisynthetic derivative of Rifampicin

A

Rifampin

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5
Q

Rifampin

Active against

A

Gm - and + cocci
Some enteric bacteria
Chlamydia

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6
Q

Rifampin

Cross resistance with

A

Rifabutin

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7
Q

Rifampin

Clinical use

A

Mycobacterial infection - + INH, ethambutol x 6month
Atypical mycobacteria - 600 mgd or 2x weekly x 6 months
Leprosy- + sulfone

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8
Q

Rifampin

Other indication

A

Meningococcal carriage
H. Influenza type B contact
Staph
Pneumococci (menigitis)

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9
Q

Synthetic, water soluble, heat stable compound

A

Ethambutol

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10
Q

Ethambutol

Most common adverse effect

A

Loss of visual acuity and red green color

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11
Q

Ethambutol

CI

A

Very young because visual acuity assessment is difficult

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12
Q

A relative of nicotinamide, stable, inexpensive

A

Pyrazinamide

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13
Q

Pyrazinamide

Inhibits

A

Intracellular organism

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14
Q

Resistant to some non tuberculous species

A

Streptomycin

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15
Q

Streptomycin

Extracellular tubercle bacilli;

A

Inflamed meninges

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16
Q

Streptomycin

Clinical use

A

Severe, life threatening forms of TB

Drug resistance

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17
Q

Streptomycin

Adverse

A

Oto toxicity

Nephrotoxicity

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18
Q

Treatment of TB: guidelines for national programmes 3rd edition. WHO Geneva June 2004

A 
H- isoniazid
R- Rifampicin
S- streptomycin
Km- kanamycin
Q- quinolone (ciprofloxacin  or ofloxaxin)
Z- pyrazinamide
E- ethambutol
Cs- cycloserine
Et- etionamide
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19
Q

DOTS stands for?

A

Directly Observed Treatment Short course

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20
Q

Five elements of DOTS

A 
Political commitment
Quality sputum microscopy for diagnosis
Regular supply of anti TB drugs
Standardized recording and reporting of TB data
Supervised treatment
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21
Q

TB and pregnancy

A

INH, Rifampicn, ethambutol vit B6

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22
Q

Risk of teratogenicity

A

PZA

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23
Q

Infants should be given 3 mos.

A

INH prophylaxis

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24
Q

Related to INH, poorly soluble in water

A

Ethionamide

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25
Q

Ethionamide

MOA

A

Blocks mycolic acid synthesis

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26
Q

Ethionamide

Adverse reaction

A

Hepatotoxic

Neurotoxicity

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27
Q

Ethionamide

Resistance

A

When used as single agent

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28
Q

Capreomycin

MOA

A

Peptide protein synthesis inhibitor from streptomyces capreolus

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29
Q

Capreomycin

Used for multi drug resistant cases

A

Streptomycin

Amikacin

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30
Q

Capreomycin

Resistance

A

rrs mutation

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31
Q

Capreomycin

Adverse effect

A

Nephrotoxic

Ototoxic

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32
Q

Cycloserine

MOA

A

Inhibitor of cell wall synthesis

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33
Q

Cycloserine

Adverse effect

A 
Peripheral neurophaty
CNS dysfunction (give pyridoxine)
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34
Q

Aminosalycylic acid

MOA

A

Folate synthesis antagonist

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35
Q

Aminosalycylic acid

Structure

A

Similar to PABA and sulfonamides

36
Q

Aminosalycylic acid

Widely distributed in tissues and body fluids except in

A

CSF

Excreted in urine

37
Q

Aminosalycylic acid

Adverse effects

A 
Anorexia
Nausea
LBM
Epigastric pain
Peptic ulceration 
Hemorrhage
Hypersensitivity reaction
38
Q

