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Respiratory II > Treatment for TB > Flashcards

Treatment for TB Flashcards

1
Q

First-line agents for TB

A

Rifampin
Isoniazid
Pyrazinamide
Ethambutol

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2
Q

Mechanism of rifampin

A

Binds to beta subunit of bacterial DNA dependent RNA polymerase to inhibit RNA synthesis

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3
Q

Bacterial resistance to rifampin

A

Point mutation in beta subunit gene
Decreased binding

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4
Q

Contraindications of rifampin

A

Strong CYP450 inducer

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5
Q

Drug for TB that turns urine, sweat, and tears orange

A

Rifampin

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6
Q

Adverse effects of rifampin

A

Cholestatic jaundice
Hepatitis
Light-chain proteinuria
Flu-like syndrome
Acute tubular necrosis

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7
Q

Drug that inhibits synthesis of mycolic acids after activation by bacterial catalase peroxidase

A

Isoniazid

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8
Q

Bacterial resistance to isoniazid

A

Decreased KatG

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9
Q

Drug for TB that is metabolized by liver N-acetyltransferase and thus affected by rapid vs slow acetylators

A

Isoniazid

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10
Q

Adverse reactions of isoniazid

A

Hepatitis
Drug induced SLE
Peripheral neuropathy
Sideroblastic anemia

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11
Q

Reason for peripheral neuropathy adverse effect of isoniazid

A

Relative pyridoxine deficiency

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12
Q

How is pyrazinamide converted to pyrazinoic acid, its active form?

A

Mycobacterial pyrazinamidase

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13
Q

Mechanism of pyrazinamide

A

Disrupts mycobacterial cell membrane metabolism and transport functions

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14
Q

Bacterial resistance to pyrazinamide

A

Impaired uptake
Mutations in pyrazinamidase

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15
Q

Adverse effects of pyrazinamide

A

Hepatoxicity
Hyperuricemia

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16
Q

Drug that inhibits mycobacterial arabinosyl transferases and polymerization reaction of arabinoglycan

A

Ethambutol

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17
Q

Bacterial resistance to ethambutol

A

Mutations resulting in overexpression of arabinosyl transferase gene

18
Q

Adverse reactions of ethambutol

A

Retrobulbar neuritis

19
Q

TB drug that can cause loss of visual acuity and red-green color blindness

A

Ethambutol

20
Q

Intensive phase of treatment for active TB infection

A

2 months of RIPE

21
Q

Continuation phase of treatment for active TB infection

A

Rifampin and isoniazid for 4 months

22
Q

Adjuvant treatment for active TB infection

A

Pyridoxine

23
Q

Treatment for latent TB infection

A

Isoniazid for 9 months

24
Q

Second-line drug for TB mainly active against EC tubercle bacilli

A

Streptomycin

25
Q

Site of action of streptomycin

A

30S subunit of ribosome

26
Q

Adverse effects of streptomycin

A

Ototoxic - vertigo and hearing loss
Nephrotoxic

27
Q

Adverse effects of capreomycin

A

Nephrotoxic
Ototoxic - tinnitus, deafness, vestibular disturbance

28
Q

Structural analog of D-alanine that inhibits wall synthesis. Used as a second-line treatment for TB.

A

Cycloserine

29
Q

Adverse effects of cycloserine

A

Peripheral neuropathy
CNS dysfunction

30
Q

Adverse effects of ethionamide

A

Hepatotoxicity
Neurologic symptoms

31
Q

Drug given to reduce/alleviate the neurologic side effects of cycloserine and ethionamide

A

Pyridoxine

32
Q

Mechanism of ethionamide

A

Blocks synthesis of mycolic acids

33
Q

Folate synthesis antagonist structurally similar to PABA and used as a second-line treatment for TB

A

Aminosalicylic acid (PAS)

34
Q

Bacterial RNA polymerase inhibitor often used in place of rifampin for treatment of TB in pts with HIV on antiretrovirals

A

Rifabutin

35
Q

Rifamycin that is a less potent CYP450 inducer

A

Rifabutine

36
Q

Effective short course treatment of latent TB when combined with isoniazid

A

Rifapentine

37
Q

Second-line drug for TB that inhibits ATP synthesis in mycobacteria

A

Bedaquiline

38
Q

Adverse effect of bedaquiline

A

QTc prolongation

39
Q

Second-line drug for TB that acts as a respiratory poison following NO release

A

Pretomanid

40
Q
A

Respiratory II (17 decks)

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