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Pharmacology > L6: Drugs for Tb and Leprosy > Flashcards

L6: Drugs for Tb and Leprosy Flashcards

1
Q

Which drug can be used to treat both Tb and Leprosy?
A. Pyrazinamide
B. Izoniazid
C. Rifampin

A

C. Rifampin

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2
Q

True or False: Tb is caused by mycobacterium tuberculosis, a bacillus

A

True

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3
Q

How is Tb acquired?
A. Oral
B. Excretory
C. Inhalation

A

C. Inhalation

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4
Q

Immunosuppression that following infection with ___ is an important risk factor for developing mycobacterial disease

A

HIV

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5
Q

Infection with tubercle bacillus results in acquired immunity and tuberculin hypersensitivity. What cell type mediates both reactions?

A

T-Lymphocytes

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6
Q

What is the first organ involved in Tb?

A

Lung
- Infection usually resides in the lower respiratory tract

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7
Q

Tubercle bacilli lodge in the ___ and may multiple in phagocytes

A

alveoli

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8
Q

True or False: Bacilli can disseminate from original pulmonary site largely through lymphatic system, to blood stream, causing infection to other organs and tissues

A

True

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9
Q

Where does Tb reactivation most commonly occur?

A

Upper lobes of lung

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10
Q

Which mycobacterial species is most frequently isolated from AIDS patients?

A

Mycobacterium avium complex

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11
Q

True or False: Therapy for treating Tb must consist of only one drug and must continue for two months

A

False
- drugs: should consist of two or more
- treatment: three to six months

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12
Q

Which three locations are tubercle bacilli believed to be found within the host?

A

1) Cavitary lesions
-O2 tension is high
- active replication

2) Closed caseous lesions
- O2 tension is low
- slow replication

3) Within macrophages
- acidic
- slow replication

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13
Q

Which two drugs function at neutral pH (extracellular)?
A. Isoniazid, Rifampin
B. Ethambutol and Pyrazinamide

A

A. Isoniazid, Rifampin

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14
Q

True or False: Rifampin, Isoniazid, Pyrazinamide, and Ethambutol all have metabolic activity in the alveoli and at acidic pH

A

True

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15
Q

What three drugs can be used to treat Tb prophylactically?

A

Rifampin, Isoniazid, and Pyrazinamide

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16
Q

In absence of drug resistance, a region of ___ and ___ administered for 9 months is curative (for Tb)

A

Rifampin and Isoniazid

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17
Q

True or False: 6 months regimens are most common for Tb treatment in the US

A

True

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18
Q

Which four drugs are used daily, for 2 months, to treat initial phase of Tb?

A

Rifampin, Isoniazid, Pyrazinamide, Ethambutol

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19
Q

Which two drugs are administered for four months to treat continuation phase of Tb?

A

Rifampin and Isoniazid

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20
Q

True or False: DOT (direct observation of therapy) has been shown to improve leprosy treatment

A

False - Tb tx

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21
Q

Which drug is the primary drug of Tb (first line anti-Tb agent, with Rifampin) but should NEVER be used alone (resistance develops!)
A. Rifampin
B. Isoniazid
C. Pyrazinamide
D. Ethambutol

A

B. Isoniazid

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22
Q

Which drug is associated with hepatitis, elevated hepatic enzymes, and peripheral neuropathy? Tx?
A. Isoniazid
B. Rifampin
C. Pyrazinomide

A

A. Isoniazid
- Tx: Vit B6 (pyroxidine)

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23
Q

True or False: Chemo for Tb in HIV patients should be given for 6 mths. Further, Isoniazid, Rifampin, and Pyrazinamide should be given daily for 2 mths.

A

True

24
Q

Visual acuity should be measured in patients receiving:
A. Rifampin
B. Isoniazid
C. Pyrazinamide
D. Ethambutol

A

D. Ethambutol

25
Q

If Pyrazinamide is given, baseline levels of serum ____ should be determined

A

Uric acid

26
Q

True or False: Rash, fever, and tachy are the most common hypersensitivity reactions associated with Tb drugs

A

True

27
Q

Mycobacterium leprae can cause ___

A

leprosy

28
Q

Leprosy is spread by ___ from the upper respiratory tract of infection persons that enter through respiratory tract of susceptible persons

A

bacilli

29
Q

What are the three types of Leprosy?

