Tuberculosis Drugs

Question 1

TB first line agents

Answer 1

Rifampin, Isoniazid, Pyrazinamide, Ethambutol

Question 2

Isoniazid MOA

Answer 2

Prodrug and act. By baterial catalase peroxidase (KatG) to inhibit synthesis of mycolic acids

Question 3

Isoniazid Resistance

Answer 3

Under expression or mutation of KatG

Question 4

Isoniazid PK

Answer 4

Acetylation of hepatic N-acetyltransferase

Question 5

Isoniazid AE

Answer 5

Hepatitis, Drug Induced SLE, peripheral neuropathy, Sideroblastic anemia

Question 6

Other drugs that acetylate with hepatic N-acetyltransferase

Answer 6

Hydralazine and Procainamide

Question 7

Explain the relation between the peripheral neuropathy and siderblastic anemia

Answer 7

Vit B6 (pyridoxine) deficiency causes peripheral neuropathy and is used as a cofactor along with RLE ALA synthetase in Heme synthesis and thus reflects as a Immature Iron siderblastic anemia.

Question 8

Rifampin MOA

Answer 8

Binds to the B subunit of bacterial DNA dependent RNA polymerase and thus inhibits RNA synthesis

Question 9

Rifampin Resistance

Answer 9

Mutate or under express RNA polymerase

Question 10

Rifampin PK

Answer 10

CyP450 inducer

Question 11

Rifampin AE

Answer 11

Orange coloration, cholestatic jaundice, acute tubular necrosis

Question 12

Ethambutol MOA

Answer 12

Inhibits mycobacterial arabinosyl transferase and polymerization of carb, arabinoglycan.

Question 13

Ethambutol Resistance

Answer 13

Overexpression of arabinoglycan

Question 14

Ethambutol AE

Answer 14

Optic neuritis and retrobulbar neurits and red green color blindness

Question 15

Pyrazinamide MOA

Answer 15

Converted to active pyrazinoic acid by pyrazinamidase and disrupts cell membrane metabolism and transport functions

Question 16

Pyrazinamide Resistance

Answer 16

Impaired uptake or mutation in pyrazinadase

Question 17

Pyrazinamide AE

Answer 17

Hepatotoxicity and hyperuricemia

Question 18

What Drug is the most common cause of hepatotoxicity in TB treatment

Answer 18

Pyrazinamide

Question 19

What is the treatment protocol for an active infection

Answer 19

Intensive: 2 mo of RIPE Continuation 4 mo RI w/ adjuvant tx Pyridoxine

Question 20

What is the treatment for a latent Infection.

Answer 20

Isoniazid for 9mo

Question 21

Most common second line treatment for TB

Answer 21

Levofloxacin, Moxifloxacin, and Linezolid

Question 22

Rifabutin

Answer 22

Less potent C450 inducer that Rifampin

Question 23

What pts are put on Rifabutin

Answer 23

HIV pts with active TB

Question 24

Rifapentine

Answer 24

Potent C450 inducer and longer acting (1 wk)

Question 25

Most common regimen for NonTB Mycobacteria

Answer 25

Macrolide Rifabutin and Ethambutol for 1 yr