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Anti Tuberculous Dru
Pharmacology
| Question | Answer |
|---|---|
| Isoniazid (INH) uses? | TB |
| MOA of isoniazid (inh) | inhibition of mycolic acid synthesis (cell wall synthesis) |
| What does the TB bacteria have to be low resistance? | Person has deletion in INHA(Inhibin-A)gene encoding acyl carrier protein (Target). |
| What does the TB bacteria have to be high resistance? | Deletion in katG gene encoding catalase enzyme needed for INH bioactiviation. Kat G prevents activation of INH, by not allowing catalase to cleave enzyme to be made. |
| INH side effects | hepatitis, neuritis, hemolysis in G6PD deficiency, sle in slow acetylators |
| Why is Pyridoxine (Vit B6) is used with INH? | Prevent numbness and tingling that occur with INH neuritis. |
| If someone has a liver condition would you give them INH? | HELL NOOO BIOTCHHH. Why? it causes hepatitis. |
| Do you give INH to slow acetylators? | NO!!!!!! they can have sle like symptoms. |
| MOA of Rifampin | Inhibits DNA-dependant RNA polymerase |
| How does resistance to Rifampin occur? | Mutation in polymerase enzyme of the bacteria. |
| Effects of Rifampin | Red-orange discoloration of urine, sweat, and tears Proteinuria Flu-like symptoms Thrombocytopenia Induces p450 (meaning it increases metabolism) |
| Lady taking birth control walks in with TB. Would you give Rifampin? | NOOOOOOOOOO it induces p450 which would increase the metabolism of the birth control making it less effective. |
| Ethambutol MOA | Inhibits synthesis of Arabinoglactan (component of the cell wall) |
| Side effects of ethambutol | loss of red green acuity, retrobulbar neuritis (optic neuritis) |
| Pyrazinamide side effects | arthralgia due to hyuperuricemia hepatotoxicity increase porphyrin synthesis |
| patient with tb walks in. has abdominal pain, mimicing porphyria would you give them pyrazinamide for tb? | NOOO it increases porphyrin synthesis |
| would you give ethambutol to a person with tb that has ms? | NOOOOOOO because they already may of retrobulbar neuritis which will get worse with ethambutol as its a side effect of the medication. |
| Which drugs come under Aminoglycosides? | streptomycin, amikacin, and kanamycin |
| MOA of aminoglycosides | inhibits protein synthesis |
| side effects of streptomycin | hearing loss, ataxia, nephrotoxicity |
| side effects of amikacin | nystagmus |
| side effects of kanamycin | electrolyte abnormalities |
| Which drugs cause neuritis? | INH and Ethambutol |
| Which drug causes proteinuria? | Rifampin |
| Which drug causes thrombocytopenia and induces p450? | Rifampin |
| Arthralgia due to hyperuricemia can be caused by which drug? | Pyrazinamide |
| Which drug is bad for the kidneys? | Streptomycin |
| Side effects of Capreomycin? | Hearing loss, ataxia |
| Which other drug has the side effects of hearing loss and ataxia that can be used in combination with capreomycin for resistant tb? | Streptomycin |
| What drugs do you use for disseminated mycobacterium avium complex (dmac)? | Azithromycin, rifabutin, ethambutol |
| side effects of rifabutin | rashes, gi effects, neutropenia, induces p450, no hepatotoxicity. |
| person comes in saying they have stomach pain and they have a rash. say they were on med for tb...what med were they probably taking? | rifabutin |
| what are the similar side effects between rifampin and rifabutin? | both induce cytochrom p450 |
| differences between rifampin and rifabutin? | rifampin has the red-orange tears etc., proteinuria, flu-like symptoms, thrombocytopenia. rifabutin induces rashes, gi effects, neutropenia, but no hepatotoxicity like rifampin. |