A

1) Tuberculoid: few skin lesions
2) Borderline: intermediate
3) Lepromatous: wide-spread, symmetrical distribution of skin lesions; macrophages

30
Q

Which of following types of Leprosy is associated with a high CMI? low CMI?

A

High CMI = Tuberculoid
Low CMI = Lepromatous

31
Q

Three cardinal signs of infection with M. leprae?

A

Skin lesions
Skin anesthesia
Enlarged nerves

32
Q

Which of the following drugs primarily used Tb (but also can be used for Leprosy) suppresses RNA synthesis by inhibition bacterial DNA-dependent RNA Polymerase?
A. Rifampin
B. Isoniazid
C. Ethambutol
D. Pyrazinamide

A

A. Rifampin

33
Q

A patient begins having GI disturbances and excretions that are red following treatment of leprosy. Which drug did she likely take?
A. Rifampin
B. Isoniazid
C. Ethambutol
D. Pyrazinamide

A

A. Rifampin

34
Q

Which of the following drugs inhibits mycolic acid biosynthesis?
A. Rifampin
B. Isoniazid
C. Ethambutol
D. Pyrazinamide

A

B. Isoniazid
- Therefore: affects lipids, nucleic acids, and glycolysis

35
Q

___ and ____ are first line anti-Tb agents used with Isoniazid

A

Pyrazimide and Ethambutol

36
Q

A patient with Tb begins taking medication for treatment. However, she notices that she begins having difficulty with her vision and develops a rash. Which drug did she likely take?

A

Ethambutol

37
Q

Which of the following is NOT a primary drug for Tb?
A. Rifampin
B. Isoniazid
C. Ethambutol
D. Pyrazinamide

A

D. Pyrazinamide

38
Q

Which drug inhibits incorporation of mycolic acid to mycobacterial cell wall?

A

Ethambutol and Isoniazid

39
Q

___ is only effective against Mycobacteria, while ___ is specific for Mycobacterium tuberculosis

A

Ethambutol; Pyrazinamide

40
Q

Hyperuricemia and hepatotoxicity may be seen with use of ____

A

Pyrazinamide

41
Q

Pyrazinamide is converted to pyrazinoic acid by mycobacteria. POA lowers __, preventing growth

A

pH

42
Q

Human populations show genetic heterogeneity with regard to rate of acetylation of ____
A. Rifampin
B. Isoniazid
C. Ethambutol
D. Pyrazinamide

A

B. Isoniazid

43
Q

True or False: Hepatitis is more likely to occur in a slow acetylator taking Isoniazid

A

True

44
Q

When is Rifampin most active?

A

During cell replication

45
Q

Which drug is used orally with isoniazid and rifampin in Tb chemotherapy?

A

Ethambutol

46
Q

Pyrazinamide exhibits bacterial action only at a slightly __ pH

A

acidic

47
Q

Pyrazinamide is not iteslf active, but it is hydrolyzed to the active compound _____, which has anti-Tb activity

A

pyrazinoic acid

48
Q

Hepatotoxicity is the main serious side effect when using ___

A

pyrazinamide

49
Q

Non-gouty polyarthralgia and hyperuricemia are AE seen with the use of which drug?

A

Pyrazinamide

50
Q

Hepatitis (less likely than with INH) and GI disturbances are common AE associated with ____use

A

Rifampin

51
Q

Which drug induces P450 enzymes (and therefore, may be prone to DDI)?

A

Rifampin

52
Q

Which red color compounds treats LEPROMATOUS LEPROSY by binding to mycobacterial DNA and interfering with bacterial growth?

Hint: drug can cause skin discoloration

A

Clofazimine

53
Q

____ is a drug that is principally bacteriostatic (not bactericidal to M. leprae) and is used for all patients infected with sulfone-sensitive Mycobacterium leprae.

Hint: it inhibits synthesis of folic acid

A

Dapsone

54
Q

True or False: You should never use Clofazimine alone, because resistance may develop

A

False - does not

55
Q

What are the three primary toxicities associated with Dapsone use?

A

1) Hemolytic Anemia
2) Methemogloinemia
3) Sulfone Syndrome

Pharmacology (53 decks)

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