Antimycobacterial Drugs

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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?

N-acetylation and hydrolysis Signup and view all the answers

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

Fast acetylators have a shorter half-life Signup and view all the answers

What is the primary route of excretion of isoniazid?

Glomerular filtration and secretion Signup and view all the answers

What is the enzyme required for the activation of pyrazinamide?

Pyrazinamidase Signup and view all the answers

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

Because most of the clinical benefit occurs early in treatment Signup and view all the answers

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

Kidneys Signup and view all the answers

Why is ethambutol used in combination with other antitubercular drugs?

Pending culture and susceptibility data Signup and view all the answers

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

Because resistant strains rapidly emerge during monotherapy Signup and view all the answers

What is the mechanism of action of rifampin?

It interacts with the β subunit of mycobacterial DNA-dependent RNA polymerase Signup and view all the answers

What is the common side effect of pyrazinamide?

Uric acid retention Signup and view all the answers

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

Penetration into the CNS is variable Signup and view all the answers

Which of the following is rifampin effective against?

Both gram-positive and gram-negative organisms Signup and view all the answers

What is the cause of resistance to rifampin?

Mutations in the bacterial DNA-dependent RNA polymerase gene Signup and view all the answers

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

It induces their activity Signup and view all the answers

What is the fate of rifampin after oral administration?

It is distributed to all body fluids and organs and undergoes enterohepatic recycling Signup and view all the answers

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

Inhibition of folic acid Signup and view all the answers

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

Nephrotoxicity and ototoxicity Signup and view all the answers

Which drug is primarily excreted unchanged in the urine?

Cycloserine Signup and view all the answers

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

Disruption of D-alanine incorporation Signup and view all the answers

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

Ethionamide Signup and view all the answers

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

Isoniazid Signup and view all the answers

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

Inhibiting dihydropteroate synthase in the folate synthesis pathway Signup and view all the answers

Why should rifampin be avoided when taking the agent mentioned?

Because it is a strong CYP3A4 inducer Signup and view all the answers

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

Skin Signup and view all the answers

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

Hemolysis Signup and view all the answers

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

Urine Signup and view all the answers

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

Pneumonia caused by Pneumocystis jirovecii Signup and view all the answers

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

Liver Signup and view all the answers

What is the primary mechanism of action of bedaquiline?

Inhibiting the ATP synthase Signup and view all the answers

What is a common adverse effect of ethionamide?

Nausea and vomiting Signup and view all the answers

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

Moxifloxacin Signup and view all the answers

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

Azithromycin is less likely to interact with other drugs Signup and view all the answers

What is the boxed warning associated with bedaquiline?

QT prolongation Signup and view all the answers

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

Clarithromycin Signup and view all the answers

What is the primary route of administration of bedaquiline?

Oral Signup and view all the answers

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

Elevated liver enzymes Signup and view all the answers

What is the primary indication for bedaquiline?

Treatment of MDR-TB Signup and view all the answers

Antimycobacterial Drugs

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Questions and Answers

What is isoniazid effective against?

What is the main reason for resistance to isoniazid?

Why is absorption of isoniazid impaired?

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

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

What is the primary route of excretion of isoniazid?

What is the enzyme required for the activation of pyrazinamide?

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

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

Why is ethambutol used in combination with other antitubercular drugs?

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

What is the mechanism of action of rifampin?

What is the common side effect of pyrazinamide?

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

Which of the following is rifampin effective against?

What is the cause of resistance to rifampin?

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

What is the fate of rifampin after oral administration?

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

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

Which drug is primarily excreted unchanged in the urine?

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

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

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

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

Why should rifampin be avoided when taking the agent mentioned?

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

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

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

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

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

What is the primary mechanism of action of bedaquiline?

What is a common adverse effect of ethionamide?

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

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

What is the boxed warning associated with bedaquiline?

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

What is the primary route of administration of bedaquiline?

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

What is the primary indication for bedaquiline?

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