Antimycobacterial (Lec 18) Flashcards

1
Q

TB Disease sxs?

A
cough > 3wks
fever
no appetite
night sweats
exhaustion
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2
Q

TB spreads?

A

droplet

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3
Q

Mycobacterium tuberculosis characteristics?

A

acid-fast
facultative intracellular paracite (U macrophages)
15-20 hrs generation time

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4
Q

1st line AntiTB drugs for active dx:

A
Isoniazid*
Rifampin*
Pyrazinamide*
Ethambutol *
* use all 4 in combo

Streptomycin
Rifabutin

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5
Q

Isoniazid (INH) mechanism?

A

inhibits mycolic acid prdxn in memb,

reaches intracellular bacilli

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6
Q

Isoniazid (INH) used how?

A

alone for TB prophylaxis

active TB in combo

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7
Q

Isoniazid (INH) administered?

A

oral

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8
Q

Isoniazid (INH) side-effects?

A

hepatitis
CNS issues
hemolysis (6GPD pts)

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9
Q

Rifampin (Rif) mechanism?

A

inhibits RNA polymerase

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10
Q

Rif DOC for?

A

TB active (in combo)
TB latent (+ isoniazid)
Leprosy (+ dapsone)
Legionella (+ azythro or quinolone)

(closest in activity to INH)

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11
Q

Rif side-effects?

A

metabolizes hormones faster =

decreases effectiveness of birth control

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12
Q

Ethambutol mechanism?

A

inhibits production of arabinogalactin in memb

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13
Q

Ethambutol active against?

A

active TB in combo

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14
Q

Ethambutol side-effects?

A

decreased visual acuity and red/green perception

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15
Q

Pyrazinamide mechanism?

A

unknown

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16
Q

Pyrazinamide active against?

A

in acidic pH
against dormant organisms
in combo for active TB

17
Q

Pyrazinamide side-effects?

A

hyperuricemia

hepatic dysfxn

18
Q

Streptomycin mechanism?

A

30S ribosome inhibitor

Aminoglycoside

19
Q

Streptomycin active against?

A

extracellular TB

20
Q

Rifabutin mechanism?

A

RNA polymerase inhibition

21
Q

Rifabutin first line drug for?

A

TB pts w/ HIV

replaces rifampin in combo

22
Q

Mycobactim Avium Complex (MAC)

A

m. avium + m. intracellulare

23
Q

MAC tx combo made of?

A

clarithromycin or azithromycin
+ ethambutol
+ Rif or cipro or clofazimine

(P) IV amikacin

24
Q

Mycobacterium leprae tx?

PB leprosy (1-5 patches)

MB leprosy (>5 patches)

A

ALWAYS combo or creates resistance

dapsone + rifampin

dapsone + rifampin + clofazimine

25
Q

Clofazimine mechanism?

A

phenazine dye that binds DNA

26
Q

Clofazimine active against?

Mechanism?

A

Mycobacter: tb, marinum, leprae

Binds DNA

27
Q

Clofazimine administration?

A

oral

28
Q

Clofazimine side-effects?

A

GI
skin discoloration
hepatitis

29
Q

Thalidomide is DOC for?

A

erythema nodosum leprosum in adults

30
Q

Thalidomide also treats?

A

brain malignancies
Kaposi’s Sarcoma
graft-vs-host
other myco