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        | First Line antimycobaterials |  | Definition 
 
        | Isoniazid Rifampacin Pyrinizinamide Ethambutol |  | 
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        | Inhibits mycolic acid synthesis |  | 
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        | p450 inhibitor metabolized in liver
 various rates of acetylation
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        | All tissues- w/ high intracellular concentrations |  | 
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        | Hepatitis B6 defficiency- peripheral neuropathy, give pyridoxine
 Inhibition of Phenytoin metabolism- ataxma
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        | binds to beta subunit of Mb RNA pol --> inhibits transcription |  | 
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        | Reddish/ brown Urine Hepatitis
 Abdominal discomfort
 fever
 skin eruptions
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        | inc elimination of other drugs esp Birth control and HIV proteases- monitor the level |  | 
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 | Definition 
 
        | doesn't affect CYP450 so use in AIDs patients so don't inc elimination of PI |  | 
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        | Pyrizinamidase converts it to pyrizinmatoic acid --> unknown MOA |  | 
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        | well distributed in tissues but concentrates in cells |  | 
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        | active in acidic environments ie lysozomes inside of macropahges |  | 
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        | Hyperuricemia- Pyrazinoic acid inhibits renal secretion of Uric acid --> Gout monitor SGOT (liver enzyme) and uric acid Heptatitis
 Arthralgia, fever, skin rashes
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        | inhibits arabinosyl tranferase --> inhibits bac wall synthesis Bacerial static
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        | most tissues, including CNS --> used for TB meningitis |  | 
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        | Retrobulbar neuritis- Optic neuritis w/o swelling of optic disc.  R/G color blindness- Monthly tests for visual acuity Peripheral neuritis
 HA
 Rash
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        | occationally used in conjunction with first line tx |  | 
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        | distributes to tissues, but doens't concentrate in cells |  | 
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        | Excreted unchanged in urine, no liver metabolism |  | 
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        | Ototoxicity- vistibular and auditory renal injury
 hypersensitivity
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        | binds 30s subunit of bac ribosome- prevents initiation complex formation. Inhibits translation
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        | Paraminosalicylic Acid- PSA- MOA |  | Definition 
 
        | competes with PABA for Mb dihyropterase synthase, interferes with folic acid and thus DNA synthesis bacteriastatic
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        | oral well absorbed
 always with food
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        | GI- nausea, abdominal pain, diarrhea, nausea if not given w/ food Goiter, hypothyroidism
 Anemia
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        | Inhibits mycolic acid synthesis |  | 
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 | Definition 
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        | Ethionamide- distribution |  | Definition 
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        | Liver metabolizes it to ethionamide sulphoxide |  | 
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        | ethionamide sulphoxide- kidney excretion |  | 
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        | pyridoxine deficiency GI- N/D/ pain
 hepatotoxicity
 allergic reactions
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        | widely concentrates in reticuloendothelil system and is slowly let out, partially accounts for long half life
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        | metabolized to several inactive metabolites and excreted in the feces and urine |  | 
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 | Definition 
 
        | Drug accumulation in tissues turns- skin, urine, and feces a red brown color, so people with leprosy don't like it b/c it marks them GI disturbances
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        | Term 
 
        | Cycloserine/ kanamycin- MOA |  | Definition 
 
        | inhibits cell wall synthesis |  | 
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        | Cycloserine/ Kanmycin- use |  | Definition 
 
        | rarely used due to poor efficacy and adverse eventes |  | 
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 | Definition 
 
        | Ciprofloxacin Moxifloxacin
 Levofloxacin
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 | Definition 
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        | Fluroquinolones- disrtibution |  | Definition 
 
        | Low intracellular concentration |  | 
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        | inhibits folate synthesis |  | 
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        | excreted into bile, reabsorbed, excreted in urine |  | 
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        | well tolerated Fever, GI, rash, exoliative dermatitis
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        | Dapsone Contratindications |  | Definition 
 
        | Don't give to someone with sulfa drug allergies |  | 
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        | Streptomyocin Paramino Salacylic Acid
 Ethionamide
 Clofazamine
 Cyloserine/ Kanomycin
 Fluroquinolones, capreomycin
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        | Rifampin& Dapsone for 6 mnths Single lesion- Rifampin, ofloxacin, Minocycline
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        | Rifampin, Dapsone, Clofazamine- 12 mos |  | 
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        | Azithromycin Ethambutol
 Rifabutin
 Fluroquinolones
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