Brainscape's Knowledge GenomeTM

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


See full index

Pharmacology > Exam 8: TB and Leprosy > Flashcards

Exam 8: TB and Leprosy Flashcards

1
Q

What are the 4 first line treatments for TB?

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

What are 3 drugs used to treat Leprosy?

A

Dapsone
Clofazimine
Rifampin

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

What drug is used to treat both TB and Leprosy?

A

Rifampin

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

What cells are primarily involved in immune defense against TB?

A

T Cells

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

In which cells does TB multiply in primary infection?

A

Alveolar Macrophages

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

What patient population is especially at risk of TB?

A

HIV/AIDS

Also foreign born patients

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are 3 different types of places TB organisms multiply?

A
  1. Cavitary Lesions- High O2, neutral pH (fast multiplication)
  2. Closed, Caseous Lesions- O2 low, neutral pH (replication is slow)
  3. Within Macrophages- Acidic (slow replication)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What 2 drugs are best at treating Actively multiplying TB (extracellular)?

A

Rifampin

Isoniazid

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

What drug is best at treating TB multiplying in macrophages (acidic environment)?

A

Pyrazinamide

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

What is the short course therapy for TB?

A

6 and 9 month regimens
Initial phase of Isoniazid, Rifampin, Pyrazinamide and Ethambutol for 2 months followed by a continuation phase of Rifampin and Isoniazid for 4 months.

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

What drugs are now preferred for preventative therapy/prophylaxis?

A

Rifampin and pyrazinamide

It used to be Isoniazid for 9 months, but this is changing due to resistance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the duration of preventative therapy?

A

2 months

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

What are the 3 types of Leprosy? What differentiates them?

A

Tuberculoid (most common. skin lesions with anesthesia) CMI High
Borderline
Lepromatous (CMI low)- Systemic. Characterized by anergy.
They differ due to differences in cell-mediated immunity

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

What animal can spread Leprosy?

A

Armadillos

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

What Leprosy drug has to be taken a long time? Shorter?

A

Dapsone (3 years)
Rifampin is only for 6 months
Clofazimine is like Dapsone (3 years)

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

Isoniazid (INH) Mechanism

A

Modified Vit B3 analogue
Inhibits synthesis of mycolic acid (cell wall component unique to mycobacteria)
Bacteriostatic for resting bacilli, but bactericidal if they are rapidly dividing ***

17
Q

What is an important consideration with Isoniazid?

A

Genetic variation in acetylation speed between people is important considering INH toxicity

18
Q

What are 2 main adverse effects of INH?

A
  1. Peripheral neuropathy
  2. Hepatitis
    Slow acetlyators are most at risk
19
Q

How do you treat peripheral neuropathy caused by INH?

A

Pyridoxine

20
Q

What is the mechanism of Rifampin?

A

Inhibits DNa dependent RNA polymerase by binding to the Beta subunit (inhibits RNA synthesis)

21
Q

What is the most common side effect of Rifampin? Others?

A

GI disturbances
Hepatitis
Orange color of urine, feces, sweat, tears, saliva.
Induces P450 enzymes

22
Q

What is the mechanism of Ethambutol?

A

Inhibits incorporation of mycolic acid into the cell wall

23
Q

What are adverse effects of Ethambutol?

A

Visual changes that are reversible

24
Q

When is Pyrazinamide effective?

A

When the pH is slightly acidic.

25
Q

What are adverse effects of Pyrazinamide?

A

Hepatotoxicity

non gouty polyarthralgia due to Hyperuricemia!

26
Q

What is the mechanism of Clofazimine?

A

Binds to mycobacterial DNA and interferes with bacterial growth.

27
Q

What is a pharmacokinetic property of Clofazimine?

A

Super long half life (70 days)

28
Q

What are 2 adverse effects of Clofazimine?

A

Discoloration of the skin (red/brown)

GI disturbances

29
Q

When is Clofazimine used?

A

Mostly for Lepromatous leprosy.

30
Q

What is the mechanism of Dapsone?

A

Inhibits folic acid synthesis by inhibiting dihydropteroate synthetase (it is a sulfonamide)
Bacteriostatic

31
Q

How is Dapsone metabolized?

A

Acetylated in the liver and excreted in the urine

32
Q

What are adverse effects of Dapsone?

A

Hemolytic anemia
Methemoglobinemia
Sulfone syndrome- makes lepromatous leprosy worse sometimes

33
Q

What is a good way to study this lecture?

A

Check out the charts at the bottom of his lecture notes.

Pharmacology (34 decks)

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