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Pharm Block 12 > TB And Worms > Flashcards

TB And Worms Flashcards

(66 cards)

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1
Q

1st line drugs for TB

A 
Rifampin 
Ethambutol 
Streptomycin 
Pyrazinamide 
Isoniazid

RESPIre

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2
Q

Drugs for mycobacterium Avium

A 
Macrolides 
Rifabutin 
Cipro
Ofloxacin
Clofazimine
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3
Q

Difference between mycoplasma and mycobacterium

A

Mycoplasma

  • causes atypical pneumonia
  • bacteria
  • NOT mycobacterium

Mycobacterium

  • slow growing
  • long treatment
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4
Q

Are mycobacterium fast or slow growing?

A

Slow growing

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5
Q

What does TB infect

A

Lungs

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6
Q

Tranmission of TB

A

Infected droplets are inhaled and bacilli deposited in lungs

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7
Q

What can TB cause

A

Massive pulmonary tissue damage

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8
Q

Dx of TB

A
  • productive cough lasting longer than 3 weeks
  • hemoptysis
  • fatigue
  • malaise
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9
Q

what is the most important TB drug

A

Isoniazid (INH)

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10
Q

MOA of isoniazid (INH)

A

Targets the enzyme responsible for assembly for mycolic acids into the outer layer of the mycobacteria

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11
Q

Resistance of isoniazid

A

Due to deletion of the gene that encodes for catalase (an enzyme required for activation of isoniazid)
-isoniazid stuck as inactive prodrug

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12
Q

Adverse effects of isoniazid

A

Peripheral neuritis (parasthesia)

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13
Q

What do people need to take when taking isoniazid to prevent peripheral neuritis

A

vitamin B6

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14
Q

Enzyme unique to mycobacterium

A

Mycolic acids

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15
Q

MOA of rifampin

A

Inhibits bacterial DNA dependent RNA polymerase, blocking transcription

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16
Q

Is rifampin specific to mycobacterium

A

No, it blocks bacterial DNA dependent RNA polymerase, blocking transcription, which is something that can affect several other organisms
-antimicrobial and antimycobacterium

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17
Q

Is rifamipin a P450 inhibitor or inducer

A

Inducer

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18
Q

Adverse affects of rifampin

A

Urine, feces, tears, and sweat will be red/orange

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19
Q

MOA of pyrazinamide

A

Sort of unknown, but know its metabolically activated to pyrazinoic acid

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20
Q

What are the uses of pyrazinamide

A

TB only

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21
Q

Adverse effects of pyrazinamide

A

Hyperuricemia

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22
Q

MOA of ethambutol

A

Inhibits synthesis of mycobacteria cell walls

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23
Q

Adverse effects of ethambutol

A

Optic neuritis, decreased VA, retinal damage with prolonged use, hyperuricemia and gout
-can cause RG colorblindness

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24
Q

What percent of patients on pyrazinamide will get hyperuricemia

A

100%

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25
What percent of patients on ethambutol will get hyperuricemia
50%
26
What types of drugs cause hyperuricemia the most
Weak acids - thiazides - loops - pyrazinamide (activated to pyrazinoic acid)
27
What TB drugs only target TB
Ethambutol Pyrazinamide Isoniazid
28
What drugs target TB and then some
Rifamipin | Streptomycin
29
MOA of streptomycin
Inhibits bacterial protein synthesis by binding to the 30s | -aminoglycoside (Like gentamicin)
30
Adverse effects of streptomycin
Ototoxicity Nephrotoxicity Neuromuscular paralysis
31
What kind of drugs other than TB does streptomycin get
Gram negatives
32
Why is streptomycin a back up drug
Because of its adverse effects and the fact that you have to be on the treatment for TB for months
33
Initiation phase of TB treatment
4 drugs for 2 months Isoniazid, rifamipin, pyrazinamide, ethambutol RIPE
34
Continuous phase of TB treatment
2 drugs for 4 months | Isoniazid and rifampin
35
What is the normal treatment regimen for TB
Initiation phase | Continuation phase
36
What is the first line agent for TB prophylaxis
Isoniazid
37
What is the second best option for TB prophylaxis
Rifampin
38
How is MAC treatment usually approached
Since it occurs in severely immunocompromised patients, we treat it prophylactically if we know they have low CD 4 counts instead of waiting until they have it
39
Who gets mycobacterium avium (MAC)
HIV patients with very low CD 4 counts (50)
40
What drugs are used for prophylaxis of MAC
Azithromycin Clarithomycin Rifabutin
41
MOA of rifabutin
Inhibits DAN-dependent RNA polymerase thereby blocking transcription (life rifampin)
42
Antibacterial spectrum of rifabutin
MAC
43
Adverse effects of rifabutin
Discolored urine
44
3 major categories of helminths
Nematodes, trematodes, and custody’s
45
Roundworms
Nematodes
46
Flatworms
Cestodes and trematodes
47
Another name for trematodes
Flukes
48
True tapeworms
Cestodes | Flatworms
49
What are the most common helminth infections
Pinworms and roundworms
50
Most common helminthic infection in the US
Enterobiasis (pinworm disease)
51
Symptoms of enterobiasis (pinworm disease)
White worms visible in the stools or perinatal area
52
What is the second most common helminthic disease in the US
Ascariasis (roundworm disease)
53
Onchocerciasis
River blindness | Major cease of blindness in Africa where the parasite once infected 20 million people
54
Drugs for treatment of nematodes
Albendazole Mebendazole Pyrantel pamoate Ivermectin
55
MOA of albendazole/mebendazole
Inhibits microtubule synthesis, cant undergo mitosis
56
drug of choice for roundworm, hookworm, whipworm and PINWORM
Albendazole or mebendazole
57
How to remember what albendazole/mebendazole do
Al or Me is bending over to see pinworm
58
What drug works similarly to succinylcholine that treats nematodes
Pyrantel pamoate
59
MOA of pyrantel
Persistently stimulates nicotinic receptors present at NMJ resulting in spastic paralysis of the worm
60
Co-drug of choice of roundworm, hookworm, and pinworm
Pyrantel
61
MOA of ivermectin
Acts as GABA agonist causing hyperpolarization of nerve and muscle cells and death of the worm
62
Drug of choice for onchocerciasis (river blindness)
Ivermectin “Rivermectin”
63
Adverse effects of ivermectin
Rashes, pain in joints | -give with antihistamines and NSAIDs
64
Drugs to treat trematodes and cestodes
Praziquantel
65
MOA of praziquantel
Increases membrane permeability to Ca causing muscle contraction followed by paralysis of muscles
66
Drug of choice for flukes and tapeworms
Praziquantel

Pharm Block 12 (7 decks)

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