Kanamycin and Amikacin

MOA

A

Inhibits 30s ribosomal subunit

39
Q

Kanamycin and Amikacin

For streptomycin resistant cases,

A

Multi drug resistant TB

Atypical mycobacterium

40
Q

Ciprofloxacin and levofloxacin

MOA

A

Inhibits gyrase mediated DNA- supercoiling

41
Q

Ciprofloxacin and levofloxacin

M. TB

A

Levo> ciprofloxacin

42
Q

Ciprofloxacin and levofloxacin

Atypical myco

A

Levo

43
Q

Ciprofloxacin and levofloxacin

Prophylaxis

A

Fluoroquinolone + PZA

44
Q

Ciprofloxacin and levofloxacin

Resistance

A

Mutations in gyrase A subunit

45
Q

Derived from rifamycin, related to rifampin

A

Rifabutin

46
Q

Rifabutin

Uses

A

TB, Avium, foruitum

Aids with cd4 count of

47
Q

Rifabutin

Resistance

A

rpo mutation

48
Q

Rifabutin

Less potent inducer

A

For HIV infected patients receiving other meds

49
Q

Analog of rifampin; against M. TB , M Avium

A

Rifapentine

50
Q

Rifapentine

MOA

A

Bacterial RNA polymerase inhibitor

51
Q

Rifapentine

Potent inducer of

A

Cytochrome p450

52
Q

Rifapentine

Dose

A

600 mg once or 2x weekly

53
Q

Last resort of multi drug resistant TB

A

Clofazimine

54
Q

Effective against leprosy

A

Clofazimine

55
Q

Clofazimine

MOA

A

Unknown

Involved in DNA binding

56
Q

Clofazimine

AE

A

Skin dis colorization

GIT intolerance

57
Q

Inhibits protein synthesis (50S)

A

Linezolid (oxazolidinones)

58
Q

Linezolid (oxazolidinones)

AE

A

Hematologic (thrombocytopenia, neutropenia)

59
Q

TB diagnostic category

A

Table memorize

60
Q

Not communicable from person to person

Disease produced are less severe than TB

A

Atypical Mycobacteria

61
Q

Disseminated disease in late stages of AIDS

A

MAC

62
Q

MAC

1st line treatment

A

Azithromycin 500mg
Clarithromycin 500 mg + ethambutol 15mg
Clofazimine/ciprofloxacin 750mg
Amikacin

63
Q

MAC

2nd line treatment

A 
Rifabutin 300
Rifampicin 
Ethionamide
Cycloserine
Imipenem
64
Q

MAC

Prophylaxis in aids PT

A

Rifabutin 300 mg OD

65
Q

Mycobacterium marinarum

1st line tx

A

Rifampicin + ethambutol

66
Q

Mycobacterium marinarum

2nd line treatment

A 
Clarithromycin
Amikacin
Kanamycin
Minocycline
Doxycycline
67
Q

Similar to TB but milder

A

Mycobacterium kansasii

68
Q

Mycobacterium kansasii

1st line treatment

A

INH + Rifampicin + ethambutol

69
Q

Mycobacterium kansasii

2nd line

A 
Ethionamide
Cycloserine
Clarithromycin
Amikacin
Streptomycin
70
Q

Cervical lymphadenitis

A

Mycobacterium fortuitum

Tx, surgical excision

71
Q

Chronic lung disease and skin soft tissue infection

A

Mycobacterium fortuitum

72
Q

Mycobacterium fortuitum

1st line

A

Amikacin+ doxycycline

73
Q

Mycobacterium fortuitum

2nd line

A

Cefoxitin,

Rifampicin

74
Q

Leprosy

A

Skin and nerve

Cell mediated immunity

75
Q

Leprosy mode of transmission

A

Nasal secretions

76
Q

Dx leprosy

A

Slit skin smears

77
Q

Skin macules with clear centers and well defined margins, anesthetic,

A

Tuberculoid leprosy

78
Q

Impaired cell immunity,
Atrophy of skin
Muscles amputations
Spontaneous ulceration

A

Lepromatous

79
Q

Major chemotherapeutic agents against M. Leprae

A 
Dapsone (DDS)
Rifampicin 
Clofazimine
Ofloxacin
Minocycline
80
Q

Other chemotherapeutic agents for leprosy

A

Levofloxacin
Sparfloxacin
Clarithromycin

81
Q

Dapsone

MOA

A

Inhibits folate synthesis

82
Q

Mycobacterium fortuitum

Adverse effects

A

Hemolysis
GIT intolerance
Erythema nodosum leprosum

83
Q

Exacerbation of lepromatous leprosy

A

Jarisch-herxheimer reaction

84
Q

Clofazimine (lamprene)

MOA

A

Inhibit the template function of DNA

85
Q

Clofazimine

SE

A

Discoloration of the skin

Eosinophilic enteritis

86
Q

Miscellaneous agents for leprosy

A

Thalidomide - tx of erythema nodosum

Ethionamide - substitute for clofazimine

87
Q

The most active drug for the treatment of TB

A

Isoniazid

Pharmacology 2nd Sem Prelim (7 decks)

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