Flashcards in 9.0 Anti-Mycobacterials Deck (15):
Which drugs are 1st line anti-mycobacterials? (5)
• Rifabutin (1st line in HIV +ve patients)
Which drugs are 2nd line anti-microbacterials? (4)
Which anti-mycobacterial agent is the sole drug for latent infection?
What is DOT?
Directly Observed Therapy: regiments are recommended in noncompliant patients or resistance strains.
-Healthcare worker is physically present when pt takes medicine
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)
How does Isoniazid resistance via mutations occur?
• mutation of deletion of KatG
• mutations of acyl carrier proteins
• overexpression of inhA
What is the most important adverse effect of Isoniazid?
How is peripheral neuritis as a result of isoniazid corrected?
Besides Peripheral Neuritis, what are the other A.E. from Isoniazid?
• Hepatotoxicity: clinical hepatitis & idiosyncratic
• CYP P450 inhibitor
• Lupus-like syndrome: rare
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
What are the clinical uses of Rifampin?
• Latent TB in INH intolerant patients
• Prophylaxis for individuals exposed to meningitis
• MRSA (with vancomycin)
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
What is the DOC for HIV patients with TB?
Which Drugs would cause an orange/red body fluid discharge?