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OS 213 Respiratory Exam 2 > Drugs for the treatment of TB and other Respiratory Infections > Flashcards

Drugs for the treatment of TB and other Respiratory Infections Flashcards

1
Q

Inhibition of Cell wall synthesis

A 
Penicillins
Cephalosporins
Vancomycin
Bacitracin
Isoniazid
Ethambutol
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2
Q

Inhibition of Protein synthesis

A

Ainoglycosides
tetracylcines
Chloramphenicol
Macrolides

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3
Q

Disruption of cytoplasmic membrane

A

Polymyxins

Polyenes

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4
Q

Inhibition of general metabolic pathway

A

Sulfonamides
Trimethoprim
Dapsone

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5
Q

Inhibition of DNA or RNA synthesis

A

Actinomycin
Nucleotide analogs
quinolones
rifampin

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6
Q

Inhibition of pathogen’s attachment to or recognition of host

A

Arildone

Pleconaril

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7
Q

treatment is based on the signs and symptoms in the involved organ system

A

Empiric therapy

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8
Q

Pharyngitis/Tonsilitis

A

Exudative or diffuse erythema (associated cough, rhinorrhea, hoarseness and/or ulcers suggest viral etiology) -no antibiotic

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9
Q

Herpes simplex

A

fever, irritability, pain upon swallowing, and regional lymphadenopathy

treatment is supportive and symptomatic

For immune-compromised and severe disease: acyclovir

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10
Q

Coxsackie A9, B-15, ECHO, Enterovirus 71

A

Herpangina - acute onset, fever, irritabilitu, a sore mouth, malaise, and difficulty eating

Vesicles develop on the posterior soft palate, tonsils and oropharynx

treatmet is supportive (no antiviral) - pain and fever management

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11
Q

Oral candidiasis

A

nystatin or miconazole gel

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12
Q

Bacterial Pharyngitis/Tonsilitis

A

Group A, C, G strep.

Ideally penicillin VK
(alternative: Amoxicillin give for 10 days)

Benzathine Pen G (Oily, single dose is equal to 2 weeks of oral penicillin)

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13
Q

Membranous pharyngitis due to diphtheria

A

C. diphtheria (human to human)
C. ulcerans
C. pseudotuberculosis (animal to human)

Diphtheria antitoxin (do scratch test before therapy)
Dose depends on stage of illness

48 hours: 20000-40000
NP membrane: 40000-60000
>3days plus bull neck: 80000-120000

Pen G
Phenoxymethylpenicillin

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14
Q

Gonococcal Pharyngitis

A

3rd generation cephalosporin: Ceftriaxone
<45kg : 125 mg single dose IM
>45 kg: 250 mg single dose IM

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15
Q

Most common cause of Acute OtitisMedia

A

H. Influenza and S. pneumoniae

Treat children <2 y.o
if >2 y.o afebrile, no ear pain, neg./questionable exam - consider analgesic treatment without antimicrobials

Usual dose: 40-60 mg/day
Amoxicillin 80-90 mg/kg/day div q12 x10d (<2 y.o) 7d (2-5), 5-7d (>6yo)

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16
Q

Most imprtant etiology of bronchiolitis

A

RSV

Ribavirin

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17
Q

CAP in neonates

A

G(-) Bacilli

Ampicillin + aminoglycosides is given

18
Q

PCAP A guidelines

A

Co-amoxiclav is already recommended

19
Q

Ideal TB drug

A

Can penetrate the mycolic acid layer and arabinogalactan layer

Can kill all kinds of TB whether dormant or active

Can immediately go to macrophages

20
Q

First line TB drugs

A 
INH
RIFAMPICIN
PYRAZINAMIDE
ETHAMBUTOL
STREPTOMYCIN
21
Q

Prodrug activated by catalase-peroxidase hemoprotein, KatG

A

Isoniazed (Isonicotinic acid hydrazide)

22
Q

High Early bactericidal activity that kills actively growing bacteria

A

Isoniazid

-rapid decrease in sputum bacilli for the first 2 weeks then slow down for non-growing bacterial populations

23
Q

Bactericidal against actively growing MTB, both intracellular and extracellular

A

ISONIAZID

-Bacteriostatic against dormant organisms

24
Q

INH KINETICS

A

A : Readily absorbed from GIT, Must be taken on an empty stomach

D: Diffuses well into all body fluids and tissues, CSF conc. 20-100% of serum, Penetrates well into caseous TB lesions)

M: NAT2 gene, Filipinos are rapid acetylators

E: Renal as unchanged drug

25
Q

ADverse effects of INH

A

Direct toxicity (Hepatic, peripheral, seiures, Hemolytic anemia)

Immunologic reactions (Fever and rash, Drug induced SLE)

26
Q

Antidote to INH

A

Vitamin B6

27
Q

Inhibits bacterial RNA synthesis by binding to the beta subunit of the DNA-dependent RNA polymerase, blocking RNA transcription

A

Rifampicin

-Semisynthetic derivative of rifamycon B, produce by amycolaptopssiis mediterrnei

28
Q

Bactericidal against rapidly proliferating MTB and against intracellular slow growing bacilli, also active against some g(+) and (-) organisms

A

Rifampicin

-Not to be used as monotherapy for other bacterial infections

29
Q

Rifampicin Kinetics

A

A: Well absorbed orally, undergoes enterohepatic circulation; must be taken on an empty stomach

D: Highly lipophilic, crosses BBB

M: Deacetylated, metabolite has antibacterial activity

E: Bile and Urine

30
Q

ADverse effect of Rifampicin

A 
Hepatotoxic, Hypersensitivity reactions
Orange color of body fluids
Hematologic abnormalities (Thrombocytopenia, HA)
31
Q

Wonder Drug that reduced treatment time of TB

A

Pyrazinamide

-synthetic analog of nicotinamide

32
Q

Bactericidal for tubercle bacilli in acid pH - intracellular in monocytes/marophages

A

Pyranizamide

33
Q

Important sterilizing agent active against residual intracellular organisms which can cause relapse

A

Pyranizamide

34
Q

Pyranizamide Kinetics

A

A: Well absorbed from the GIT

D: Widely distributed in body tissues including CNS, lung and liver

M: Hepatic, half life is 8-11 hours

E: Renal

35
Q

Adverse effect of Pyranizamide

A

Hepatotoxicity
HyperUricemia
Allergic Reactions

36
Q

Inhibits the snthesis of arabinoglycan by inhibiting arabinosyl transferase

A

Ethambutol

37
Q

Bacteriostatic in macrophages and active against large populations of bacilli in cavities

A

Ethambutol

38
Q

Ethambutol Kinetics

A

A: Well absorbed from the gut

D: CSF concentration increases with inflamed meninges

M: Partially metabolized in the liver

E: Feces and urine

39
Q

Aminoglycoside, BActericidal against MTB in vitro, Activity limited to extracellular bacteria

A

Streptomycin

40
Q

Streptomycin Kinetics

A

A: Poor, not given orally, Given only in IM or IV

D: Distribute into the most body fluids except the brain; therapeutics concentrations may pass in inflamed meninges

E: Renal

OS 213 Respiratory Exam 2 (15 decks)

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