MCQ Antitubercular drugs

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Tricks to remember classification of Antitubercular Drugs https://youtu.be/1hxK9Ym2Zdk

Antitubercular drugs Repeatedly asked Questions , frequently asked questions. https://youtu.be/DCwR0oOEetk

Isoniazide INH Antitubercular drug https://youtu.be/pD2A6_HsUCY

Ethambutol Antitubercular Drugs, ethambutol SAR, ethambutol hydrochloride https://youtu.be/wY1b0PKkXm4

Classification

i) p-amino salicylic acid derivative – e.g. PAS

ii) Pyridine derivatives – e.g. Isoniazid, Ethionamide

iii) Pyrazine derivatives- e.g. Pyrazinamide

iv) Ethylene diamine derivatives – e.g. Ethambutol

v) Antibiotics – e.g. Cycloserine, Streptomycin, Rifampicin

OR

i) First line drugs: e.g.Isoniazid, Rifampin, Ethambutol, Pyrazinamide, Streptomycin, Thioacetazone etc.

ii) Second line drugs e.g.Ethionamide, Kanamycin, capreomycin, Cycloserin, Para amino salicylic acid etc.

iii) Third line drugs e.g.Clarithromycin, Thioacetazone OR 1. Synthetic anti-tubercular drugs: Para Amino Salicylic acid (PAS), Isoniazide, Ethambutol, Pyrazinamide, Ethionamide 2. Antibiotics: Streptomycin, Cycloserine, Rifampin, Clarithromycin

Mechanism of Action

Rifampin

Rifampin exerts its effects by reversibly inhibiting DNA-dependent RNA polymerase, which further inhibits protein synthesis and transcription of the bacteria.

Isoniazid

Isoniazid is a pro-drug that is converted to its active form metabolite by catalase-peroxidase and exerts its action by further inhibiting the biosynthesis of mycolic acid.

Pyrazinamide

Pyrazinamide’s mechanism of action remains unknown and not fully understood. Pyrazinamide is converted to its active form pyrazinoic acid and exerts its effect by inhibiting trans-translation and possibly coenzyme A synthesis needed for the bacteria to survive.

Ethambutol

Ethambutol inhibits the enzyme arabinosyltransferases and prevents the biosynthesis of the mycobacterial cell wall.

Aminoglycosides (Streptomycin, Kanamycin, Capreomycin, Amikacin)

Aminoglycosides exert their action by binding to the 30S subunit of ribosomes and inhibiting the protein synthesis of the mycobacteria. Fluoroquinolones (Levofloxacin, Moxifloxacin, Gatifloxacin) Fluoroquinolones exert their effects by inhibiting DNA gyrase and topoisomerase IV, further inhibiting DNA synthesis within the bacteria.

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