Antimycobacterials Flashcards

1
Q

first line drug for treatment of TB

A
RIPE
Rifamycins (Rifampin and Rifabutin)
Isoniazid
Pyrazinamide
Ethambutol
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2
Q

second line drug for treatment of TB

A
SALE
Streptomycin
Amikacin
Levofloxacin
Ethionamide
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3
Q

used for treatment of C. difficile

A

Fidoxomicin
Metronidazole
Vancomycin

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4
Q

drug regimen for latent TB and duration one should take the drug

A

Isoniazid for 6-9 months

Rifampin for 4 months

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5
Q

mechanism of isoniazid

A

is a pyridoxine (vit B6) analogue that targets mycolic acid synthesis enzymes, enoyl acyl carrier protein reductase (AcpM) and b-ketoacyl-ACP synthase

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6
Q

what activates isoniazid

A

mycobacterial catalase peroxidase

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7
Q

pharmacokinetics of isoniazid

A

one can be a fast acetylator or a slow acetylator of the drug and fast acetylators required higher doses

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8
Q

adverse effects of isoniazid

A

Lupus like syndrome
CYP450 inhibitor
Hepatotoxicity

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9
Q

can isoniazid be used in pregnancy

A

yeah but must supplement with pyridoxine aka vit b6

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10
Q

what are the rifamycins

A

rifampin and rifabutin

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11
Q

mechanism of rifamycins (name them)

A

rifampin and rifabutin

binds to beta subunit of bacterial DNA dependent RNA polymerase hence blocking transcription –> inhibition of RNA synthesis

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12
Q

preferred drug for treatment of TB in HIV positive patients

A

Rifabutin

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13
Q

adverse effects of rifamycins (name them)

A

rifampin and rifabutin

CYP450 inducer
Orange colored secretions
GI distress

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14
Q

mechanism of ethambutol

A

inhibits arabinosyl transferase involved in mycobacterial cell wall synthesis

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15
Q

adverse effects of ethambutol

A

dose dependent visual disturbances

red green color blindness

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16
Q

contraindications of ethambutol

A

children that are too young for vision tests

17
Q

mechanism of pyrazinamide

A

conversion of the drug to pyrazinoic acid lowering the pH of environment

18
Q

adverse effects of pyrazinamide

A

HAN

Hyperuricemia
Acute gouty arthritis
Non gouty polyarthralgia

19
Q

mechanism of ethionamide

A

congener of isoniazid

20
Q

drugs used to treat leprosy

A

Dapsone
Clofazimine
Rifampin

21
Q

mechanism of dapsone

A

dihydropteroate synthesis inhibition –> inhibition of folate synthesis

structurally similar to sulfonamides

22
Q

what is acedapsone

A

repository form of dapsone that provides inhibitory plasma concentration for several months

23
Q

adverse effects of dapsone

A

Erythema nodosum leprosum
Hemolysis esp in G6PD
CYP inhibitor

24
Q

mechanism of clofazimine

A

phenazine dye that bind to DNA to inhibit replication

also has redox properties that generate cytotoxic oxygen radicals

25
Q

adverse effects of clofazimine

A

red brown discoloration of skin (harmless)
GI irritation
eosinophilic enteritis