TB drugs

Question 1

MTB prophylaxis

Answer 1

isoniazid

Question 2

M. avium-intracellulare prophylaxis

Answer 2

axithromycin, rifabutin

Question 3

MTB treatment

Answer 3

rifampin, isoniazid, pyrazinamide, ethambutol

Question 4

M. leprae treatment

Answer 4

long term treatment with dapsone and rifampin for tuberculoid form; add clofazimine for lepromotous form

Question 5

M. avium treatment

Answer 5

azithromycin or clarithromycin + ethambutol; can add rifabutin or ciprofloxacin

Question 6

isoniazid moa

Answer 6

decreases synthesis of mycelia acids; bacterial catalase peroxidase (encoded by KatG) needed to convert ING to active metabolite

Question 7

isoniazid clinical use

Answer 7

MTB; only agent used as solo prophylaxis

Question 8

isoniazid toxicity

Answer 8

neurotoxicity, hepatotoxicity; pyridoxine (vit B6) can prevent neurotoxicity and lupus

Question 9

rifamycin drugs

Answer 9

rifampin, rifabutin

Question 10

rifampin use

Answer 10

MTB; delays resistance when used for leprosy; used for meningococcal prophylactic and chemoprophylaxis in contacts of children wen H. flu type B

Question 11

rifampin toxicity

Answer 11

CYP inducer (need to increase dosing of birth control, warfarin, etc.), orange body fluids

Question 12

pyrazinamide moa

Answer 12

thought to acidify intracellular environment via conversion to pyrazinoic acid; effective in acidic pH of phagolysosomes where TB engulfed by macrophages is found

Question 13

pyrazinamide toxicity

Answer 13

hyperuricemia (stones), and hepatotoxicity

Question 14

ethambutol moa

Answer 14

decreases carbohydrate polymerization of mycobacterium cell wall by blocking arabinosyltransferase

Question 15

ethambutol toxicity

Answer 15

optic neuropathy (red-green color blindness)