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Host and Defense COPY > Antimicrobials 5 - Smith - From Cutler > Flashcards

Antimicrobials 5 - Smith - From Cutler Flashcards

1
Q

What type of bacterium have nearly impermeable cell walls?

A

-Mycobacterium

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2
Q

What shields and prevents many drugs from accessing the cell membrane of mycobacterium?

A

-Mycolic acids

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3
Q

What are three way that mycobacterial defenses make it exceptionally difficult for antimicrobials to do their jobs?

A

-Thick hydrophobic cell wall-Efflux pumps-Some species can hide inside patients cells

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4
Q

What area of the body does Mycobacterium tuberculosis primarily effect?

A

-Lung, but can cause disease in almost any tissue

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5
Q

What conditions do Mycobacterium leprae grow better in?

A

-Cooler body temps closer to skin surface

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6
Q

What are other names for a TB test?

A

-TST -PPD

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7
Q

If a person has a TST greater than 5 mm who is that indicative of a positive TB test in?

A

-HIV patients-Close contacts of active cases-Have fibrotic chest x-ray films

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8
Q

What is the prophylactic treatment of choice for some who has latent/asymptomatic infections of primary tuberculosis?

A

-Isoniazid for 9 months

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9
Q

What is the treatment of choice for over/active infection of primary tuberculosis?

A

-(RIPE) Rifampin + Isoniazid + Pyrazinamide+ Ethambutol

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10
Q

When you are treating the overt/active infection of Primary TB after you do a 2 month treatment with what do you do?

A

-Do a 4 month treatment of Rifampin + Isoniazid

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11
Q

If there is an intracellulare organism in the overt/active infection of primary TB how do you treat?

A

-RIPE for 12 months + azithromycin

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12
Q

How long is the longest you should use the Pyrazinamide in a TB treatment?

A

-2 months because of hepatotoxicicity

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13
Q

Healthy patients infected with TB have a ____ % risk of reactivation in the first ____ years and then a ____ % lifetime risk of reactivation?

A

-5-2-5

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14
Q

What is the treatment of choice for secondary TB?

A

-(RIPES)-Rifampin + isoniazid + pyrazinamide +Ethambutol + streptomycin (2 months)-4 months treatment with isoniazid and rifampin

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15
Q

What is an aminoglycoside drug that can be used in TB?

A

-Streptomycin

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16
Q

What is a macrolide drug that can be used in TB?

A

-Azithromycin

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17
Q

What is a nucleic acid synthesis inhibitor drug that can be used in TB?

A

-Rifampin

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18
Q

What is the Drug of choice for a prophylaxis treatment of Mycobacterium tubercuosis?

A

-Isoniazid (INH)

19
Q

What is the mechanism of Isoniazid?

A

-Decreases Mycolic acid synthesis

20
Q

T/F Isoniazid is a prodrug

A

True

21
Q

Where is Isoniazid activated?

A

-Bacterial enzyme KatG

22
Q

Whenever you give a patient Isoniazid what do you always want to administer with it?

A

-Vitamin B6

23
Q

What is the purpose of administering vitamin B6 with Isoniazid?

A

-Maintain heme synthesis-Prevent neurotoxicity

24
Q

What are the adverse effects of Isoniazid?

A

-Hepatotoxicity-Disulfuram-Like reaction (Hangover feeling)

25
Q

What drug do you use in the treatment of Active Mycobacterium tuberculosis infection?

A

-Pyrazinamide

26
Q

What is the mechanism of Pyrazinamide?

A

-Inhibits mycolic acid cynthesis

27
Q

What are the adverse effects of Pyrazinamide?

A

-Hepatotoxicity-Can cause gout or make it worse-Contraindicated in pregnancy

28
Q

What does Pyrazinamide require to be activated?

A

-Acidic pH

29
Q

When is Ethambutal used?

A

-Treatment of active mycobacterium tuberculosis

30
Q

What is the mechanism of action for Ethambutal?

A

-Decrease carbohydrate polymerization by inhibiting arbinosal transferase

31
Q

What are the major adverse effects of ethambutal?

A

-Ocular toxicity-Ocular neuritis (lead to blindness)

32
Q

What drug do you use for multi-drug resistant TB?

A

-Bedaquiline

33
Q

What is the mechanism of Bedaquiline?

A

-Inhibit mycobacterial ATP synthase

34
Q

What is the adverse effect of Bedaquiline?

A

-Prolonged QT syndrome

35
Q

What are four drugs that cause hepatotoxicity?

A

-Rifampin-Isoniazid-Pyrazinamide-Dapsone

36
Q

What is the drug of choice for treatment for TB and Leprosy?

A

-Rifampin

37
Q

What is the drug of choice for prophylaxis of Leprosy?

A

-Dapsone

38
Q

What is the mechanism of Dapsone?

A

-Competes with PABA to inhibit bacterial dihydrofolate synthesis

39
Q

What two diseases do you use Dapsone in for prophylactic treatment?

A

-Leprosy-Pneumocystis jiroveci

40
Q

Which type of leprosy has a poor immune response?

A

-Lepromatous leprosy

41
Q

What type of leprosy has a good immune response?

A

-Tuberculoid leprosy

42
Q

What is the drug of choice for the treatment of traveler’s diarrhea due to E. coli?

A

-Rifaximin

43
Q

What is the drug of choice when you have invasive Campylobacter and Shigella causing traveler’s diarrhea?

A

-Ciprofloxacin (flouroquinolone)

44
Q

If you have Pseudomembranous colitis (C. difficile) causing diarrhea what is the drug of choice?

A

-Metronidazole

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