Antimycobacterials

Question 1

Isoniazid

Answer 1

TB (first line)

Activated by katG and inhibits synthesis of mycolic acids, important component of the mycobacterium cell wall

Hemolytic anemia

Question 2

Rifampicin

Answer 2

Aka Rifampin

TB (first line) and leprosy

Binds to and inhibits DNA-dependent RNA polymerase in prokaryotic cells

Acute interstitial nephritis (rare)
Orange tinge to saliva, tears, and sweat

Question 3

Ethambutol

Answer 3

TB (first line)

Likely inhibits arabinosyl transferase to impair mycobacterial cell wall synthesis

Optic neuritis (red-green colour blindness)
Peripheral neuropathy

Question 4

Pyrazinamide

Answer 4

TB (first line)

Analog of nicotinamide, inhibits fatty acid synthase and is tuberculostatic at acidic pH

Gout
Hepatic damage

Question 5

Capreomycin

Answer 5

TB (second line)

Peptide antibiotic likely binds to 70S ribosomal unit and inhibiting protein synthesis

Kidney damage
Auditory nerve injury (leads to deafness and ataxia)

Question 6

Cycloserine

Answer 6

TB (second line)

Broad-spectrum antibiotic that inhibits bacterial cell wall synthesis by preventing the formation of tripeptide side chain of N-acetlymuramic acid

Primarily CNS

Question 7

Bedaquiline

Answer 7

Inhibits ATP synthase in mycobacteria

New agent for MDR tuberculosis

Question 8

Delamanid

Answer 8

A cell-wall active nitro-dihydroimidazooxazoles that inhibits the synthesis of mycolic acids

New agent for MDR tuberculosis

Question 9

Dapsone

Answer 9

Leprosy treatment

Related to sulfonamides, likely act through folate synthesis inhibition

Hemolysis
Methemoglobinemia
Lepra reactions (making inflammation and leprosy worse)

Question 10

Clofazimine

Answer 10

Leprosy treatment

Dye, proposed to act on leprosy bacilli DNA

Reddish colour of the skin and urine