C/2. Drugs For Tuberculosis 1st Line Agents

Question 1

Drugs need to know

Answer 1

Rifampin
Isoniazid
Pyrazinamide
Ethambutol
Streptomycin
Amikacin/kanamycin
Cycloserine
Dapsone

Question 2

Rifampin

Answer 2

Inhibits DNA-dependent RNA polymerase
Bactericidal effect

For Tuberculosis and Leprosy tx

Oral
Inducer of CYP450 enzymes

Nephrotoxicity
Hepatotoxicity
Skin rash

Question 3

Isoniazid

Answer 3

Inhibits synthesis of mycolic acid

Tuberculosis

Oral, prodrug
Hepatic metabolism
Inhibitoor of CYP450 enzymes

Question 4

Pyrazinamide

Answer 4

Unknown mechanism

Bacteriostatic

Tuberculosis

Oral, prodrug
Partial hepatic metabolism

Non-gout polyarthralgia
Hyperuricemia
Hepatotoxicity
Skin rash

Avoid in pregnancy

Question 5

Ethambutol

Answer 5

Inhibits cell-wall synthesis

Tuberculosis

Oral
Eleminated unchanged in urine

Dose dependent visual disturbances

Question 6

Streptomycin

Answer 6

Aminoglycoside
Protein synthesis inhibitor

2nd line tx against tuberculosis, life-threatening diseases (meningitis, miliary dissemination)

Question 7

Amikacin/kanamycin

Answer 7

Aminoglycoside
Protein synthesis inhibitor

Tuberculosis resistant to streptomycin

Question 8

Cycloserine

Answer 8

Inhibits peptidoglycan synthesis

Tuberculosis resistant to 1st -line agents
No further clinical use due to severe side effects (CNS dysfunction)

Question 9

Dapsone

Answer 9

Inhibits folic acid synthesis
Bacteriostatic

For leprosy
+Rifampin, Clofazimine