Term
| What are the 5 main Rxs used to Tx TB? |
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Definition
| Isoniazid (INH), Rifampin (Apart of Rifamycins: Rifabutin, Rifapentine), Pyrazinamide, Ethanbutol, Streptomycin |
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Term
| What is the first line Tx for TB? |
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Definition
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Term
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Definition
| Narrow spec., CNS (A/Es), Inhibits P450, Peripheral neuritis (Tx with Vit. B12), ProRx -> Rx via KatG and acts on AcpM & KasA, is both static and cidal, is broken down by N-acetylation, dont take w/ food (esp carbs or aluminum coated antacids) |
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Term
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Definition
| Inhibits RNA synthesis via binding to beta-subunit, broad spec., -cidal, Taken orally, enters CNS, leaves in bile and urine, sole Rx in Tx INH intolerant pts, prophylaxsis 4 meningitis pts, A/Es: light chain proteinuria, flu-like syndrome, harmless orange fluids |
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Term
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Definition
| Used in HIV pts, A/Es: uveitis, skin hyperpigmentation, neutropenia |
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Term
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Definition
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Term
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Definition
| Is a pro-> pyrazinoic acid (broken down by pyrazinamidase) via hydrolase, -cidal, given in combo, MAO?, oral, CNS, A/Es: asym hyperuremia, nongouty polyarthralgia, photo sens, hepatotoxicity, myalgia, GI irritation, porphyria, avoid in preg |
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Term
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Definition
| Narrow spec., CNS, -static, unchanged & in urine, gout, can combo, inhibits cell wall syn., dose dependent eye probs |
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Term
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Definition
| Used for Rx resistant strains that cause millilary desemmination, A/Es: oto & nephro -toxicity, vertigo, permenent hearing loss |
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Term
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Definition
| Used for streptomycin- or multi-Rx-resistant strains, used in combo |
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Term
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Definition
| Used when resistance is to 1st line, used in combo |
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Term
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Definition
| Congener of INH (no cross resistance), severe GI irritation + adverse neurologic effects |
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Term
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Definition
| INH for 6-9 mos, Rifampin 4 mos |
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Term
| What is the standard regimen for empirical Tx of pulmonary TB? |
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Definition
| 3 Rxs (INH, rifampin, pyrazinamide), if pt is susceptible and HIV -ve then pyrazineamide can be discontinued after 2mos and the other 2 continued for 4 mos |
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Term
| What is the Alternative regimens? |
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Definition
| If fully susceptible then: INH+rifampin (9 mo); INH+ethambutol (18 mo); intermittent (2 or 3 X wkly) high does 4 Rx regimens |
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Term
| What if there is resistance (>4%)? |
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Definition
Initial Rx regimen shud include ethambutol or streptomycin;
INH resistance strains shud get Rifampin+pyrazinamide+ethambutol or streptomycin (6 mo);
Multi-Rx resistant strains: 3 or more Rxs for 18 mos until culture negative then continue for yet another 12 mos |
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Term
| Leprosy (aka Hansen's Dz) causes? |
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Definition
| Granulomatous Dz of peripheral nerves + mucosa of URT |
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Term
| What is the WHO Tx for Leprosy? |
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Definition
Dapsone
Clofazimine
Rifampin |
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Term
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Definition
| Structurally related to sulfonamides, thus inhibit folate syn via dihydropteroate synthetase I, -static, Tx of PJP, distributed to high levels in skin (and cause its inflammatory -> erythema nodosum leprosum, Tx w/ corticosteroids or thalidomide), hepatic acetylation (& into bile?), urine, ACEdapsone is the repositiry form, forms alot of oxidising agents thus hemolysis (esp in G6PD def pts), GI irritation, methemoglobinemia, peripheral neuropathy |
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Term
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Definition
| Phenazine dye, binds to DNA + inhibits replication, may produce cytotoxic free radicals, bactericidal to MAC aswell, oral w/ no CNS, A/Es: red-brown skin (w/out erythema nodosum as has anti-inflammatory axn), eosinophilic enteritis |
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