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