Pharmacology Exam I

Card Set Information

Author:
Rx2013
ID:
61324
Filename:
Pharmacology Exam I
Updated:
2011-01-22 16:18:23
Tags:
Anti Mycobacterial Agents
Folders:

Description:
Anti-Mycobacterial Agents
Show Answers:

Home > Flashcards > Print Preview

The flashcards below were created by user Rx2013 on FreezingBlue Flashcards. What would you like to do?


  1. Tuberculosis no longer contagious after
    two weeks of therapy
  2. Those suceptible to tuberculosis infections
    • older
    • malnurished
    • HIV
  3. % of Tb patients that are HIV positive
    18-40%
  4. TB may be difficult to diagnose in aids pt due to
    decreased immune response to skin test antigens
  5. Targets of TB therapeutic agents
    • cell wall mycolic acid
    • cell wall polysaccharides
    • cell wall peptidoglycan
  6. First line treatments for TB
    • Isoniazid
    • Rifampin
    • Pyrazinamide
    • Ethambutol
    • Streptomycin
  7. Drug resistant TB is no longer killed by the agents
    • isoniazid
    • rifampin
  8. Isoniazid
    most active drug against sensitive strains
  9. Isoniazid MoA
    inhibition of Mycolic Acid synthesis
  10. Mutations resulting in Isoniazid resistance
    • inhA
    • KatG
    • KasA
  11. Possibility of a mutation when using 1 drug
    1 in 106
  12. possibility of a mutation when using 2 drugs
    1 in 1012
  13. Kinetics of Isoniazid
    • fast absorption
    • 20-100% CSF distribution
    • metabolized by acetylation
    • 3hr HL in slow acetylators
  14. If peripheral neuropathy developes with isoniazid use, use:
    pyridoxine
  15. Isoniazid toxicity
    • fever and rash
    • hepatitis
    • peripheral neuropathy
  16. Avoid isoniazid with this ARV
    stavudine
  17. Bacteriocidal agent against M. Tuberculosis and M. Leprae
    Rifampin
  18. Rifamycin MoA
    binds beta subunit of RNA polymerase
  19. Rifampin clinical use
    • atypical mycobacterium
    • latent infection
    • meningococcal carriage
    • prophylaxis against hemophilus influenza B
  20. Rifampin toxicity
    • orange body fluids
    • flu-like symptoms
    • liver toxicity
    • induction of CYP450 pathway
  21. Rifampin increases metabolism of
    • PIs
    • NNRTIs
  22. Ethambutol inhibits
    • arabinoglycan
    • arbinosyl transferase encoded by emb
  23. Isoniazid + ethambutal would have a _____ effect
    synergistic
  24. Ethambutol kinetics
    • good bioavailability
    • HL = 2-4 hr
  25. Ethamutol is contraindicated in
    children
  26. Pyrazinamide
    • active in lysosomes
    • unknown mechanism
    • resistance occurs by mutation in pncA
  27. Pyrazinamide kinetics
    • t1/2 = 8-11 hr
    • metabolism in liver
  28. Side effects of pyrazinamide
    • hepatotoxicity (1-5%)
    • hyperuricemia (gouty attack)
  29. Streptomycin
    • aminoglycoside
    • binds bacterial ribosome
  30. Side effects of streptomycin
    • n/v
    • rash
    • fever
    • ototoxic
    • nephrotoxic esp. in elderly
  31. Minimum duration of therapy for TB
    6 months
  32. duration of therapy with isoniazid + rifampin + pyrazinamide
    6 months
  33. duration of therapy with isoniazid + rifampin
    9 months
  34. Duration of therapy for rifamipn + ethambutol + pyrazinamide
    6 months
  35. Isoniazid target
    mycolic acid
  36. Rifamycin target
    RNA polymerase
  37. Ethambutol target
    arabinoglycan synthesis
  38. Pyrazinamide target
    unknown
  39. Streptomycin target
    protein synthesis (ribosome)
  40. Second line agens for TB
    • ethionamide
    • capreomycin
    • cycloserine
    • aminosalicylic acid
    • rifabutin
  41. Ethionamide
    • inhibits mycolic acid synthesis
    • poor OB
    • hepatotoxic and neurotoxic
  42. Capreomycin
    • protein synthesis inhibitor
    • nephro and oto toxic
    • contraindicated in pregnancy
  43. Cycloserine
    • inhibitor of cell wall synthesis
    • nephro and oto toxic
    • peripheral neuropathy
  44. Aminosalicylic acid
    • folate synthesis antagonist
    • hepatosplenomegaly
    • hepatitis
  45. Rifabutin
    • cross resistance with rifamycins
    • less potent inducer of CYP450 therefore recommended in HIV pt
  46. Keys to successful treatmet
    • at least 6 months of therapy
    • treatment within 4 days of diagnosis
    • monthly monitoring
    • compliance is crutial
  47. clinical improvemnt should be observed in
    10-14 days
  48. Sputum AFB performed
    every 2 weeks until negative
  49. Sputum cultures performed
    monthly until negative
  50. Treatment is continued for _____ beyond 1st negative culture
    3 months
  51. If cultures remain positive >4 months
    suspect resistance
  52. Drugs used in leprocy
    • dapsone (used with rifampin)
    • clofazimine (2 month half life)

What would you like to do?

Home > Flashcards > Print Preview