Brainscape's Knowledge GenomeTM

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


See full index

Respiratory Pathophys > Integrative Pharmacology of MTB > Flashcards

Integrative Pharmacology of MTB Flashcards

1
Q

What TB patients get the extra 7 months of therapy?

A
  • cavitary pul TB still positive after 2 months
  • initial phase did not contain PZA
  • Pts receiving 1 weekly INH + rifa whose sputum still positive
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the MOA of Isoniazid (INH)?

A

Pro drug that messes with cell wall synthesis

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

How is Isoniazid metabolized?

A

liver-N-acetyltransferase! watch out for different degrees of acetylators

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

When is INH induced hepatotoxicity most common?

A

4-8 weeks into therapy

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

What are two Adverse Drug Effects of INH?

A

Hepatotoxicity

Dose Related Peripheral Neuropathy

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

What role does INH have on phenytoin levels?

A

INH decreases metabolism so increases levels of phenytoin

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 bacterial RNA synthesis by binding to bacterial DNA dependent RNA polymerase

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

What is a side effect of Rifampin (minor)?

A

Red secretions

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

What is a major adverse effect of Rifampin?

A

Hepatitis!

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

What levels are elevated in Rifampin toxicity?

A

hepatotoxicity, increased bilirubin and increased alkaline phosphatase

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

What levels are increased in INH toxicity?

A

hepatotoxicity, increased aminotransferase levels

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

What effect does Rifampin have on CYP 450 (3A4)?

A

inducer of cyps!! so DDI due to decreased levels of other drugs

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

What is the MOA of Pyrazinamide (PZA)?

A

unknown!! but we do know it’s a prodrug

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

What are the adverse drug effects of PZA?

A

Nausea + vomiting
Dose-dependent hepatotox
increased serum uric acid (non gouty polyarthragia)

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

What is the MOA of ethambutol?

A

Inhibits cell wall synthesis

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

What is the major toxicity of ethambutol?

A

retrobullar optic neuritis

VISION impairments

17
Q

Whats the MOA of streptomycin?

A

Aminoglycoside antibiotic (30s ribosome protein synthesis inhibitor)

18
Q

What are the adverse drug effects of streptomycin?

A

otoVESTIBULAR

nephrotoxicity

19
Q

What is the major place in therapy for Rifabutin?

A

substitute for rifampin in patients treated w/ protease inhibitors for HIV!! (avoid the cyp 3A4 DDI)

20
Q

What are the two second line agents for TB therapy?

A

Fluroquinolones and Linezolid

21
Q

How do we manage the ADE of GI disturbance?

A

First step is to rule out hepatotox! check LFT, if normal try taking with food

22
Q

How do we manage ADE of Rash

A

manage symptomatically with antihistamines. if severe, stop ALL meds and reintroduce one by one 2-3 day intervals

23
Q

How do we manage ADE of hepatitis?

A

increase LFT without symptoms- do not stop regimen but monitor more. WITH symptoms discontinue therapy and reintroduce meds 1 week intervals.

24
Q

Elevated bilirubin and alkaline phosphatase strongly suggest WHAT?

A

rifampin toxicity

Respiratory Pathophys (12 decks)

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