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40 Cards in this Set

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Anti TB first line agents
Isoniazid
Rifampin
Ethambutol
Pyrazinamide
Streptomycin
Second line TB drugs
Para- aminosalicylic acid
Ethionamide
Cycloserine
Why are second line TB drugs not a drug of choice but back up drug
TOXICITY
Anti Leprosy agents
Dapsone
Rifampin
Isoniazid MOA
Inhibits MYCOLIC ACID synthesis
Drug of choice for Mycobacterium Avium intracellulare (AIDS patients)
Ethambutol
MOA Rifampin
Inhibits RNA synthesis by binding to DNA dependent RNA polymerase
Pyrazinamide MOA
It is a prodrug that must be converted by pyrazinamidase present in M. tuberculosis to pyrazinoic acid which acts against intracellular organisms - NOT EFFECTIVE AGAINST OTHER MYCOBACTERIA- TB ONLY
Para aminosalicylic acid MOA
Inhibits dihydropteorate synthesis of tubercle bacilli - WIDELY DISTRIBUTED (except to the brain)
Ethionamide MOA
Blocks mycolic acid synthesis
Cycloserine MOA
Inhibits ALANINE RACEMASE and is an effective anti tumor agent
Dapsone MOA
- Inhibits folic acid production much like sulfonamides - resistance could develop
Most effective bactericidal drug against M.leprae (leprosy)
Rifampin
Which TB drug is best for disease that spread to the brain
Rifampin - great distribution to the tissues
Which drug in combination with trimethoprim used for prophylaxis of Pneumocystis carinii pneumonia in AIDS patients
Dapsone
Which TB drug concentrates in erythrocytes (serve as depot)
Ethambutol
Isoniazid adverse reactions
-HEPATOTOXIC especially in elderly and FAST acetylators
- Peripheral and central neuropathy - to fix this supplement with B6
Ethambutol adverse reactions
- Optic neuritis
- Joint pain
Rifampin adverse effects
- AT toxic levels drug present in tears, sweat, urine, saliva (turn red)
- Acetylates in liver
- Stomach cramps, drowsiness, fatigue, headache, renal failure could occur
Pyrazinamide adverse effects
- Hyperuricemia can occur - "pseudogout" - PATIENT SHOULD AVOID EATING MEAT
Para aminosalicylic acid adverse effects
Sever GI problems + HYPERSENSITIVITY
Ethionamide adverse effects
- SEVERE gastric pain
- Neurotoxic potential
- Resistance develops rapidly
Cycloserine adverse effect
Drug induced psychosis
Dapsone adverse effects
-Rashes
- Hemolytic anemia - check CBC
Isoniazid is contraindicated in _
- ALCOHOLIC - because of hepatotoxicity
- SEIZURE PATIENTS
Dapsone is contraindicated in patients with _
G6PD- increases risk of hemolytic anemia
Which drugs should not be used together with isoniazid
- Alfentanil- strong analgesic
- Carbamazepine and phenytoin
- Alcohol
Whic drug should not be used together with dapsone
Didanosine (HIV medication) - because DAPSONE requires acidic environment to be absorbed
How do you diagnose acute otitis media
Earache is the only symptom with sufficient positive predictive value
- Cloudiness and bulging of tympanic membrane can help in diagnosis
Most common pathogen causing otitis media
Strep. pneumoniae
What antibiotic is initial treatment of choice in otitis media
Amoxicillin, if that doesnt work give amoxicillin/clavulanate - AUGMENTIN - but may cause diarrhea
WHat is initial drug of choice for otitis media if the child is allergic to penicillins
Sulfonamides (bactrim) could be used as long as there is no hemolytic problems
For children allergic to sulfa drugs what would you give for otitis media
Erythromycin
Name few intracellular pathogens
Chlamydia
Rickettsia
Legionella
E coli
Shigella
Salmonella
Antibiotic of choice for Rocky Mountain Spotted fever
Doxycycline
MOA for tetracyclines
Tetracyclines inhibit 30S ribosome or more specifically anticodon reading portion of protein synthesis
Adverse effects for doxycycline
GI cramping or pain
CNS issues
allergy
phototoxicity - can lead to Stevenson-Johnson syndrome
If the patient with Rocky Mountain spotted fever intolerable to doxycycline, what is the next best drug
Chloramphenicol
Antibiotic with superior CSF penentration
Chloramphenicol
If patient with brain abscess is intolerant to chloramphenicol, what is the other drug
Ceftriaxone or ceftazidime
Imipenem+ cilastin is another option