TB Meds

Question 1

is mycobacterium slow or fast growing?

Answer 1

Slow growing

Question 2

What makes mycobacterium cell wall relatively impermeable to many antibiotics?

Answer 2

Mycolic acid

Question 3

What primarily happens to mycobacteria?

Answer 3

Survive in the macrophages (another layer for antibiotic to get through)

Question 4

How long are therapies for TB?

Answer 4

months

Question 5

How is TB transmitted?

Answer 5

Airborne particles

Question 6

What does isoniazid target?

Answer 6

Inhibits mycolic acid synthesis through the formation of :
reactive oxygen-radicals
isonicotinic acid

Question 7

What type of antibiotic is isoniazid?

Answer 7

Bacteriostatic and bactericidal

Question 8

When is isoniazid considering bactericidal?

Answer 8

When the mycobacterium is rapidly dividing

Question 9

Does isoniazid have any cross resistance?

Answer 9

No because they have a different mechanisms

Question 10

What are some AEs of Isoniazid?

Answer 10

Peripheral neuritis: pyridoxine deficiency

Question 11

What should you prescribe along with Isoniazid?

Answer 11

Pyridoxine (B6)

Question 12

What does isoniazid inhibit the metabolism of?

Answer 12

Phenytoin

Question 13

What is a side effect of isoniazid that increases iwth rifampin or daily ETOH?

Answer 13

Hepatitis/ hepatotoxicity

Question 14

What is the black box warning with isoniazid?

Answer 14

Severe and sometimes fatal hepatitis associated w/ isoniazid therapy may occur and even develop after many months of treatment

Question 15

How does rifampin work?

Answer 15

Interact w/ DNA_dependent RNA polymerase

Question 16

Which has a broader spectrum- INH or rifampin?

Answer 16

rifampin

Question 17

What is rifampin effective against?

Answer 17

gram + and - organisms. Used prophylactically in individuals exposed to meningitis

Question 18

What type antibiotic is rifampin?

Answer 18

Bactericidal

Question 19

What does rifampin induce?

Answer 19

Its own meatbolism and meatbolism of oral contraceptives

Question 20

How if rifampin eliminated?

Answer 20

feces, urine

Question 21

What can happen to rifampin with tears?

Answer 21

Orange-red color tears

Question 22

Besides changing color of fluids what are some AEs of rifamyins?

Answer 22

Minor- N/V

Question 23

What type antibiotic is pyranzinamide?

Answer 23

bactericidal

Question 24

What does pyrazinamide affect?

Answer 24

Mycolic acid biosyntehsis byt inhibiting fatty acid synthase

Question 25

Where does pyrazinamide accumulate?

Answer 25

Macrophages, monocytes,

helps prolong therapy

Question 26

What are some AEs of pyrazinamide?

Answer 26

liver injury
jaundice
check liver function tests

Question 27

What type antibiotic is ethambutol?

Answer 27

bacteriostatic

Question 28

What is an exception to the combing of bacteriostatic and bactericidal?

Answer 28

Ethambutol w/ other TB meds

such a slow growing organism that it doesn’t affect

Question 29

What does ethambutol inhibit?

Answer 29

synthesis of polysaccharides and transfer mycolic acids to cell wall

Question 30

What drug helps prevent more rifampin resistance for developing?

Answer 30

Ethambutol

Question 31

What is the most important AE of ethambutol?

Answer 31

optic neuritis results in
diminished visual acuity
loss of red/ green discrimination