bine

Question 1

abx for osteomyelitis (caused by bacteria)

Answer 1

Antibiotics: Ceftriaxone (Cephalosporin), Vancomycin (Glycopeptide)

Question 2

abx for osteomyelitis (caused by mycobacterium)

Answer 2

Antibiotics: Rifampicin, Isoniazid,
Pyrazinamide, Ethambutol (RIPE), Vitamin B6

Question 3

MOA of bisophonates

Answer 3

Alendronate, Risedronate (PO)

Structural analogs of pyrophosphate, a natural substance that inhibits bone breakdown

Question 4

Adverse effects of bisophonates

Answer 4

Nausea, dyspepsia, diarrhoea, bone and back pain

Question 5

MOA of RANK ligand inhibitor

Answer 5

Denosumab (SC)

Monoclonal antibody targeting at RANK, responsible in bone resorption pathway

Question 6

Adverse effect of denosumab

Answer 6

Fatigue, asthenia, hypophosphatemia, nausea, hypercholesterolemia, musculoskeletal pain and cystitis.

Note: Hypocalcaemia

Question 7

MOA of teriparatide (Parathyriod hormone analogue)

Answer 7

Like endogenous PTH to increase bone formation

Question 8

AE of teriparatide

Answer 8

Dizziness, depression,
insomnia, vertigo, rhinitis, increase cough, leg cramps, nausea, arthralgia

Question 9

AE ceftriaxone

Answer 9

Well-tolerated; Rash and diarrhoea most common adverse effect

1-4% patient allergic reaction: severe hypersensitivity are but potentially fatal;
Thrombophlebitis

Question 10

MOA of ceftriaxone

Answer 10

Bacteria cell wall synthesis inhibitor (inhibit transpeptidation1)

Question 11

MOA of vancomycin

Answer 11

bacterial cell wall synthesis inhibitor (inhibit transglycosylation1)

Question 12

AE of vancomycin

Answer 12

Nausea, vomiting,
anaphylaxis, superinfections, nephrotoxicity, ototoxicity and Red Man’s syndrome

Question 13

Drugs used for Osteomyelitis by M.tuberculosis

Answer 13

Rifamycin: Inhibits RNA synthesis by targetting RNA polymerase

Streptomycin: Inhibits protein synthesis by targeting the 30s ribosomal subunit

Question 14

MOA of rifampicin

Answer 14

Inhibit RNA synthesis

Question 15

MOA of isoniazid

Answer 15

Inhibit mycolic acid

Question 16

MOA of Pyrazinamide

Answer 16

Inhibit bacteria cell membrane

Question 17

MOA of Ethambutol

Answer 17

Inhibit cell wall synthesis

Question 18

Adverse effect of Rifampicin

Answer 18

Nausea, vomiting, heartburn, epigastric pain, anorexia, flatulence, diarrhoea, cramping, orange discolouration of urine, sweat, tears Pseudomembranous colitis, acute renal failure, hepatotoxicity, hyperuricaemia, blood dyscrasias

Question 19

Adverse effect of Isoniazid

Answer 19

Nausea, vomiting, epigastric pain,
pellagra (give with Vit B6 to
prevent), anaphylaxis, peripheral
neuropathy, optic neuritis,
hepatotoxicity, blood dyscrasias

Question 20

AE of Pyrazinamide

Answer 20

Gouty arthritis, increase in serum
uric acid, rash,
Anaphylaxis, hepatotoxicity, fatal
haemoptysis, haemolytic anaemia

Question 21

AE of Ethambutol

Answer 21

Nausea, vomiting, headache, dizziness, anaphylaxis, optic neuritis

Question 22

duration of treatment for musuloskeleton TB

Answer 22

9 months

Question 23

Patient education for Rifampicin

Answer 23

1. Imparts a harmless orange color to urine, sweat, and tears (soft contact lenses may be permanently stained)
2. Skin eruptions, fever and GIT disturbances are the most common side effects.
3. Alcohol intake

Question 24

Patient education for Isoniazide

Answer 24

1. Take pyridoxine when taking INH to prevent pellagra + peripheral neuropathy
2. For breastfeeding moms, INH can pass through breastmilk
3. Reduce alcohol intake
4. Tingling sensations (neuropathy)

Question 25

Patient education for Pryrazinamide

Answer 25

1.Use sunscreen
2. Alcohol intake