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NR565 WEEK 6 STUDY GUIDE

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NR565 WEEK 6 STUDY GUIDE WEEK 6: CHAPTER 24: Drugs used in treating infectious disease ANTIMYCOBACTERIALS  Mycobacteria- among the most difficult to cure (e.g. tuberculosis [TB]) o They g... row slowly and are relatively resistant to drugs that are largely dependent on how rapidly cells are dividing o Have a lipid-rich cell wall relatively impermeable to many drugs o Are usually intracellular and inaccessible to drugs that does not have good intracellular penetration o Have the ability to go into a dormant state o Easily develop resistance to any single drugs o Pregnancy categories:  Isoniazid: Pregnancy category A  Streptomycin: Pregnancy category D  The rest: Pregnancy category C  Fetal death- d/t TB: isoniazid + rifampin + ethambutol for TB tx if pregnant and if drug resistance is a possibility. • Spectrum of coverage for various organisms/Pharmacodynamics o Isoniazid - most active drug for tx of TB  Bactericidal- against susceptible mycobacteria (intracellular and extracellular organisms)  Interferes with lipid and nucleic acid biosynthesis in growing organisms.  Isoniazid and ethambutol- inhibits synthesis of mycolic acid (important constituents for mycobacteria cell walls and are not found in mammalian cells). o Rifamycins – rifampicin, rifabutin, rifapentine  Bactericidal- against susceptible mycobacteria  Bind to the beta subunit of mycobacteria DNA-dependent RNA polymerase and inhibit RNA synthesis -> destruction of both multiplying and inactive bacilli.  Readily penetrate most tissues and can kill bacteria that are poorly accessible to many drugs.  Rifampin and rifabutin: N. gonorrhoeae, staphylococci, streptococci, Mycobacterium leprae, MAC, and H. influenzae type B.  Rifampin-resistance develop rapidly when used as monotherapy- should be combined with another active abx for tx of established infections. o Ethambutol [Show More]

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