Ethionamide and Prothionamide

Ethionamide and prothionamide are weakly bacteriocidal against M. leprae and can be used as alternatives to clofazimine in the treatment of MDR leprosy. Both cause GI intolerance and are expensive.

^ Study Questions

1. A 35-year-old man under treatment for pulmonary tuberculosis has acute-onset right big toe pain, swelling, and low- grade fever. His physical examination was consistent with gouty arthritis, and he was found to have high serum uric acid levels. Which of the following antituberculosis drugs is known to cause high uric acid levels?

(A) Cycloserine

(B) Thiacetazone

(C) Pyrazinamide

(D) Rifampin

(E) Aminosalicylic acid

2. A 26-year-old truck driver, a recent immigrant from Mexico, could not obtain a Florida driving license because of his poor performance in red-green color vision discrimination. He denies any family history of color vision-related problems in the past. He is taking a four-drug regimen for pulmonary tubercu losis. He does not recall the names of the drugs. Which of the following antituberculosis drugs is responsible for his lack of color vision discrimination?

(A) Ethambutol

(B) Ethionamide

(C) Aminosalicylic acid

(D) Rifampin

(E) Isoniazid

3. A 68-year-old white South African man receiving treatment for lepromatous leprosy has increasing red-brown pigmentation. Which of the following an-tileprosy drugs is responsible for the patient's skin pigmentation?

(A) Dapsone

(B) Rifampin

(C) Clofazimine

(D) Capreomycin

(E) Thiacetazone

4. A 23 year-old college student is diagnosed with Neisseria meningitidis based on his clinical presentation, gram-negative diplococci on Gram stain, and isolation of bacteria from cerebrospinal fluid. Which of the following drugs can be used as a prophylactic agent for roommates and other close contacts?

(A) Amoxicillin

(B) Isoniazid

(C) Dapsone

(D) Clarithromycin

(E) Rifampin

5. A 32-year-old Haitian man has acute-onset confusion and suicidal ideation. Two weeks ago he began combination therapy for multi-drug resistant pulmonary tuberculosis. He has a history of depression that required intermittent treatment in the past. Which of the following antitubercular agents is responsible for the patient's neurological symptoms?

(A) Pyrazinamide

(B) Aminosalicylic acid

(C) Cycloserine

(D) Rifampin

(E) Ethambutol

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