University:
University of North Carolina at Chapel Hill
Course:
NURS 312 | Pharmacology
Academic year:

2020
Views:

73

Pages:

1
Author:

rezancuk2j

3.2 – “For a Few Mycobacte Mycobacteria ria more”: Rifampin, rrifabutin, ifabutin, etha ethambutol, mbutol, clofazimine • In the US, many mycobacterial infections seen are atypical, i.e. non-tuberculous. As with tb, resistance is a problem so typically use multidrug rx. • M. avium complex causes disseminated disease in AIDS, especially when CD4 < 50 (immunosuppressed cane; red AIDS ribbon; speed limit 50). Made of M. avium & M. intracellular (bird in a cage for bird – avium – and intracellular inside macrophages). Much less susceptible to standard RIPE therapy. o Tx: macrolide + ethambutol (crows + Sheriff Ethel). Azithromycin & clarithromycin both treat MAC & are the drugs of choice for prophylaxis with ↓↓immunity (crow sitting on speed limit sign) o Rifabutin may be used if a 3rd agent recommended (Arizona Buttes). Related to rifampin (rifle). Less potent CYP450 activator than rifampin (slowing down horse). Rifabutin recommended in HIV+ patients, d/t less activation of CYP450, i.e. less interference with ART. • M. leprae (leaping armadillo) o Armadillo is an animal reservoir in the US o Tx ▪ Dapsone (deputy zone) • Agranulocytosis (multi-lobed hourglass) • Hemolytic anemia in G6PD deficiency (G6PD watermelon, with bite marks & seeds – like Heinz bodies) ▪ Clofazimine (gun cleaning cloth) • Treat for lepromatous leprosy (lion face mask for leonine faces) ▪ Rifampin (rifle) • Treatment in combination with other drug for treatment of atypical mycobacteria.