TB and Mycobacteria

Question 0

Acid-fast bacteria have what in their wall

Answer 0

Mycolid acid and arabinogalactan (in addition to peptidoglycan)
Not G+ or G-

Question 1

Narrow spectrum drug that treats only Acid-fast bacteria

Answer 1

Ethambutanol
Rifampin/Rifabutin
ISOniazid?

Question 2

DOC for active TB

Answer 2

ISOniazid + rifampin/rifabutin (if HIV) + Ethumbutanol + PYRAzinamide
Tx: total 6 months: 2 months on all 4 drugs, 4 months on 2 drugs (Iso +Rifampin)

Question 3

DOC for latent TB

Answer 3

either ISOniazid or Rifampin

both together are cidal

Question 4

SE of ISOniazid (oral)

Answer 4

• causes Liver damage/hepatitis
• CNS stimulation
• Pheripheral neuritis in slow acetylators
• Hemolysis in pts with 6GPD deficiency
• Metabolized by acetylation (liver) inactivates drug

Question 5

MOA of Rifampin (oral)

Answer 5

Inhibit RNA polymerase

Question 6

Rifampin is DOC for

Answer 6

Myco Leprae (Dapsone + Rifampin)

Question 7

Rifampin spectrum

Answer 7

G+/G-

Question 8

SE of Rifampin

Answer 8

• not serious
• induced P450 and increases metabolism on thyroid, adrenals - VOID in HIV
• ORANGE
• DECREASES EFFECT OF BIRTH CONTROL

Question 9

SE of ethambutol (oral)

Answer 9

VISION LOSS and RED-GREEN percetion
don’t use in kids < 13 yo
decrease dose in pts with renal insufficiency

Question 10

Ethambutol MOA

Answer 10

inhibits Arabinogalactan (part of cell wall) -> STATIC

Question 11

PYRAzinamide (no MOA, oral)

Answer 11

*ACTIVE AT LOW pH (acidic)

mostly against DORMANT (latent)

Question 12

SE of PYRAzinamide

Answer 12

HEPATIC dysfx

Question 13

Streptomycin (amino, PARENTERAL)

Answer 13

irreversibly binds to 30S

Question 14

Streptomycin SE

Answer 14

Amino:
oto
nephro

Question 15

Rifabutin MOA

Answer 15

inhibitis RNA polymerase -> CIDAL

Question 16

Rifambutin (oral) SE

Answer 16

Orange

less potent inducer of P450 so use in HIV instead of Rifampin

Question 17

2nd line drugs to TB are

Answer 17

less potent and more toxic
Para-aminosalicylic acid
ETHionamide
Capreomycin
RIFApentin
Amikacin
Quinolones

Question 18

Myco Avium DOC

Answer 18

Macrolide (clarithro/azithro) + ETHAMBUTON + Rifampin/Rifabutin/Cipro +/- Amikacin (if resistant to macrolide)

Question 19

Myco Leprae

Answer 19

Dapsone + rifampin

Question 20

Dapsone MOA

Answer 20

PABA antagonist (similar to Sulfanomides: inh folate synthesis, prevents DNA synthesis)

Question 21

SE of Dapsone (oral)

Answer 21

Nasal obstruction (improves in 3-6 months)

Question 22

Thalidomide

Answer 22

TETRATOGENIC!!!

Tx: mycobacterial infections (leprae)

Question 23

PRAZIquantel treats

Answer 23

tapeworms and flukes

Question 24

SE of PRAZIquantel (oral)

Answer 24

PARALYSIS
don’t give to pregs
few SE

Question 25

Pyrantel pamoate and IVEmectin treat

Answer 25

round worms