Miscellaneous Quiz / anti-mycotic / anti-leprosy drugs

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Can you name the anti-mycotic / anti-leprosy drugs?

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MOA: rifamycin derivative - bacterial RNA polymerase inhibitor; inhibits P450 enzymes
Strains of TB resistant to at least 2 of the main 1st line drugs (INH and RIF)
Resistance via overexpression of the arabinosyl transferase
Rifabutin class
p-Aminosalicyclic Acid class
SE: neprotoxicity and ototoxicity
SE: GI intolerance, dry skin, and discoloration
MOA: similar to PABA - folate synthesis inhibitor
SE: hepatotoxicity, n/v, fever, hyperuricemia, polyarthralgia
Azithromycin class
Excreted mainly through the liver/bile. SE: reddish color in urine, sweat, tears, and contact lenses; rashes; renal failure (nephritis); thrombocytopenia; cholestatic jaundice; hep
Dapsone class
Used as a combo with rifampin and clofazimine recommended to prevent resistance
Pyrazinamide class
Clofazimine class
MOA: Injectable protein synthesis inhibitor for tx of drug-resistant TB
Cycloserine class
MOA: phenazine dye that can be used as an alternative to dapsone. Inhibits bacterial DNA synthesis
SE: concentration and time dependent - ototoxicity and nephrotoxicity. Resistance via ribosomal binding site
Resistance via mutations in pncA gene which encodes ___________
Rifampin class
SE: hemolysis (esp in G6PD deficiency), erythema nodosum leprosum
Levofloxacin class
Resistance via mutations in the InhA gene and/or mutation or deletion of katG gene
MOA: Inhibits bacterial RNA synthesis by binding to the b subunit of bacterial RNA polymerase; used against active TB and as an anti-leprosy agent
Tx of MB leprosy
Isoniazid class
Streptomycin class
Amikacin class
Contraindicated in _____ allergy, hepatotoxicity, and acute liver dz. Also inhibits P450 mediated drug metabolism (caution for increased concentration of phenytoin, carbamazepine,
HintAnswer
MOA: Unknown; Active against mycobacteria in the acidic lysosomes; structurally related to nicotinamide
Tx of M. kansaii
Contraindicated in HIV pts d/t high relapse rate with rifampin resistant strains
Ciprofloxacin class
MOA: macrolide that binds to and inhibits 50S ribosomes
Used for sulfone resistant leprosy or when pts are intolerant to sulfones. Useful for the tx of erythema nodosum leprosum
MOA: inhibits bacterial folate synthesis by inhibiting dihydropteroate synthase
Capeomycin class
MOA: aminoglycoside - inhibits protein synthesis used in the tx of streptomycin-resistant TB
Contraindicated with certain meds (warfarin, digoxin, quinidine, cyclosporine, ketoconazole, phenytoin, anti-HIV agents, oral contraceptives) d/t strong inducer of P450
Ethambutol class
M. tuberculosis complex tx
Accumulates in RF. SE: dose-related retrobulbar neuritis (loss of visual acuity and red-green color blindness)
M. leprae tx
Inhibits P450 enzymes; SE increased serum aminotransferase --> hepatotoxicity; peripheral neuropathy d/t pyridoxine deficiency; seizures (d/t decreased GABA)
MOA: Inhibits mycolic acid synthesis by targeting InhA; penetrates into macrophages; needs activation; most active drug
MOA: Inhibits mycobacterial arabinosyl transferase; bacteriostatic
Strains of TB also resistant to the best 2nd line meds (fluoroquinolone and at least one of the three IV drugs - amikacin, kanamycin, or capreomycin)
Clarithromycin class
MOA: similar to INH, mycolic acid synthesis inhibitor. SE: GI upset, hepatitis, hemolysis
Used in place of rifampin for tx of TB in HIV-infected pts who are receiving concurrent anti-retroviral tx
Tx of PB leprosy
MOA: Cell wall synthesis inhibitor taken with pyridoxine. SE: peripheral neuropathy, CNS dysfunction - monitor serum concentration
Tx of M. avium complex (MAC)
MOA: Aminoglycoside injectable drug which causes irreversible inhibition of 30S ribosome
MOA: Fluroquinolone - DNA synthesis inhibitor active against M. tuberculosis and atypical mycobacteria
Rifapentine class
Ethionamide class
Resistance via point mutations of rpoB gene --> decreases binding of __________ to RNA polymerase

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Created Apr 25, 2011ReportNominate
Tags:drug

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