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antimycobacterial drugs
pharm ch. 47
25
Pharmacology
Graduate
10/19/2009

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Term
clinical use of INH
Definition
tuberculosis
Term
MOA of INH
Definition
inhibition of mycolic acids
Term
MOA of rifampin
Definition
inhibits DNA-dependent RNA polymerase
Term
MOA of ethambutol
Definition
inhibits arabinosyl transferases
Term
the primary reason for use of drug combinations in the tx of TB is to
Definition
delay or prevent the emergence of resistance
Term
course of action for pulmonary TB is
Definition
hospitalize the pt and start tx w/ 4 antimycobacterial drugs
Term
when tx for TB is started, which drug regimen should be initiated in this pt?
Definition
INH, rifampin, pyrazinamide, ethambutol
Term
which statement concerning the possible use of INH in this pt is false
Definition
persons from southeast asia require lower maintenance doses of INH than most other persons in the US
Term
on her release from the hospital, the pt is advised not to rely solely on OC to avoid pregnancy b/c they may be less effetive while she is being maintained on antimycobacterial drugs. the agent most likely to interfere w/ the action of OC is
Definition
rifampin
Term
the mechanism of high level INH resistance of M TB is
Definition
reduced expression of the katG gene
Term
a pt w/ AIDS and a CD4 cell count of 100/uL has persistent fever and weight loss associated w/ invasive pulmonary disease that is due to MAC. optimal management of this pt is to
Definition
tx w/ TMP-SMX
Term
a pt w/ pulmonary TB resulting from an INH-susceptible strain of M tuberculosis (rate of INH resistance known to be <4%) has been treated w/ INH, rifampin, and pyrazinamide for a total of 2 mo. if the pyrazinamide is stopped at this time, tx should be continued w/ INH and rifampin for a min of
Definition
4 months
Term
a 10 yo boy has uncomplicated pulmonary TB. after initial hospitalization, he is now being treated at home w/ isoniazid, rifampin, and ethambutol. which statement about this case is accurate?
Definition
his mother, who takes care of him, should receive INH prophylaxis
Term
this drug has been used prophylactically in contacts of children w/ infection caused by H. influ B. it is also prophylactically in meningococcal and stap carrier states. although the drug eliminates a majority of meningococci from carriers, highly resistant strains may be selected out during treament
Definition
rifampin
Term
which statement about antitubercular drugs is accurate?
Definition
resistance to ethambutol involves mutations in the emb gene
Term
once weekly administration of which of the following antibiotics has prophylactic activity against bacteremia caused by MAC in AIDS pts?
Definition
azithromycin
Term
risk factors for multidrug-resistant TB
Definition
hx of tx of TB w/o rifampin, recent immigration from asia and living in an area of over 4% isoniazid resistance, recent immigration from latin america, residence in regions where isoniazid resistance is known to exceed 4%
Term
which drug is most likely to cause loss of equilibrium and auditory damage
Definition
amikacin
Term
side effects of INH
Definition
peripheral neuropathies
Term
side effects of rifampin
Definition
secretions turn red, hepatitis, increasing metabolism of OC
Term
side effects of pyrizinamide
Definition
hepatitis
Term
side effects of streptomycin
Definition
vestibular toxicity and nephrotoxicity
Term
side effects of capreomycin
Definition
ototoxicity and nephrotoxicity
Term
ethambutol side effects
Definition
reversible retrobulbar neuritis
Term
cycloserine (seromycin) side effects
Definition
allergic dermatitis, CNS toxicity
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