Question
A 45-year-old nurse complaining of evening rise of temperature since a month with loss of appetite and weight is presenting with sputum positive for AFB and diagnosis for primary pulmonary tuberculosis. (
- (a) Enumerate the orally administered first line drugs ( 2 mark(s)
- (b) Write the mechanism of action and other uses of Rifampin. ( 3 mark(s)
- (c) Enumerate four drugs given for mycobacterium avium complex infection 1 mark(s)
Answer
a) Orally administered first-line drugs Isoniazid, Rifampicin, Pyrazinamide, Ethambutol.
b) Rifampicin — mechanism of action and other uses MOA: rifampicin → inhibits bacterial DNA-dependent RNA polymerase → blocks mRNA synthesis → bactericidal against both actively dividing and semi-dormant organisms (a broader-population activity than isoniazid).
Other uses: leprosy (combination therapy), chemoprophylaxis for close contacts of meningococcal/H. influenzae meningitis, and other severe staphylococcal infections in combination with other antibiotics.
c) Four drugs for Mycobacterium avium complex infection Clarithromycin (or Azithromycin), Ethambutol, Rifabutin, and (in severe/disseminated disease) Amikacin or Streptomycin.