TB Tx Flashcards

Question

INH

Answer 1

prodrug activated by KatG

Answer 2

complex w/KasA which inhibits synthesis of mycolic acids, a cell wall component, killing cell

Answer 3

overexpression of inhA mutation or deletion in katG overexpression of aphC mutations in kasA

Answer 4

- hepatitis, age dependent, rare under 20, increased risk w/alcoholics and pregnancy - minor increases in liver aminotransferases (benign) - peripheral neurophathy and other CNS issues due to vit B deficiency, supplementation helps - drug fever - rashes - drug induced SLE

Answer 5

hepatitis | serious rxns

Answer 6

readily penetrates into phagocytic cells and can kill organisms that are poorly accessible to other agents

Answer 7

binds to beta-subunit of DNA dependent RNA polymerase inhibiting RNA synthesis bactericidal

Answer 8

several points of mutation in rpoB gene

Answer 9

``` mycobacterial infections menigococcal carriers prophylaxis of children exposed to H. influenza B staphylococcal carriers serious staphylococcal infections ```

Answer 10

``` strong P450 inducer extreme caution in HIV harmless red/orange color to urine, feces, saliva, sweat, tears, CSF, contact lenses rashes GI thrombocytopenia nephritis hepatotoxicity (not as common as INH) less then 2x/wk flu like symptoms ```

Answer 11

prodrug converted to pyrazinoic acid by pncA

Answer 12

imparied uptake of pyrazinamide | mutations in pncA

Answer 13

hepatotoxicity (most of all 1st line agents) GI hyperuricemia drug rash (most of all 1st line agents)

Answer 14

inhibits mycobacterial arabinosyl transferases encoded by embCAB, essential part of cell wall

Answer 15

overexpression of emb gene | mutations w/embB gene

Answer 16

retrobulbar neuritis-> loss of visual acuity, red-green color blindness CI in children where acuity and color vision cannot be assessed

Answer 17

aminoglycoside | well absorbed as IM, typically administered

Answer 18

irreversibly inhibitor of protein synthesis | 30S

Answer 19

mutations in rpsL gene mutations in rrs gene TB, MAC, and M. kansasii only mycobacteria that are susceptible

Answer 20

ototoxicity nephrotoxicity relative CI in prego

Answer 21

1st line resistance failure w/traditional therapy serious adverse effects of traditional therapy

Answer 22

``` ethionamide capreomycin cycloserine aminosalicyli acid (PAS) kanamycin and amikacin FQs linezolid rifabutin rifapentine ```

Answer 23

``` blocks synthesis of mycolic acids oral hepatotoxicity intense GI thyroid and neuro adverse effects single agent -> rapid resistance ```

Answer 24

``` peptide protein synthesis inhibitor IM injections resistance due to rrs mutations nephro and ototoxic significant pain and abscesses at injection site ```

Answer 25

inhibits cell wall synthesis | peripheral neuropathy and CNS dysfnx

Answer 26

folate synthesis inhibitor active exclusively against TB GI adverse effects severe hypersensativity rxns

Answer 27

protein synthesis inhibitors amikan less toxic used w/MDR and streptomycin resistant TB adverse effects- nephro and ototoxicity

Answer 28

block bacterial DNA synthesis via DNA gyrase and toposiomerase IV also active against atypical myco resistance due to point mutations in grase A used when resistant to first line agents GI and CNS disturbances can occur impaired glucose control

Answer 29

significant and potentially life-threatening adverse effects bone marrow suppresion, irreversible peripheral and optic neuropathy rifabutin

Answer 30

``` TB MAI M. fortuitum patients with HIV on ARV expensive ```

Answer 31

active against TB and MAI

Answer 32

dapsone rifampin clofazimine

Answer 33

similar to sulfonamides, inhibits folate synthesis hemolysis and methemoglobinemia common P. jiroveci in AIDs Tx as well

Answer 34

half life up to 2 months sulfone resistant leprosy skin discoloration, GI intolerance

Answer 35

resembles TB

Answer 36

``` cipro clarithromycin ethambutol INH rifampin trimethoprim-sulfamethoxazole ```

Answer 37

granulomatous cutaneous disease

Answer 38

``` Amikacin clarithromycin ethambutol doxycycline minocycline rifampin trimethoprim-sulfamethoxazole ```

Answer 39

cervical adenitis in kids

Answer 40

amikacin, erythromycin, rifampin, streptomycin | surgical excision Tx of choice

Answer 41

pulmonary disease in patients w/chronic lung disease, disseminated in AIDs

Answer 42

``` amikacin azithromycin clarithromycin cipro ethambutol rifabutin ```

Answer 43

abscess sinus ract ulcer bone, joint, or tendon infection

Answer 44

amikacin, doxy, imipenem, macrolide, tobramycin

Answer 45

abscess sinus ract ulcer bone, joint, or tendon infection

Answer 46

``` amikacin cefoxitin cipro doxy ofloxacin trimethoprim-sulfamethoxazole ```

Answer 47

skin ulcers

Answer 48

INH, streptomycin, rifampin, minocycline, | surgical excision