Antimycobacterial Drugs
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Questions and Answers

What is isoniazid effective against?

  • Both rapidly growing bacilli and intracellular organisms (correct)
  • Only intracellular organisms
  • Neither rapidly growing bacilli nor intracellular organisms
  • Only rapidly growing bacilli

    • What is the main reason for resistance to isoniazid?

  • Chromosomal mutations (correct)
  • Genetic mutations in patients
  • Deletion of KatG
  • Overexpression of InhA

    • Why is absorption of isoniazid impaired?

  • When taken with water
  • When taken with food, particularly high-fat meals (correct)
  • When taken with other medications
  • When taken in a hot climate

    • What is the mechanism of inactivation of isoniazid in the body?

    <p>N-acetylation and hydrolysis (B)</p> Signup and view all the answers

    What is the difference between fast and slow acetylators of isoniazid?

    <p>Fast acetylators have a shorter half-life (C)</p> Signup and view all the answers

    What is the primary route of excretion of isoniazid?

    <p>Glomerular filtration and secretion (A)</p> Signup and view all the answers

    What is the enzyme required for the activation of pyrazinamide?

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

    What is the reason for usually discontinuing pyrazinamide after 2 months of a 6-month regimen?

    <p>Because most of the clinical benefit occurs early in treatment (B)</p> Signup and view all the answers

    What is the primary organ responsible for the excretion of ethambutol and its metabolites?

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

    Why is ethambutol used in combination with other antitubercular drugs?

    <p>Pending culture and susceptibility data (A)</p> Signup and view all the answers

    Why is rifampin not given as a single agent in the treatment of active tuberculosis?

    <p>Because resistant strains rapidly emerge during monotherapy (D)</p> Signup and view all the answers

    What is the mechanism of action of rifampin?

    <p>It interacts with the β subunit of mycobacterial DNA-dependent RNA polymerase (A)</p> Signup and view all the answers

    What is the common side effect of pyrazinamide?

    <p>Uric acid retention (A)</p> Signup and view all the answers

    What is the limitation of ethambutol in the treatment of tuberculous meningitis?

    <p>Penetration into the CNS is variable (A)</p> Signup and view all the answers

    Which of the following is rifampin effective against?

    <p>Both gram-positive and gram-negative organisms (A)</p> Signup and view all the answers

    What is the cause of resistance to rifampin?

    <p>Mutations in the bacterial DNA-dependent RNA polymerase gene (D)</p> Signup and view all the answers

    What is the effect of rifampin on hepatic cytochrome P450 enzymes?

    <p>It induces their activity (B)</p> Signup and view all the answers

    What is the fate of rifampin after oral administration?

    <p>It is distributed to all body fluids and organs and undergoes enterohepatic recycling (A)</p> Signup and view all the answers

    Which mechanism of action does para-aminosalicylic acid work through?

    <p>Inhibition of folic acid (B)</p> Signup and view all the answers

    What is the primary concern when using capreomycin for the treatment of MDR-TB?

    <p>Nephrotoxicity and ototoxicity (A)</p> Signup and view all the answers

    Which drug is primarily excreted unchanged in the urine?

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

    What is the primary effect of cycloserine on the bacterial cell wall?

    <p>Disruption of D-alanine incorporation (C)</p> Signup and view all the answers

    Which of the following drugs is a structural analog of isoniazid?

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

    Which of the following drugs is not typically used for the treatment of MDR-TB?

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

    What is the primary mechanism of action of dapsone in inhibiting bacteria?

    <p>Inhibiting dihydropteroate synthase in the folate synthesis pathway (B)</p> Signup and view all the answers

    Why should rifampin be avoided when taking the agent mentioned?

    <p>Because it is a strong CYP3A4 inducer (C)</p> Signup and view all the answers

    What is the primary site of concentration of dapsone in the body?

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

    What is a common adverse reaction of dapsone, especially in patients with glucose-6-phosphate dehydrogenase deficiency?

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

    What is the primary route of elimination of dapsone and its metabolites?

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

    What is another disease that dapsone is used to treat, besides leprosy?

    <p>Pneumonia caused by Pneumocystis jirovecii (A)</p> Signup and view all the answers

    What is the primary organ responsible for the metabolism of ethionamide?

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

    What is the primary mechanism of action of bedaquiline?

    <p>Inhibiting the ATP synthase (D)</p> Signup and view all the answers

    What is a common adverse effect of ethionamide?

    <p>Nausea and vomiting (A)</p> Signup and view all the answers

    Which of the following fluoroquinolones is effective against multidrug-resistant tuberculosis?

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

    What is the primary reason for preferring azithromycin over clarithromycin in certain patients?

    <p>Azithromycin is less likely to interact with other drugs (C)</p> Signup and view all the answers

    What is the boxed warning associated with bedaquiline?

    <p>QT prolongation (C)</p> Signup and view all the answers

    Which of the following macrolides is a substrate and inhibitor of cytochrome P450 enzymes?

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

    What is the primary route of administration of bedaquiline?

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

    Which of the following is a common laboratory abnormality associated with bedaquiline therapy?

    <p>Elevated liver enzymes (A)</p> Signup and view all the answers

    What is the primary indication for bedaquiline?

    <p>Treatment of MDR-TB (C)</p> Signup and view all the answers

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