Ashton Shared "RSM - TB Pharmacology" - 12 Picmonics
With Picmonic, facts become pictures. We've taken what the science shows - image mnemonics work - but we've boosted the effectiveness by building and associating memorable characters, interesting audio stories, and built-in quizzing. Whether you're studying for your classes or getting ready for a big exam, we're here to help.
RSM - TB Pharmacology
Mycobacterium Tuberculosis Characteristics
- Characteristics
- Mycolic Acid Cell Wall
- Acid-fast
- Carbolfuchsin Stain Red
- Lowenstein-Jensen Agar
- Serpentine Cord Factor
- Primary TB
- Primary TB
- Caseating Granuloma
- Ghon Focus
- Hilar Lymph Nodes
- Ghon Complex
- Reactivation TB
- Reactivation TB
- Reactivation in Apex
3 mins
Tuberculosis Skin Mantoux Test (PPD)
- Delayed Hypersensitivity (Cell Mediated Response)
- Intradermal Injection
- Read 48-72 hours
- Positive Results
- ≥ 5 mm Induration
- Immunosuppressed
- ≥ 10 mm Induration
- High Risk Patients
- ≥ 15 mm Induration
- Considerations
- Chest X-Ray
3 mins
Mycobacterium Tuberculosis Treatments
- Front Line
- Isoniazid (INH)
- Rifampin
- Ethambutol
- Pyrazinamide
- Fluoroquinolones
- Levofloxacin
- Moxifloxacin
- Injectables
- Amikacin
- Capreomycin
- Kanamycin
- Streptomycin
- Core or Add-on 2nd Line
- Ethionamide
- Cycloserine
- P-aminosalicylic acid (PAS)
- Combination Drug Therapy (RIPE)
Isoniazid
- Indications
- Tuberculosis (TB)
- Mechanism of Action
- Requires Catalase Peroxidase
- Decreases Mycolic Acid Synthesis
- Fast vs Slow Acetylators
- Side Effects
- B6 Deficiency
- Neurotoxicity
- Hepatotoxicity
- Drug-induced Lupus
1 min
Vitamin B6 (Pyridoxine) Deficiency
- Deficiency From Isoniazid
- Deficiency From Oral Contraceptives
- Seizures
- Hyperirritability
- Peripheral Neuropathy
- Sideroblastic Anemia
3 mins
Rifampin
- Tuberculosis (TB)
- Blocks RNA Polymerization
- Haemophilus influenzae Type B
- Leprosy
- Meningitis
- P450 inducer
- Red-orange urine
55 secs
Ethambutol
- Mechanism of Action
- Bacteriostatic
- Blocks Arabinosyltransferase
- Arabinosyltransferase Polymerizes Carbohydrates
- Carbohydrate Polymers Make Mycobacterium TB Cell Wall
- Side Effects
- Red/Green Color Blindness
- Reversible with Drug Discontinuation
40 secs
Pyrazinamide
- Hyperuricemia
- Hepatotoxicity
- Mycobacterium tuberculosis
- Effective in acidic pH of phagosomes of macrophages
Fluoroquinolones Antibiotics
- -floxacin
- Mechanism of Action
- Inhibits Topoisomerase II & IV
- Bactericidal
- Indications
- Gram-negative Rods
- Pneumonia
- Gastrointestinal Infections
- Urinary Tract Infection
- Genital Infections
- Drugs
- Levofloxacin
- Ciprofloxacin
- Has Pseudomonas Coverage
- Considerations
- Avoid Polyvalent Cations
3 mins
Fluoroquinolones Toxicities
- Diarrhea
- Skin Rash
- Headache
- Tendon Rupture in Adults
- Myalgias in Kids
- Damage to Cartilage
- Teratogen
- QT Prolongation
1 min
Aminoglycosides
- Drug Names
- Gentamicin
- Neomycin for Bowel Surgery Prep
- Amikacin
- Tobramycin
- Streptomycin
- Mechanism of Action
- Bactericidal
- Inhibit Formation of Initiation Complex
- Cause Misreading of mRNA
- Require O2 for Uptake
- Resistance
- Resistance by Transferase Enzymes
- Acetylation
- Phosphorylation
- Adenylation
- Indications
- Gram-Negative Rod Infections
- Synergistic with B-Lactam Antibiotics
- Side Effects
- Nephrotoxicity Especially When Used with Cephalosporins
- Ototoxicity Especially When Used with Loop Diuretics
- Teratogen
5 mins
Tuberculosis Treatment Regiments
- Standard
- Intensive Phase: INH,RIF,EMB,PZA (2m)
- Continuation Phase: INH,RIF (18w)
- Latent
- INH daily for 9m
- Directly Observed Therapy: INH & RPT weekly for 3m
- Pregnancy
- Active TB must be treated
- INH, RIF, EMB (& PZA outside of the US)
- AIDS/HIV
- Start TB Tx before HIV Tx
- Avoid weekly INH-RPT
- CD4 count <100/uL: Avoid biweekly INH-RIF
- MDR-TB
- Resistance to INH and RIF
- 1st Line & 2nd Line Agents for 20mo
- Bedaquiline +3 other drugs
- Inhibits bacterial ATP Synthase
