Brainscape's Knowledge GenomeTM

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


See full index

Pharma 2nd semester > C.2. Antimycobacterial drugs > Flashcards

C.2. Antimycobacterial drugs Flashcards

1
Q

list the 1st line antimycobacterial agents

A 
'RIPE'
Rifampin
Isoniazid (INH)
Pyrazinamide
Ethambutol
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

list the 2nd line antimycobacterial agents

A 
streptomycin 
Amikacin
Kanamycin 
Cycloserine
Ciprofloxacin
Ofloxacin
linezolid
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what is the MoA of Isoniazid?

A

inhibits synthesis of mycolic acid

bactericidal effect

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

what is the mechanism of resistance of Isoniazid?

A

deletions in katG gene

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

what is the most important drug used in TB treatment?

A

Isoniazid

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

what are the indications for TB prophylaxis (3)?

A
  1. TB exposure in young children, TST negative
  2. TST conversion in the past 2 years
  3. TST reactors with high risk (diabetes, HIV positive, immunosuppressive treatment, leukemia)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what is the MoA of Rifampin?

A

inhibits DNA-dependent RNA polymerase (transcription inhibitor)
bactericidal effect

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

what is the mechanism of resistance of Rifampin?

A

alteration of the polymerase enzyme

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

which agents are given prophylaxis TB?

A

Isoniazid (INH) or Rifampin

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

how are TB and leprosy drugs given?

A

Orally

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

what are the other indications for Rifampin other than TB?

A
  1. leprosy
  2. in combination with vancomycin–>active against MRSA and PRSP
  3. Prophylaxis: N.meningitidis, H. influenza, staphylococci
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what is the MoA of Ethambutol?

A

inhibits synthesis of arabinogalactan

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

what is the mechanism of resistance of Ethambutol

A

alteration of drug target

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

which TB drug is an inhibitor of CYP450 enzymes?

A

Isoniazid

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

which TB drug is an inducer of CYP450 enzymes?

A

Rifampin

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

mechanism of action of Pyrazinamide

A

unknown

bacteriostatic

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

mechanism of resistance of Pyrazinamide

A

mutations in gene encoding enzymes involved in drug activation

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

which drugs T1/2 ↑ in renal/hepatic impairment?

A

pyrazinamide

19
Q

which TB drug should be avoided in pregnancy?

A

pyrazinamide

20
Q

which TB agents are prodrugs (activation by catalase)?

A

isoniazid

pyrazinamide

21
Q

how long is the phase I TB treatment? (‘RIPE’)

A

2 months

22
Q

how long is the phase II TB treatment? (‘RI’)

A

4-7 months

23
Q

what is the T1/2 of Isoniazid ?

A

fast acetylators–> 60-90 min’

slow acetylatos–> 3-4 h’

24
Q

SE of Isoniazid (6)

A
  1. Neurotoxicity due to B₆ deficiency- insomnia, muscle twitching, peripheral neuritis
  2. sideroblastic anemia
  3. hepatotoxicity
  4. drug-induced lupus
  5. acute hemolysis in G6PD deficient patients
  6. AG metabolic acidosis
25
Q

SE of Rifampin (5)

A
  1. nephrotoxicity
  2. skin rash
  3. thrombocytopenia
  4. hepatotoxicity
  5. orange colored secretions (saliva, tears, urine)
26
Q

SE of ethambutol (2)

A
  1. dose-dependent visual disturbances

2. headache, confusion

27
Q

SE’s of pyrazinamide (4)

A
  1. non-gout polyarthralgia
  2. hyperuricemia
  3. hepatotoxicity
  4. skin rash
28
Q

when do we give 2nd line agents for TB?

A

when the TB is resistant to the 1st line agents

29
Q

which drug is used for the treatment of life-threatening associated diseases in TB (meningitis, miliary dissemination, end -organ TB)?

A

streptomycin

30
Q

which agents are used when TB is resistant to streptomycin?

A

Amikacin

Kanamycin

31
Q

what are streptomycin, Amikacin and kanamycin?

A

Aminoglycosides

protein synthesis inhibitor

32
Q

what is Cycloserine?

A

cell wall active Ab

cyclic analogue of D- ala–> inhibits peptidoglycan synthesis

33
Q

what is Ciprofloxacin and Oflxacin?

A

2nd gen’ fluoroquinolones

nucleic acid synthesis inhibitor

34
Q

what is Linezolid?

A

protein synthesis inhibitor

35
Q

what does MDR TB mean?

A

multidrug resistant M. Tuberculosis

resistant to at lease Isoniazid and Rifampin

36
Q

what does XDR TB mean?

A

extensively drug-resistant M. Tuberculosis

resistant to fluoroquinolones and at least 1 additional 2nd line drugs

37
Q

how do we treat MDR -TB and XDR-TB and for how long?

A

extensive use of 2nd line agents
18-24 months
+12 months after sputum culture is negative
maybe surgery for lung abscess

38
Q

what are the drugs used for leprosy?

A

Dapsone+Rifamin +/- Clofazimine

39
Q

which drug is also used as an alternative treatment for Pneumocystis jirovecii pneumonia in AIDS patients

A

Dapsone

40
Q

what is the T1/2 of Clofazimine?

A

up to 2 m’

41
Q

what is the mechanism of Dapsone?

A

inhibits folic acid synthesis

bacteriostatic

42
Q

what is the mechanism of clofazimine?

A

unknown

bacteriostatic

43
Q

what are the side effects of Dapsone?

A

GI symptoms
skin rash, fever
methemoglobinemia
acute hemolysis in G6PD deficient patients

44
Q

what are the drugs used against M. avium complex?

A

Clarithromycin +Ethambutol +/-Rifabutin

*prophylaxis treatment in AIDS patients

Pharma 2nd semester (49 decks)

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