Mycobacterials Flashcards
Description of mycobacteria
Aerobic
Acid fast_ contain mycolic acid (carbolfuschin stain)
MDR tuberculosis
Multi drug resistant
_ isoniazid
_ rifampin
XDR tuberculosis
Resistance to first line AND second line drugs (fluoroquinolone¡ mycins)
First line drugs for tuberculosis
Rifampin
Isomoazid
Pyrazynamide
Ethambutol
Second line agents
Tuberculosis
fluoroquinolones (cipro, levo, moxi) Streptomycin Amycacyn Kanamycin Cycloserine
Izoniazid
Mech
Inhibits synthesis of enzymes needed for mycolic acid synthesis
Best antituberculous drug (water soluble)
Izoniazid
Side effects
Hepatotoxicity
Neurotoxicity
Lupus like syndrome and anemia
Rifampin
Mech
Fat soluble
Blocks bacterial rna synthedis binds to dna dependednt rna polymerase
Used in TB AND LEPROSY
Rifampin
Side effects
CI
Turns body fluids red orange color
Gi upset
CONTRAINDICATED WITH PROTEASE INHIBITORS FOR HIV “navir”
Alternatives to rifampin
Rifamycins
- rifapentin longer half life (also contraindicated with se inhibitors)
-rifabutin tx for hiv ( when they use protease inhibitors) pt also for prophylaxis of mycobacterium avian complex
Ethambutol
Mech
Water soluble
Blocks arabinogalactin __ component of bacterial cell wall
Ethambutol
Effects
Retinal damage
Peripheral neuritis
Visual disturbances
Pyrazinamide
Mechanism
Spectrum
Disrupts membranes function
Narrow spectrum for TB
Pyrazinamide
Effects
Derivative of nicotinic acid Hepatic dysfunctions Polyarthralgia Myalgia Hyperuricemia
Streptomycin
Tx
Tx tuberculosis meningigits and organ tuberculosis
Cycloserine
Mech
D ala analogue
Inhibits incorporstion of d alanine into peptidoglycan
Exclusively used to tx tb
Causes CNS disorders
Leprosy tx
Rifampin
Dapsone
Clofazimine (for severe inf)
Dapsone
Mech
Inhibits bacterial folic acid synthesis
Best one to tx leprosy
Clofazimine
Mech
Dna binding
Alternate drug for leprosy
Tx for non tuberculosis mycobacterium
ETHAMBUTOL
RIFAMPIN
macrolides (erythromycin azithromycin clarithromycin)
Fluoroquinolones
In a patient how has HIV and Tuberculosis and is currently taking protease inhibitors- what do you give
Rifabutin
Pyrazinamide
Length of tx And why
Used 2/6 months due to toxicity
Nicotinic acid derivative
What do you give to tx side effects of izoniazid
Pyridoxine (B6)
Izoniazid derivative of
Pirydoxine B6
Pyrazinamide derivative of
Nicotinic acid
Use of dapsone in AIDS patient
use of dapsone in AIDS pt is to tx PCP not leprosy
