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ANTIMYCOBACTERIAL DRUGS
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ANTIMYCOBACTERIAL DRUGS

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Questions and Answers

What is one of the problems in treating Mycobacteria SPP mentioned in the text?

  • Fast growth rate
  • High permeability due to a thin cell wall
  • Dormant state in the body for a short period (correct)
  • Treatable with only one drug

    • Why are first-line agents always used in combination for treating Mycobacteria SPP?

  • To speed up the treatment process
  • To prevent the development of resistance (correct)
  • Because single-drug treatment is more effective
  • To reduce the cost of medication

    • What characteristic of the cell wall of Mycobacteria SPP makes it difficult for drugs to enter?

  • Thin structure
  • High permeability
  • Lipid-rich composition (correct)
  • Protein-rich composition

    • How long does it typically take for symptoms to develop after Mycobacteria SPP enters the body?

    <p>2-3 months</p> Signup and view all the answers

    When are second-line agents used in treating Mycobacteria SPP?

    <p>When first-line agents have failed</p> Signup and view all the answers

    How many drugs are typically given during the initial intensive phase of tuberculosis treatment?

    <p>4</p> Signup and view all the answers

    Which drug allows the total duration of therapy for tuberculosis to be reduced to 6 months without loss of efficacy?

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

    What is the mechanism of action of Isoniazid against Mycobacterium tuberculosis?

    <p>Inhibits mycolic acid synthesis</p> Signup and view all the answers

    Which enzyme activates Isoniazid within Mycobacterium tuberculosis cells?

    <p>Catalase-peroxidase (KatG)</p> Signup and view all the answers

    When is the continuation phase of tuberculosis treatment initiated?

    <p>After 2 months of treatment</p> Signup and view all the answers

    What is the main reason to extend tuberculosis treatment for an additional 4 months in some cases?

    <p>If Mycobacterium is still present</p> Signup and view all the answers

    What is the recommended daily dosage of Isoniazid for treatment of latent tuberculosis?

    <p>300 mg/d</p> Signup and view all the answers

    Which enzyme is responsible for metabolizing Isoniazid in the liver?

    <p>N-acetyltransferase</p> Signup and view all the answers

    What is a common adverse effect of Isoniazid that can be prevented by supplementing with Pyridoxine?

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

    Which body fluid or tissue has concentrations of Isoniazid ranging from 20% to 100% of simultaneous serum concentrations?

    <p>Central nervous system</p> Signup and view all the answers

    All medications can experience increased concentrations due to the inhibitory effects of Isoniazid on cytochrome P450 enzymes, except?

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

    How does Rifampin exert its bactericidal effect on mycobacteria?

    <p>By inhibiting RNA synthesis</p> Signup and view all the answers

    What is the primary mechanism of resistance to Rifampin?

    <p>Reduced binding of Rifampin to RNA polymerase</p> Signup and view all the answers

    How is Rifampin mainly excreted from the body?

    <p>Through the liver into bile</p> Signup and view all the answers

    What is a characteristic of Rifampin that allows it to kill intracellular organisms?

    <p>It penetrates into phagocytic cells</p> Signup and view all the answers

    How does Rifampin affect the elimination of other drugs in the body?

    <p>It increases the elimination of numerous other drugs by inducing cytochrome P450 isoforms</p> Signup and view all the answers

    What type of organisms is Rifampin active against in vitro?

    <p>Gram-positive organisms, some Gram-negative organisms, Mycobacteria, and Chlamydiae</p> Signup and view all the answers

    What is the mechanism of action of Rifampin in inhibiting bacterial RNA synthesis?

    <p>Binding to the β subunit of RNA polymerase</p> Signup and view all the answers

    Which factor can lead to resistance to Rifampin in bacteria?

    <p>Point mutations in the gene for the α subunit of RNA polymerase</p> Signup and view all the answers

    In what scenario does Rifampin achieve adequate cerebrospinal fluid concentrations?

    <p>Only in the presence of meningeal inflammation</p> Signup and view all the answers

    Which adverse effect is occasionally associated with Rifampin use?

    <p>Cholestatic jaundice</p> Signup and view all the answers

    How does Rifampin impact the metabolism of other drugs in the body?

    <p>It strongly induces most cytochrome P450 isoforms</p> Signup and view all the answers

    For what purpose is Rifampin commonly used as prophylaxis?

    <p>In contacts of children with Haemophilus influenzae type b disease</p> Signup and view all the answers

    What is the primary mechanism of resistance to ethambutol?

    <p>Overexpression of emb gene products</p> Signup and view all the answers

    How does ethambutol affect renal failure patients?

    <p>It accumulates in the body</p> Signup and view all the answers

    What is the most common serious adverse event associated with ethambutol use?

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

    When does ethambutol cross the blood-brain barrier?

    <p>When the meninges are inflamed</p> Signup and view all the answers

    In what scenario should ethambutol dosage be reduced to three times weekly?

    <p>If creatinine clearance is less than 30 mL/min</p> Signup and view all the answers

    What is the recommended monitoring schedule for visual acuity and color discrimination in patients taking ethambutol?

    <p>Baseline and monthly monitoring</p> Signup and view all the answers

    What is the active form of Pyrazinamide that exerts its activity against mycobacteria?

    <p>Pyrazinoic acid</p> Signup and view all the answers

    How is Rifampin mainly excreted from the body?

    <p>Through bile</p> Signup and view all the answers

    How does Pyrazinamide exert its activity against mycobacteria?

    <p>By disrupting cell membrane metabolism and transport functions</p> Signup and view all the answers

    What is the main cause of resistance to Pyrazinamide?

    <p>Mutations in pncA</p> Signup and view all the answers

    Where is Pyrazinamide converted to its active form, pyrazinoic acid?

    <p>Within mycobacteria by pyrazinamidase</p> Signup and view all the answers

    What is the primary site of action of Pyrazinamide against mycobacteria?

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

    How is Pyrazinamide primarily absorbed in the body?

    <p>By passive diffusion through cell membranes</p> Signup and view all the answers

    Which combination of drugs is recommended for the initial therapy of lepromatous leprosy?

    <p>Dapsone, Rifampin, Clofazimine</p> Signup and view all the answers

    What is the most widely used drug for leprosy that inhibits folate synthesis?

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

    Which adverse reaction is commonly associated with the use of Dapsone?

    <p>Hemolysis in individuals with G6PD deficiency</p> Signup and view all the answers

    Where is Dapsone predominantly retained in the body?

    <p>Skin, muscle, liver, and kidney</p> Signup and view all the answers

    What is a common metabolic fate of most excreted Dapsone?

    <p>Biliary excretion and intestinal reabsorption</p> Signup and view all the answers

    Which condition is often seen during Dapsone therapy of lepromatous leprosy?

    <p>Erythema nodosum leprosum</p> Signup and view all the answers

    In what scenario might the dose of Dapsone need adjustment?

    <p>Renal failure</p> Signup and view all the answers

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