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6 Cards in this Set

  • Front
  • Back
Four drugs used in treatment of TB
Isoniazid
Rifampin
Ethambutol
Pyrazinamide
Isoniazid
1. Mechanism
2. Resistance
3. Pharmacokinetics
4. SE
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).
Rifampin
1. Mechanism
2. Resistance
3. Metabolism
4. Prophylactic use in other infections
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.
Ethambutol
1. Mechanism
2. SE
1. Inhibits arabinosyl transferase enzyme used in cell wall synthesis
2. SE include loss of color discrimination and visual accuity.
Pyrazinamide
1. Mechanism
1. Inhibits mycolic acid biosynthesis.
TB: Therapy Principles
1. Resistance
2. Tx targets
3. Initial and 2nd stage tx
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.