Tb Drugs

Front 1

standard therapy for tp

Back 1

RIPE for 8 weeks for initial phase
RI for weeks 8-26 weeks for cont phase

Front 2

why 4 drugs

Back 2

risk of resistance decreases

Front 3

when is streptomycin used

Back 3

hopspitalized, parenterally

Front 4

dominant bactericidal drugs

Back 4

PIE

Front 5

sterilizing drug

Back 5

rifampin b/c it has better penetration

Front 6

what makes RIPE compatible with eachother

Back 6

excellent absorption/distribution, similar half life, mixed hepatic/ clearance

Front 7

chemical relative of pyridoxine

Back 7

isoniazid

Front 8

bactericidal in growing mycobacteria

Back 8

INH

Front 9

disrupts mycolic acid synthesis (InHA and KasA)

Back 9

INH

Front 10

activated inside mycobacteria into active metabolite via KATG

Back 10

INH

Front 11

used as solo prophylaxis against TB

Back 11

INH

Front 12

resistance mechs of INH

Back 12

deletion of KAT G gene
overexpression/mutation of InhA and KasA

Front 13

fast acetylators of INH

Back 13

asians

Front 14

fast acetylators excrete INH as

Back 14

N-acetyl-INH

Front 15

slow acetylators have increased exposure to

Back 15

hepatotoxic metabolite- N acetyl-hydrazine which is metabolized by CYP 450

Front 16

major adverse effects of INH

Back 16

hepatotoxicity, neurtoxicity

Front 17

cofactor for GABA synthesis

Back 17

pyridoxine (vit b6)

Front 18

INH depletes pools of and leads to

Back 18

pyridoxine; neutoxicity

Front 19

inhibits DNA dependent RNA polymerase

Back 19

rifampin

Front 20

high intracellular penetration

Back 20

rifampin

Front 21

stains things red. orange

Back 21

rifampin

Front 22

strong inducer of cyp450

Back 22

rifampin

Front 23

increaeses metabolism of other drugs

Back 23

rifampin

Front 24

increases clearance of oral contraceptives, warfarin, statins, etc

Back 24

rifampin

Front 25

can increase clearance of HIV drugs

Back 25

rifampin

Front 26

substitute for rifampin for what in HIV pts?

Back 26

rifabutin

Front 27

active primarily at acidic pH

Back 27

pyrazinamide

Front 28

hepatotoxicity and gout

Back 28

pryrazinamide

Front 29

uncertain MOA that has to do with mycolic acid biosynthesis

Back 29

pryrazinamide

Front 30

requires activation in mycobacteria

Back 30

pryrazinamide

Front 31

reaches intracellular pathogens only at acidic pH

Back 31

pryrazinamide

Front 32

narrowest spec-targets only mycobacterium tb
broadest spec

Back 32

pryrazinamide and INH\
rifampin

Front 33

inhibits arbinosyl transferases (participates in cell wall synth) and cell wall synthesis

Back 33

ethambutol

Front 34

resistance mech of ethambutol

Back 34

mutation of enzyme

Front 35

optic neuritis, color disturbance, gout

Back 35

ethambutol

Front 36

gout side effect via blocking tubular secretion of urate

Back 36

ethambutol and pryrazinamide

Front 37

best therapy of tx

Back 37

DOT

Front 38

rule for 2nd line drugs

Back 38

NEVER ADD SINGLE 2ND LINE DRUG TO FAILED TX

Front 39

what 2 drugs do you always retain despite failed tx

Back 39

I and R

Front 40

in US, for pregnant women with TB, we leave out

Back 40

pyrazinamide

Front 41

tb in pts with HIV. tx what first?

Back 41

TB

Front 42

tx of latent tb

Back 42

INH and rifapentine, 3 months, once weekly

Front 43

MDR TB can be used in combo with at least 3 other drugs..NOT second line

Back 43

bedaquiline