TB Flashcards
What are treatment options for MDR
1) Delamanind is a drug which inhibits mycolic acid synhesisof TB cell wall and when added to standard regime reduced MDR TB by 45% as comapred to std regime. SE:no sx but QTC prolongation noted
2) Bedaquiline
How sensetive gene expert test is in picking +ve smear TB and ridampacin resistence?
98% for smear +ve
72% for smear -ve however repeating genexpert thrice have sens 98.2%
What is Rx of choice for pnemicoccal meningitis in penicillin allergic pt?
1) Vanc +cipro
2) moxifloxacin
What are classes of antifungals?
1) Polyenes
2) Azoles
3) Echinocandins
4) allylamines
5) nikkimycibs
6) sodarins
7) N-myristoyl transferase inh
8) sphinglipids inh
Polyenes MOA
Bind erogsterol
Azole Moa
Inhibit ergosterol
Stnthesis
Echinocandins MOA
Inhibit glucan synthesis
Allylamines MOA?
Inhibits squalelenepoxidase
Nikkimycin MOA?
Chitin synthesis inhibition
SodarinsMOA ?
Inhibit protein synthesis
what are SE of Isonizid?
headache dizziness encephelopathy, hepatitis and jaundice
OD seizures metabolic acidosis and coma
what are MOA of TB drugs?
1) rifampicin ihibits mycobacterial RNA polymerase
2) Ethambutol inhibits arabinosyle transferas(synthesise Arabinogalactin )
3) Isonized Inhibit Mycolic acid wall building and inactivates bacterial Peroxidase
4) Pyrinzamide inhibits bacterial fatty acid synthase aid in Mycolic acid wall
5) Streptomycin acts on 30 S subunit of ribosome (Miliary TB and Meningitis)
what is size of positive induration in different pt
In Latent TB
more than 15 mm-Previous exposure
>10mm in close contacts ,children less than 4
IVDU, pt with TB
> 5mm – Immuno-compromised
Latent TB Rx?
Rifampicin –>4 month
INZ —>6months
what is difference in Rx of Tb in HIV vs non HIV pt?
Rifampicin in replaced with Rifabutin in HIV pt
What is MOA for bedaquiline?
Targets ATP synthase
What is the Risk for TB reactivation with different Biologics ?
React -CIA-Etan
Certolizumab>inflixamab>adalimumab>etanercept
