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Flashcards in TB And Worms Deck (66):
1

1st line drugs for TB

Rifampin
Ethambutol
Streptomycin
Pyrazinamide
Isoniazid

RESPIre

2

Drugs for mycobacterium Avium

Macrolides
Rifabutin
Cipro
Ofloxacin
Clofazimine

3

Difference between mycoplasma and mycobacterium

Mycoplasma
-causes atypical pneumonia
-bacteria
-NOT mycobacterium

Mycobacterium
-slow growing
-long treatment

4

Are mycobacterium fast or slow growing?

Slow growing

5

What does TB infect

Lungs

6

Tranmission of TB

Infected droplets are inhaled and bacilli deposited in lungs

7

What can TB cause

Massive pulmonary tissue damage

8

Dx of TB

-productive cough lasting longer than 3 weeks
-hemoptysis
-fatigue
-malaise

9

what is the most important TB drug

Isoniazid (INH)

10

MOA of isoniazid (INH)

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

11

Resistance of isoniazid

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

12

Adverse effects of isoniazid

Peripheral neuritis (parasthesia)

13

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

vitamin B6

14

Enzyme unique to mycobacterium

Mycolic acids

15

MOA of rifampin

Inhibits bacterial DNA dependent RNA polymerase, blocking transcription

16

Is rifampin specific to mycobacterium

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

17

Is rifamipin a P450 inhibitor or inducer

Inducer

18

Adverse affects of rifampin

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

19

MOA of pyrazinamide

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

20

What are the uses of pyrazinamide

TB only

21

Adverse effects of pyrazinamide

Hyperuricemia

22

MOA of ethambutol

Inhibits synthesis of mycobacteria cell walls

23

Adverse effects of ethambutol

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

24

What percent of patients on pyrazinamide will get hyperuricemia

100%

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