Anti-Tb And Anti-Fungal

Front 1

Four drugs used in treatment of TB

Back 1

Isoniazid
Rifampin
Ethambutol
Pyrazinamide

Front 2

Isoniazid
1. Mechanism
2. Resistance
3. Pharmacokinetics
4. SE

Back 2

1. Inhibits mycolic acid synthesis-bactericidal
2. Resistance by random mutations in activating enzyme.
3. Depend on hepatic N-acetyl transferase isoform. Clearance via hepatic acetylation.
4. Hepatitis, peripheral neuropathy (avoided by giving pyridoxine (B6).

Front 3

Rifampin
1. Mechanism
2. Resistance
3. Metabolism
4. Prophylactic use in other infections

Back 3

1. Inhibits beta-subunit of DNA-dependent RNA polymerase--bactericidal
2. Rapid resistance d/t mutations in RNA polymerase when used alone
3. Induces cytochrome p450
4. Phophylaxis for n. meningitidis, h. flu type B.

Front 4

Ethambutol
1. Mechanism
2. SE

Back 4

1. Inhibits arabinosyl transferase enzyme used in cell wall synthesis
2. SE include loss of color discrimination and visual accuity.

Front 5

Pyrazinamide
1. Mechanism

Back 5

1. Inhibits mycolic acid biosynthesis.

Front 6

TB: Therapy Principles
1. Resistance
2. Tx targets
3. Initial and 2nd stage tx

Back 6

1. Resistance occurs rapidly.
2. Tx must address rapidly dividing cells and non-dividing persisters.
3. Initial tx uses 2-4 drugs qd for 2 months. 2nd stage uses 2 drugs (isoniazid and rifampin) for 4-10 months.