Pharm - Antimycobacterials

Front 1

Appropriate course of action for following pt: immigrant from SE Asia, tired for past mo, weight loss, fever and night sweats 2 weeks ago, cough with green sputum and blood, CXR with infiltrate in upper lobe; prelim dx of pulm TB

Back 1

hospitalize and start tx with INH, rifampin, pyrazinamide and ethambutol

Front 2

T or F about INH? flushing, palpitations, sweating, dyspnea after ingesting tyramine foods

Back 2

true; inhibits MAO type A

Front 3

T or F about INH? persons from SE Asia require lower maintanance doses

Back 3

false; fast acetylators like Native Ams and Asians require higher doses

Front 4

T or F about INH? should take pyridoxine daily

Back 4

TRUE

Front 5

T or F about INH? sx of peripheral neuritis may occur

Back 5

TRUE

Front 6

T or F about INH? risk of hepatitis is less than 2%

Back 6

true; 0.3% in 21-35 yo and > 2% in 50+ yo

Front 7

Which antimycobacterial agent can inhibit the action of BCPs?

Back 7

rifampin, by inducing formation of P450 which increases rate of elim of anticoags, ketoconazole, methadone and steroids

Front 8

Mech of high-level INH resistance in TB

Back 8

reduced expression of katG gene

Front 9

Optimal management of AIDS pt with CD4 = 100, persistent fever and weight loss, dx invasive MAC

Back 9

clarithromycin (or erythromycin), ethambutol and rifabutin (not rifampin due to drug interactions)

Front 10

If pt has pulm TB (resistance < 4%) is tx with INH, rifampin and pyrazinamide for 2 mo; then pyrazinamide is stopped, for how long due you continue the other drugs?

Back 10

4 mo; if pyrazinamide weren't given at all, INH and rifampin should be given for 9 mo

Front 11

Drug used prophylactically in contacts of kids with HiB and meningococcal and staph carrier states (but highly resistant strains may be selected during treatment)

Back 11

rifampin

Front 12

T or F about antitubercular drugs? antimycobact actions of streptomycin involve inhibition of arabinosyl transferase

Back 12

false; this occurs with ethambutol

Front 13

T or F about antitubercular drugs? cross resistance of M TB to INH and pyrazinamide is common

Back 13

false; because these have different MOAs

Front 14

T or F about antitubercular drugs? ocular toxicity of ethambutol is prevented by thiamine

Back 14

false; ocular toxicity is dose dep and reversible with D/C

Front 15

T or F about antitubercular drugs? pyrazinamide tx should be D/C immediately if hyperuricemia occurs

Back 15

false; this is a uniform SE and not a reason to D/C tx

Front 16

T or F about antitubercular drugs? Resistance to ethambutol involves mutations in emb gene

Back 16

TRUE

Front 17

Drug used in prophylaxis of bacteremia caused by MAC in AIDS pt

Back 17

azithromycin (due to long half life)

Front 18

Which antimycobacterial drug is most likely to cause loss of equil and auditory changes?

Back 18

amikacin (aminoglycoside)

Front 19

Meningitis prophylaxis in exposed patients

Back 19

rifampin

Front 20

Treatment for TB patients (think RIPE)

Back 20

Rifampin, Isoniazid, Pyrazinamide, and Ethambutol

Front 21

Common side effect of Rifampin

Back 21

Red urine discoloration

Front 22

Appropriate course of action for following pt: immigrant from SE Asia, tired for past mo, weight loss, fever and night sweats 2 weeks ago, cough with green sputum and blood, CXR with infiltrate in upper lobe; prelim dx of pulm TB

Back 22

hospitalize and start tx with INH, rifampin, pyrazinamide and ethambutol

Front 23

T or F about INH? flushing, palpitations, sweating, dyspnea after ingesting tyramine foods

Back 23

true; inhibits MAO type A

Front 24

T or F about INH? persons from SE Asia require lower maintanance doses

Back 24

false; fast acetylators like Native Ams and Asians require higher doses

Front 25

T or F about INH? should take pyridoxine daily

Back 25

TRUE

Front 26

T or F about INH? sx of peripheral neuritis may occur

Back 26

TRUE

Front 27

T or F about INH? risk of hepatitis is less than 2%

Back 27

true; 0.3% in 21-35 yo and > 2% in 50+ yo

Front 28

Which antimycobacterial agent can inhibit the action of BCPs?

Back 28

rifampin, by inducing formation of P450 which increases rate of elim of anticoags, ketoconazole, methadone and steroids

Front 29

Mech of high-level INH resistance in TB

Back 29

reduced expression of katG gene

Front 30

Optimal management of AIDS pt with CD4 = 100, persistent fever and weight loss, dx invasive MAC

Back 30

clarithromycin (or erythromycin), ethambutol and rifabutin (not rifampin due to drug interactions)

Front 31

If pt has pulm TB (resistance < 4%) is tx with INH, rifampin and pyrazinamide for 2 mo; then pyrazinamide is stopped, for how long due you continue the other drugs?

Back 31

4 mo; if pyrazinamide weren't given at all, INH and rifampin should be given for 9 mo

Front 32

Drug used prophylactically in contacts of kids with HiB and meningococcal and staph carrier states (but highly resistant strains may be selected during treatment)

Back 32

rifampin

Front 33

T or F about antitubercular drugs? antimycobact actions of streptomycin involve inhibition of arabinosyl transferase

Back 33

false; this occurs with ethambutol

Front 34

T or F about antitubercular drugs? cross resistance of M TB to INH and pyrazinamide is common

Back 34

false; because these have different MOAs

Front 35

T or F about antitubercular drugs? ocular toxicity of ethambutol is prevented by thiamine

Back 35

false; ocular toxicity is dose dep and reversible with D/C

Front 36

T or F about antitubercular drugs? pyrazinamide tx should be D/C immediately if hyperuricemia occurs

Back 36

false; this is a uniform SE and not a reason to D/C tx

Front 37

T or F about antitubercular drugs? Resistance to ethambutol involves mutations in emb gene

Back 37

TRUE

Front 38

Drug used in prophylaxis of bacteremia caused by MAC in AIDS pt

Back 38

azithromycin (due to long half life)

Front 39

Which antimycobacterial drug is most likely to cause loss of equil and auditory changes?

Back 39

amikacin (aminoglycoside)

Front 40

Meningitis prophylaxis in exposed patients

Back 40

rifampin

Front 41

Treatment for TB patients (think RIPE)

Back 41

Rifampin, Isoniazid, Pyrazinamide, and Ethambutol

Front 42

Common side effect of Rifampin

Back 42

Red urine discoloration

Front 43

Neurotoxicity with isoniazid (INH) prevented by

Back 43

Administration of Vit. B6 (pyridoxine)

Front 44

SE of INH

Back 44

Peripheral neuritis and hepatitis

Front 45

Drug of choice for leprosy

Back 45

Dapsone, rifampin and clofazimine combination

Front 46

MOA of rifampin

Back 46

inhibits DNA-dep RNA polymerase (encoded by rpo)

Front 47

drug used with vancomycin for MRSA and PRSP

Back 47

rifampin

Front 48

SEs of ethambutol

Back 48

dose dep visual disturbances (decreased acuity, red-green blindness, optic neuritis and retinal damage)

Front 49

MOA of dapsone

Back 49

inhibition of folic acid synthesis

Front 50

Drug used for leprosy that may cause skin discoloration (red-brown to black)

Back 50

clofazimine