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 (B)</p> Signup and view all the answers

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

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

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

<p>4 (D)</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 (D)</p> Signup and view all the answers

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

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

Which enzyme activates Isoniazid within Mycobacterium tuberculosis cells?

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

When is the continuation phase of tuberculosis treatment initiated?

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

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

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

Which enzyme is responsible for metabolizing Isoniazid in the liver?

<p>N-acetyltransferase (D)</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 (D)</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 (A)</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 (D)</p> Signup and view all the answers

How does Rifampin exert its bactericidal effect on mycobacteria?

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

What is the primary mechanism of resistance to Rifampin?

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

How is Rifampin mainly excreted from the body?

<p>Through the liver into bile (B)</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 (A)</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 (D)</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 (D)</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 (D)</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 (A)</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 (A)</p> Signup and view all the answers

Which adverse effect is occasionally associated with Rifampin use?

<p>Cholestatic jaundice (C)</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 (C)</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 (A)</p> Signup and view all the answers

What is the primary mechanism of resistance to ethambutol?

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

How does ethambutol affect renal failure patients?

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

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

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

When does ethambutol cross the blood-brain barrier?

<p>When the meninges are inflamed (A)</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 (A)</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 (D)</p> Signup and view all the answers

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

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

How is Rifampin mainly excreted from the body?

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

How does Pyrazinamide exert its activity against mycobacteria?

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

What is the main cause of resistance to Pyrazinamide?

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

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

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

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

<p>Lysosomes (D)</p> Signup and view all the answers

How is Pyrazinamide primarily absorbed in the body?

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

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

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

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

<p>Dapsone (A)</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 (C)</p> Signup and view all the answers

Where is Dapsone predominantly retained in the body?

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

What is a common metabolic fate of most excreted Dapsone?

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

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

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

In what scenario might the dose of Dapsone need adjustment?

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

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