TB Drugs Flashcards
1
Q
Rifampin
A
- <!--StartFragment-->Class: rifamycins
- Most potent antituberculosis agent
- MOA: binds to DNA-dependent RNA polymerase → blocked synthesis of mRNA
- Higher affinity for bacterial polymerases than humans ones → selectivity
- Uses: mycobacteria, but also prophylaxis of close contacts w/ meningococcal and Haemophilus meningitis
- Administration: oral
- Adverse effects:
- Red/orange body fluids
- Rash
- Anemia
- Thrombocytopenia
- Jaundice
- Hypersensitivity reactions with intermittent use
- Can cause hepatitis when combined with isoniazid and pyrazinamide
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2
Q
Isoniazid
A
- <!--StartFragment-->MOA: Inhibits mycolic acid synthesis via Fatty Acid Synthetase 1 (FAS2) → specific inhibition of mycobacteria (bactericidal)
- Administration: oral, usually 1/day
- Distribution: well throughout body tissues, including CSF and caseous granulomas
- Precautions: given with pyridoxine to prevent neurologic side effects (e.g., peripheral neuropathy)
- Adverse effects:
- Neurologic complications
- Hepatitis
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3
Q
Pyrazinamide
A
- <!--StartFragment-->MOA: inhibits mycolic acid synthesis via Fatty Acid Synthetase 1 (FAS1)
- Precautions: must be comined with other antituberculosis drugs because otherwise resistance rapidly appears (aka resistance during monotherapy)
- Adverse effects: hyperuricemia, hepatotoxicity
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4
Q
Ethambutol
A
- <!--StartFragment-->Least potent first-line agent
- Distribution: well throughout body tissues, but reaches only low levels in CSF
- MOA: inhibits the polymerization of arabinoglycan, a critical constituent of the mycobacterial cell wall (bacteriostatic)
- Precautions: must be comined with other antituberculosis drugs because otherwise resistance rapidly appears (aka resistance during monotherapy)
- Must monitor visual acuity during therapy (see below)
- Adverse effects: **optic neuritis **(red-green color blindness)
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