Anti-Mycobacterial Agents

Question 1

Treatment for rapidly growing tuberculosis with high bacillary load (cavitary)

Answer 1

Isoniazid

Question 2

Treatment for spurters within the caseous material (caseous)

Answer 2

Rifampicin

Question 3

Slow growing tuberculosis located intracellularly in macrophages and inflamed site

Answer 3

Pyrazinamide

Question 4

Treatment for dormant tuberculous bacilli

Answer 4

Not susceptible

Question 5

Symptoms of TB

Answer 5

chronic cough, fever, and weight loss

Question 6

Drug with the strongest/most potent sterilizing activity that covers all subpopulations

Answer 6

Rifampicin

Question 7

First line anti-TB drug that prevents relapse

Answer 7

Pyrazinamide

Question 8

First line anti-TB drug that prevents resistance

Answer 8

Ethambutol

Question 9

MOA of Rifampicin

Answer 9

RNA synthesis inhibitor

Question 10

MOA of Isoniazid

Answer 10

Mycolic acid (Cell wall) synthesis inhibitor)

Question 11

MOA of Pyrazinamide

Answer 11

Disruption of membrane energy metabolism

Question 12

MOA of Ethambutol

Answer 12

Cell wall synthesis inhibition (Arabinoglycan)

Question 13

DME inducer of the first line anti-TB drugs

Answer 13

Rifampicin

Question 14

DME inhibitor of the first line anti-TB drugs

Answer 14

Isoniazid

Question 15

Rifampicin’s adverse effect

Answer 15

Red orange secretions and urine

Question 16

Isoniazid’s adverse effect

Answer 16

Peripheral neuritis

Question 17

Pyrazinamide’s adverse effect

Answer 17

Hyperuricemia

Question 18

Ethambutol’s adverse effect

Answer 18

Optic neuritis and impaired red-green color discrimination

Question 19

Mechanism of resistance against Isoniazid

Answer 19

Mutation in Kat G and Inh A

Question 20

First line drug used for latent TB infection; bactericidal after 24 hours

Answer 20

Isoniazid

Question 21

Adverse effects of Isoniazid

Answer 21

Peripheral neuropathy (Vit B6 deficiency), Hepatitis, elevated ALT

Question 22

Co-administration of this drug inactivates isoniazid

Answer 22

Vitamin C

Question 23

Isoniazid increases toxicity of these drugs:

Answer 23

Phenytoin and Theophylline

Question 24

Isoniazid increases its hepatotoxicity with:

Answer 24

Rifampicin and alcohol

Question 25

Mechanism of resistance to Rifampicin

Answer 25

Mutation in rpo gene

Question 26

Alternative to Isoniazid for latent TB infection, to Isoniazid resistant organisms, or to MOTT

Answer 26

Rifampicin

Question 27

Drug given as an alternative to Rifampicin in HIV and TB patients

Answer 27

Rifabutin

Question 28

This first line anti-TB drug is inactive at neutral pH

Answer 28

Pyrazinamide

Question 29

Mechanism of resistance to Pyrazinamide

Answer 29

Mutation in pncA gene

Question 30

Dosage effects of Ethambutol

Answer 30

Bacteriostatic at usual dose (15mg/kg/day) | Bactericidal at high dose (>25mg/kg/day)

Question 31

Mechanism of resistance to Ethambutol

Answer 31

Mutation in emb B gene

Question 32

Clinical use of Ethambutol

Answer 32

Intermittent therapy for drug resistant TB, prevent emergence of resistance, treatment of NMTB

Question 33

First of the 2 phases of DOTS

Answer 33

Intensive or bactericidal phase: First 2 months, at least 4 drugs

Question 34

Second of the 2 phases of DOTS

Answer 34

Continuation or sterilizing phase: 3rd to 6th months, uses Isoniazid and Rifampicin

Question 35

Advantages of Fixed Dose Combination

Answer 35

Simplicity, monotherapy is avoided (less drug resistance), and improve patient compliance

Question 36

Resistance to a drug without prior treatment

Answer 36

Primary drug resistance

Question 37

Resistance to a drug developed during the treatment

Answer 37

Secondary drug resistance

Question 38

MDR plus resistance to fluoroquinolones and 1 injectable drug

Answer 38

Extensive drug resistance

Question 39

Presence of at least 1% of mycobacterium strains resistant to both isoniazid and rifampicin

Answer 39

Multi-drug resistance

Question 40

Indicated for TB meningitis and pericarditis

Answer 40

Steroids

Question 41

Mechanism of resistance to Streptomycin

Answer 41

Mutation in S12 protein encoded by rpsl and 16s rRNA encoded by rss gene

Question 42

Clinical indication for Streptomycin

Answer 42

Serious forms of TB (Disseminated TB and TB meningitis), and MDR-TB susceptible to streptomycin

Question 43

Drugs used for streptomycin resistant strains

Answer 43

Amikacin and Kanamycin

Question 44

Drugs used for streptomycin and kanamycin resistant strains

Answer 44

Capreomycin

Question 45

This hepatotoxic drug has an obnoxious taste and blocks mycolic acid synthesis similar to isoniazid

Answer 45

Ethionamide

Question 46

Mechanism of resistance to Ethionamide

Answer 46

Mutation in inhA

Question 47

Folic acid synthesis inhibitor used in patients with extended spectrum of drug resistance (XDR)

Answer 47

PAS (Para-amino salicylic acid)

Question 48

Drugs with flu-like syndrome

Answer 48

PAS and Rifampicin

Question 49

This drug is used in combination regimen for MDR-TB and is the last resort drug for MDR-TB resistant to first and second line drugs

Answer 49

Linezolid

Question 50

Adverse effect of Linezolid

Answer 50

Bone marrow suppression

Question 51

Respiratory fluoroquinolones having better activity than ciprofloxacin against TB Bacilli

Answer 51

Gatifloxacin and Moxifloxacin

Question 52

Potent analog of Rifamycins with a longer half life

Answer 52

Rifapenine

Question 53

Newly repurposed anti-tuberculosis drugs

Answer 53

Bedaquiline and Delamanid

Question 54

MOA of Fluoroquinolones

Answer 54

DNA gyrase inhibition

Question 55

Booster for BCG Vaccine

Answer 55

MYA85A

Question 56

MOA of Dapsone

Answer 56

Dihydropteroate synthase inhibitor (inhibiting folic acid synthesis)

Question 57

Used for all forms of leprosy, dermatitis herpetiformis and prophylaxis and treatment of Pneumocystis jirovecii

Answer 57

Dapsone

Question 58

Adverse effects of Dapsone

Answer 58

Steven-Johnson syndrome and Sulfone Syndrome

Question 59

Fastest bactericidal for Mycobacterium leprae

Answer 59

Rifamycin

Question 60

Greatest limiting factor for Rifamycin usage

Answer 60

Cost

Question 61

This drug accumulates in tissues for prolonged periods making possible discontinuous treatment separated by 4 weeks

Answer 61

Clofazimine

Question 62

Drug used for Erythema Nodosum Leprosum and M. avium intracellulare infection

Answer 62

Clofazimine

Question 63

Long acting tetracycline that has ototoxic effects

Answer 63

Minocycline

Question 64

Drug of choice for treatment of Erythema Nodosum Leprosum

Answer 64

Thalidomide

Question 65

Alternative treatment for Erythema Nodosum Leprosum

Answer 65

Corticosteroid