TB

Question 1

The 4 drugs that are used as treatment for TB are

Answer 1

RIPE

• Rifampin/Rifampicin, Isoniazid, Pyrazimamide, Ethambutol

Question 2

Isoniazid is a ______ inhibitor

Answer 2

• Mycolic acid synthesis inhibitor

Question 3

Dalamanid is a ________ inhibitor and is a 2nd line treatment again MDR-TB and XDR-TB

Answer 3

• Mycolic acid synthesis inhibitor

Question 4

Ethambutol is a ______ inhibitor

Answer 4

• Cell wall synthesis inhibitor

Question 5

Cycloserine is a _____ inhibitor and is a 2nd line treatment against MDR-TB and XDR-TB

Answer 5

• Cell wall synthesis inhibitor

Question 6

Examples of RNA polymerase inhibitors that are used to treat TB include:

Answer 6

Rifampin/Rifampicin, Rifabutin

Question 7

Bedequiline is an __________ inhibitor that is used as a second line treatment for MDR-TB and XDR-TB

Answer 7

• ATP synthase inhibitor

Question 8

Streptomycin, amikacin, and kanamycin are all _____ that are protein synthesis inhibitors used to treat MDR-TB and XDR-TB

Answer 8

• aminoglycosides (bind the 30 S subunit and are bactericidal)

Question 9

Levofloxacin and moxifloxacin are ___________ and they are DNA synthesis inhibitors

Answer 9

• Fluoroquinolones [(bactericidal and they inhibit DNA gyrase (topoisomerase II and IV)]

Question 10

MDR-TB is resistant to:

Answer 10

• Isoniazid and Rifampin

Question 11

XDR-TB is resistant to:

Answer 11

• Isoniazid, Rifampin, and 2 classes of 2nd line therapies

Question 12

TDR-TB is resistant to:

Answer 12

• Isoniazid, Rifampin, and 2 classes of 2nd line therapies AND others

Question 13

What is the mechanism of action of pyrazimamide?

Answer 13

• proton motive force (the drug becomes trapped inside of the mycobacterium and accumulate based on the higher pH that allows for higher concentrations of the drug to accumulate in the neutral, protonated form

Question 14

Which 2 drugs are only effective against active TB?

Answer 14

• Isoniazid and ethambutol

Question 15

Pyrazinamide is effective against _____ TB

Answer 15

• Latent

Question 16

Which drugs are effective against both active and latent TB?

Answer 16

• Rifampin and rifabutin

Question 17

Which drugs produce the characteristic orange coloration of skin, urine, feces, saliva, and tears?

Answer 17

• Rifampin and rifabutin

Question 18

Ethambutol causes what unique side effect?

Answer 18

Optic neuritis (Red-Green color blindness)

Question 19

Ethambutol inhibits __________ that is important in the synthesis of arabinogalactan

Answer 19

• Arabinosyl-transferase

Question 20

______ has no significant CYP-associated drug interactions

Answer 20

• Delamanid

Question 21

Having polymorphisms in the NAT2 gene determine whether or not someone is a fast or slow acetylator. _____ acetylators are at a higher risk for liver damage when taking _______ for active TB

Answer 21

• Slow; Isoniazid

Question 22

Ethanol should not be consumed when taking this drug

Answer 22

• Isoniazid (CYP2E1)

Question 23

Mutations in the bacterial genes KatG or InhA confer resistance to _______

Answer 23

• Isoniazid

Question 24

Do not co-administer bedaquiline and HIV protease/ RT inhibitors with _______ because it reduces its effectiveness by inducing all pharmacologically relevant CYPs

Answer 24

• Rifampin and rifabutin

Question 25

Nephrotoxicity/ interstitial nephritis is specifically linked to _____ because it is renally cleared

Answer 25

- Rifampin and Rifabutin

Question 26

Isoniazid and pyrazinamide are associated with ________

Answer 26

- Hepatoxicity