Antituberculosis Drugs and Quinolones Overview
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Questions and Answers

What is the primary mechanism of action of clofazimine?

  • Inhibits folate synthesis
  • Inhibits bacterial cell wall synthesis
  • Disrupts protein synthesis
  • Inhibits template function of DNA (correct)
  • Which of the following is NOT a side effect of amithiozone?

  • Bone marrow depression
  • GIT disturbances
  • Renal failure (correct)
  • Hepatic damage
  • Which drug is considered the drug of choice for systemic fungal infections?

  • Ketoconazole
  • Nystatin
  • Amphotericin-B (correct)
  • Flucytosine
  • Which of the following adverse effects is commonly associated with intravenous administration of Amphotericin-B?

    <p>Fever and chills</p> Signup and view all the answers

    What type of infections is griseofulvin primarily used to treat?

    <p>Mucocutaneous infections</p> Signup and view all the answers

    Which statement is false regarding the pharmacokinetics of Amphotericin-B?

    <p>It requires dose adjustment in renal insufficiency</p> Signup and view all the answers

    What is a significant risk associated with prolonged use of amithiozone?

    <p>Antibiotic resistance</p> Signup and view all the answers

    Nystatin is primarily used in which form of treatment?

    <p>Topical therapy</p> Signup and view all the answers

    What is the primary mechanism of action of Cycloserine?

    <p>Inhibits bacterial cell wall synthesis</p> Signup and view all the answers

    Which of the following is a common side effect of Ethionamide?

    <p>Visual disturbances</p> Signup and view all the answers

    Which of these drugs is not typically used in the treatment of leprosy?

    <p>Streptomycin</p> Signup and view all the answers

    What adverse effect is associated with the use of Dapson?

    <p>Hemolytic anemia</p> Signup and view all the answers

    Why is it important to adjust the dosage of Cycloserine in patients with renal failure?

    <p>It is primarily excreted through urine</p> Signup and view all the answers

    What is the role of Pyridoxine (Vitamin B6) in the administration of antituberculous drugs?

    <p>To counteract peripheral neuropathy</p> Signup and view all the answers

    Which of the following is the mode of action of Rifampicin?

    <p>Inhibits DNA-dependent RNA polymerase</p> Signup and view all the answers

    What is the primary mechanism of action of Rifampicin?

    <p>Inhibits DNA-dependent RNA polymerase enzyme of mycobacteria</p> Signup and view all the answers

    Which adverse effect is associated with Ethambutol?

    <p>Retrobulbar neuritis</p> Signup and view all the answers

    What adjustment is necessary for dosing Ethambutol in patients with renal failure?

    <p>Dosing intervals should be extended</p> Signup and view all the answers

    Which of the following is a common side effect of Rifampicin?

    <p>Harmless orange discoloration of body fluids</p> Signup and view all the answers

    Leprosy treatment can include which of the following drugs?

    <p>Rifampicin</p> Signup and view all the answers

    Which of the following is NOT a side effect of Pyrazinamide?

    <p>Retrobulbar neuritis</p> Signup and view all the answers

    What is the antibacterial spectrum of Rifampicin?

    <p>Mycobacterium tuberculosis, Mycobacterium leprae, and prophylaxis for meningitis</p> Signup and view all the answers

    What should be monitored in patients taking Isoniazid?

    <p>Pyridoxine deficiency-induced peripheral neuritis</p> Signup and view all the answers

    Study Notes

    Quinolones

    • Quinolones can damage growing cartilage, contraindicated under 18, pregnant, and lactating women due to secretion in milk.
    • Can lead to tendon rupture.

    Tuberculosis

    • Infectious disease caused by Mycobacterium tuberculosis.
    • Primarily affects lungs, but can affect other organs.
    • Clinical features: fever, anorexia, hemoptysis, cough, sputum, weight loss, anemia, night sweats, enlarged lymph nodes, tubercle formation, necrosis, and lung fibrosis.

    Antituberculosis Drugs

    • First-line (standard) drugs: Isoniazid (INH), Rifampicin, Ethambutol, Streptomycin, Pyrazinamide.
    • Second-line (reserve) drugs: used if first-line drugs fail or if microorganisms are resistant; Examples: Ciprofloxacin, Ofloxacin, Amikacin, Cycloserine, Ethionamide, Para-aminosalicylic acid, Capreomycin, Rifabutin.
    • Drugs are typically given in combination to prevent bacterial resistance.

    Isoniazid (INH)

    • Mode of action: Inhibits mycolic acid synthesis in mycobacterial cell walls.
    • Pharmacokinetics: Orally absorbed; absorption impaired by food (especially carbohydrates and antacids), best taken before breakfast. Serum and cerebrospinal fluid levels are similar. Metabolized in the liver by acetylation; excretion in urine (some unchanged drug). Dosage adjustment may be needed for liver impairment, but not for kidney impairment.
    • Indications: Tuberculosis.
    • Side effects: Hypersensitivity reactions (skin rashes, fever), hepatitis (most frequent serious side effect, risk increases with age, pregnancy, and postpartum), peripheral neuritis (caused by pyridoxine deficiency), which is correctable with pyridoxine supplementation.

    Other Antituberculosis Drugs (brief overview)  

    • Rifampicin: Inhibits DNA-dependent RNA polymerase; used for tuberculosis, leprosy, and meningitis prophylaxis.  Side effects: nausea, vomiting, rash, fever, harmless orange discoloration of fluids (urine, sweat, tears). Interactions with other medications may affect their effectiveness.

    • Ethambutol: Inhibits RNA synthesis (prevents growth of resistant mutants).  Side effect: Retrobulbar neuritis (loss of visual acuity) and color blindness, contraindicated in children due to difficulty assessing side effects.

    • Pyrazinamide: Action unknown, but likely inhibits protein synthesis in tubercle bacilli. Side effects: liver damage, gastrointestinal disturbances, allergic skin rashes, gout.

    • Streptomycin: Inhibits protein synthesis (binding with 30S ribosomal subunit). Side effects: hypersensitivity reactions, cholestatic jaundice, hepatitis, vestibular nerve damage, nephrotoxicity, superinfection, interactions with other medications.

    • Ethionamide: Inhibits protein synthesis in tubercle bacilli. Side effects: allergic reactions, gastrointestinal disturbances.

    • Other drugs: Additional drugs are mentioned, but specifics are not elaborated on in a way that is informative enough for a summary here. 

    Leprosy

    • Caused by Mycobacterium leprae.
    • Causes characteristic skin and peripheral nerve lesions.
    • Drugs: Sulphones (e.g., dapsone), phenazines (e.g., clofazimine), anti-tubercular drugs (e.g., rifampicin), others (e.g., thiambutosine, amithiozone).

    Antifungal Drugs (overview)

    • Classification: Systemic (e.g. amphotericin B, flucytosine, azoles—ketoconazole, itraconazole, fluconazole, griseofulvin). Topical (e.g. nystatin, topical azoles).
    • Systemic antifungal drugs: Used for systemic fungal infections. Side effects may include renal failure, hypotension, anemia, hypersensitivity.
    • Topical antifungal drugs: Used for localized infections (skin, mucous membranes, vagina).

    Antiprotozoal Drugs (overview)

    • Malaria: Caused by Plasmodium parasites, transmitted by Anopheles mosquitoes.
    • Life cycle: Includes sporozoite, liver, and erythrocytic stages.

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    Description

    This quiz covers essential information regarding quinolones and antituberculosis drugs. It includes details on contraindications, clinical features of tuberculosis, and the classification of first-line and second-line antituberculosis medications. Test your knowledge about the interactions and impacts of these drugs on various populations and conditions.

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