9.0 Anti-Mycobacterials Flashcards Preview

Pharmacology > 9.0 Anti-Mycobacterials > Flashcards

Flashcards in 9.0 Anti-Mycobacterials Deck (15):
1

Which drugs are 1st line anti-mycobacterials? (5)

• Isoniazid
• Rifampin
• Rifabutin (1st line in HIV +ve patients)
• Ethambutol
• Pyrazinamide

2

Which drugs are 2nd line anti-microbacterials? (4)

• Streptomycin
• Ethionamide
• Levofloxacin
• Amikacin

3

Which anti-mycobacterial agent is the sole drug for latent infection?

Isoniazid

4

What is DOT?

Directly Observed Therapy: regiments are recommended in noncompliant patients or resistance strains.

-Healthcare worker is physically present when pt takes medicine

5

What is the MOA of Isoniazind?

• Pro-drug (activated by a mycobacterial catalaseperoxidase- KatG)
• Targets enzymes involved in mycolic acid synthesis:
• enoyl acyl carrier protein reductase (InhA)
• B-ketoacyl-ACP synthase (KasA)

6

How does Isoniazid resistance via mutations occur?

• mutation of deletion of KatG
• mutations of acyl carrier proteins
• overexpression of inhA

7

What is the most important adverse effect of Isoniazid?

Peripheral Neuritis

8

How is peripheral neuritis as a result of isoniazid corrected?

Pyridoxine supplementation

9

Besides Peripheral Neuritis, what are the other A.E. from Isoniazid?

• Hepatotoxicity: clinical hepatitis & idiosyncratic
• CYP P450 inhibitor
• Lupus-like syndrome: rare

10

What is the MOA of Rifampin?

• Blocks transcription by binding to B subunit of bacterial DNA-dependent RNA polymerase
-> leading to inhibition of RNA synthesis

11

What are the clinical uses of Rifampin?

• TB
• Latent TB in INH intolerant patients
• Leprosy
• Prophylaxis for individuals exposed to meningitis
• MRSA (with vancomycin)

12

How does Rifampin gain resistance?

• Point mutations in rpoB, the gene for the B subunit of RNA polymerase
-> decreased affinity of bacterial DNA-dependent RNA polymerase for drug

• Decreased permeability

13

What is the DOC for HIV patients with TB?

Rifabutin

14

Which Drugs would cause an orange/red body fluid discharge?

Rifampin

15

Which anti-mycobacterial drug is specific for strains of M.tuberculosis & M.kansasii?

Ethambutol