Atypical Antimycobacterium drugs Flashcards Preview

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Flashcards in Atypical Antimycobacterium drugs Deck (21)
1

MOTT (mycobacterium other than TB) are generally not sensitive to

many anti-TB regimens

2

Rifabutin uses

Rifampin analog for single-agent prophylaxis of M. avium-intracellulare (MAC) in AIDS patients; recommended for those with low CD4 counts (<100/mm3)

3

Rifampin analog for single-agent prophylaxis of M. avium-intracellulare (MAC) in AIDS patients; recommended for those with low CD4 counts (<100/mm3)

Rifabutin

4

multi-drug treatment of MAC or other mycobacteria

Rifabutin

5

Toxicities of Rifabutin

• Similar to rifampin but less frequent
• Most common are nausea and rash
• Drug interactions similar to rifampin, but a less potent CYP inducer

6

part of multi-drug regimen for treatment of M. avium-intracellulare in AIDS patients and used for MAC prophylaxsis

Clarithromycin

7

Bactericidal, even for intracellular forms and works Synergistic or additive in vitro with rifabutin or clofazimine

Clarithromycin

8

M. avium-intracellulare (MAC; MAI)

Clarithromycin (or azithromycin) + ethambutol
(+ ciprofloxacin + rifabutin + clofazimine).

9

Two major types - lepromatous and tuberculoid (localized)
and Endemic areas: Asia, Africa, South America, Phillipines, South Pacific Islands

Leprosy or Hansens disease

10

Same as sulfonamides; structural analog of para-aminobenzoic acid (PABA); inhibits synthesis of folic acid
bacteriostatic

Dapsone
Is the ONE to use for leprosy

11

Mechanism for Dapsone

inhibits synthesis of folic acid
bacteriostatic
Same as sulfonamides; structural analog of para-aminobenzoic acid (PABA);

12

prophylaxis (& treatment) of Pneumocystis jiroveci (carinii) in AIDS patients

Dapsone

13

•Dapsone is used in combination with other drugs (e.g. rifampin)
Who should use this?

therapy with multiple drugs for all leprosy patients
• Prophylaxis for leprosy contacts

14

How is Dapsone metabolized?

Metabolized by the same enzyme which acetylates INH; slow and fast acetylators
• Metabolites excreted in urine
completely absorbed from GI tract
• Widely distributed to body fluids and tissues; especially concentrated in infected
skin`

15

Adverse affects of Dapsone

Hemolytic anemia and methemoglobinemia

16

Clofazimine mechanisms

binds to mycobacterial DNA interfering with reproduction and growth

17

Uses of Clofazimine

combination chemotherapy, often for sulfone-resistant leprosy
• Also in combination therapy for M. avium-intracellulare in AIDS patients

18

Bright red urine/GI well tolerated

Clofazimine

19

Clofazimine adverse effects

Red urine/well tolerated. some GI

20

Widely used in combination therapy (e.g. with dapsone)
Very active bactericidal antilepromatous drug

Rifampin

21

Some Treatment Regimens for Leprosy

a. For lepromatous disease: dapsone + clofazimine + rifampin daily for 2 years

b. For tuberculoid disease: dapsone + rifampin daily for 1 year