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89 Cards in this Set
- Front
- Back
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mycobacteria: gram ---
acid-fast ----- |
positive
bacilli |
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mycobacteria has distinct --- layer forms ---- cell coat
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phosphoglyclipid
waxy |
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what acid forms waxy cell coat
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mycolic
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mtb very --- growing, can exist in -- states for long periods of time
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slow
dormant |
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m abcessus, fortuitum, chelonae is slow/fast growing
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fast
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what gives mycobacteria extra protection so meds have to penetrate
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waxy cell
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why do you have to tx tb for long periods of time
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tb
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in tb the particles are phagocytized by -----, form ---
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macrophages
granulomas |
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tb can cause --- infection
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latent
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what percent of latent will turn into active infection
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10%
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combo tx given for tb in the 1st 2 months
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isoniazid
rifampin ethambutol pyrazinamide |
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4 mo of comb tx for tb includes
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isoniazid
rifampin |
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what meds will help get into gramuloma
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ethambutol
pyrazinamide (very toxic. . . don't take long term) |
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pulmonary tb tx for --- months
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6-9 months
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hiv pt w/ tb give tx for --- months
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9-12 months
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how long do you give tb tx if complicated . . . in other body parts?
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18-24 months
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why shouldn't u use single tx for tb
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to prevent resistance
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when is isoniazid bacteriostatic?
cidal? |
static: latent
cidal: dividing bacteria |
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isoniazid inhibits --- ---- production
inhbits --- ----- --- |
mycolic acid
waxy cell coat |
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75-95% excreted as --- metabolite
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acetylated
. . . . eskimos are fast acetylators so need high doses |
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fast to slow acetylators of isoniazid t1/2's
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70 min vs. 2.5 hrs
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isoniazid metabolically activated by bacterail ---- ----
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catalase-perioxidase
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isoniazid reissitance:
by mutation in dna coding for --- --- |
activation enzyme
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isoniazid ---- absorbed
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well
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t/f
isoniazid doesn't xcns |
f
x cns |
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when do u use isoniazid alone
in combo |
alone: prophylactic use
combo: active disease |
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allergic rx w/ isoniazid
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lupus like syndrome
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ae of isoniazid
----. . . its increased w/ etoh and w/ age |
hepatitis
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how is peripheral neuritis caused w/ isoniazid
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pyridoxine deficiency
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cns ae w/ isoniazid
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seizures
euphoria psychosis memory impairment |
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when do u use isoniazid alone
in combo |
alone: prophylactic use
combo: active disease |
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allergic rx w/ isoniazid
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lupus like syndrome
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ae of isoniazid
----. . . its increased w/ etoh and w/ age |
hepatitis
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how is peripheral neuritis caused w/ isoniazid
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pyridoxine deficiency
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cns ae w/ isoniazid
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seizures
euphoria psychosis memory impairment |
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semi synthetic form of rifamycin b from
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rifampin
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rifampin is broad/narrow spectrum
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broad
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rifampin is gram --- or -----
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positive
negative |
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rifampin inhibits dna dependent --- ------,
forms complex w/ ---- |
rna polymerase
enzyme |
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rifampin rarely used alone cuz of --- ----
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rapid tolerance
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primary use of rifampin
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tb
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rifampin is a prophylatic for
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meningococcal
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rifampin used for gram neg only . . . .what disease
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endocarditis
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ae of rifampin:
induces ----- |
p450
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liver probs w/ rifampin
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jaundice
hepatitis (chronic liver disease) |
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what med causes orange colored secretions
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rifampin
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hypersensitivity of rimfapin:
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flu-like syndrome
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rifampin can cause -- disturbances
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gi
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ethambutol is bacterio----
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static
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ethambutol inhibits --- ----
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mycolic acid incorporation into membranes
no effect on other bacteria |
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ethambutol ----- the cell wall and allows other agents better access
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weakens
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75% of ethambutol excreted ----
adjust in --- disease |
unchanged
renal |
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when will resistance develop w/ ethambutol
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if used alone develops quickly
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ae of ethambutol:
--- disturbances decreased ----- disrimination decreased ---- --- icreaed --- --- levels |
visual (limited in kids)
red-gree visual uric acid |
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pyrazinamide is comverted to --- -----
lowers--- so bact can't grow enters ---- |
pyrazinic acid
pH macrophages |
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pyranzinamide will decrease duration of ----
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combo tx
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when do you give pyrazinamide
why |
1st 2 months
to avoid liver toxicitiy |
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ae of pyrazinamide:
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hepatitis
inhibits uric acid. . . all hyperuricemic avoid in pregnancy |
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t/f
ok to use pyrazinamide in pregnancy |
f
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if there --- or ---- resistance tx for 18-24 months
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isoniazid
rifampin |
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leprosy:
bacterium distributes from --- to ---- esp body parts w/ cooler temp |
blood
tissue |
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leporosy is endemic in many -- partos of the world
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tropical
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#1 tx for leprosy
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dapsone
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daposone inhibits mycobacteria -- --- -------
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folic acid syntheisis ( r/t sulfonamides)
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dapsone slowly accumulates in ----, -----, ---- quickly/slowly to tx levels
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skin
kidney liver slowly |
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why resistance w/ dapsome
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long term use
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what pneumonia is dapsome effective in
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pneumocystis jerovicii in aids patients
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dapsome:
immunosuppressive activity: systemic --- |
lupus
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ae of dapsone:
---lysis - glucose - phosphate deficiency -- disturbances --- rash, ---- |
hemolysis
gi fever puritis |
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CLOFAZAMINE binds to ---
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DNA
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t1/2 of clofazamine
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70 days
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clofazamine accumulates in ---
excreted in --- |
fat
bile |
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clofazamine causes --- discoloration
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skin
lesions turn red or black |
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prob w/ clofazamine
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compliance due to color change. .. .stigma w/ leprosy
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dapsome resistance use ---
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amithiazone
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what do you use for resistant tb and leprosy
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thalidomide
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type 1 rxn to leprosy
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lesions swell
edematous ulcerate |
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type 2 rxn to leprosy
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nodular rash
high fever arthritis nephritis lymph nodes tx w/ thalidomide |
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t/f
if there's a leprosy rxn you withdraw tx |
f
cuz will not kill need to take for a long time |
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mycobacterium avium complex seen most frequently in ---- pts
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immunocompromised
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mycobacterium avium complex is a --- disease
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pulmonary
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10-40% of -- pt infectec w/ mycobacterium avium complex
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HIV
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mycobacterium avium complex can occur w/ cd4 count below ---
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100
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what to use against mycobacterium avium complex
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rifabutin
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rifabutin is -- soluble
t1/2: |
lipid
45 hrs |
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rxn of rifabutine
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rash
neutropenia blurred vision discolors body fluids induces P-450 enzymes |
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what other meds can u use against mycobacterium avium complex
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clarithomycin
azithromycin plus ethambutol rifampin clofazimine |
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combo tx used against mycobacterium avium complex for -- weeks
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16
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what do u use for HIV pt w/ mycobacterium avium complex
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clarithromycin and azithromycin prophylaxis
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