Rifampicin

Rifampicin

Q. 1 Rifampicin acts by:
 A RNA dependent RNA polymerase
 B DNA dependent RNA polymerase
 C RNA dependent RNA polymerase
 D DNA dependent DNA polymerase
Q. 1 Rifampicin acts by:
 A RNA dependent RNA polymerase
 B DNA dependent RNA polymerase
 C RNA dependent RNA polymerase
 D DNA dependent DNA polymerase
Ans. B

Explanation:

DNA dependent RNA polymerase


Q. 2

All of the following are true about Rifampicin, EXCEPT:

 A

Microsomal enzyme inducer

 B

Useful for treatment meningiococcal meningitis

 C

May cause OCP failure

 D

Bactericidal in nature

Q. 2

All of the following are true about Rifampicin, EXCEPT:

 A

Microsomal enzyme inducer

 B

Useful for treatment meningiococcal meningitis

 C

May cause OCP failure

 D

Bactericidal in nature

Ans. B

Explanation:

Rifampicin is a bactericidal antibiotic. Rifampicin is an effective liver enzyme-inducer, promoting the upregulation of hepatic cytochrome P450 enzymes (such as CYP2C9 and CYP3A4), increasing the rate of metabolism of many other drugs. It reduces the efficacy of hormonal contraception. It is used in prophylactic therapy (not for treatment) against Neisseria meningitidis (meningococcal) infection.


Q. 3

A diabetic female on INH and rifampicin for TB suffers from deep vein thrombosis. She is started on warfarin but her prothrombin time is not raised. What is the next best step in management of the condition?

 A

Use LMW heparin

 B

Long term heparin therapy

 C

Switch ethambutol for rifampin

 D

Replace warfarin with acesoumarin

Q. 3

A diabetic female on INH and rifampicin for TB suffers from deep vein thrombosis. She is started on warfarin but her prothrombin time is not raised. What is the next best step in management of the condition?

 A

Use LMW heparin

 B

Long term heparin therapy

 C

Switch ethambutol for rifampin

 D

Replace warfarin with acesoumarin

Ans. A

Explanation:

The patient in the question is receiving rifampicin it enhance the metabolism of warfarin, as rifampicin is a microsomal enzyme inducer.

Increased metabolism of warfarin results in insufficient prolongation of prothrombin time.

Most effective next step in management is to increase the dose of warfarin.

Since such an option is not mentioned, next suitable approach would be to use low molecular weight heparin as an anticoagulant.

Ref: Essentials of Medical Pharmacology By KD Tripathi, 5th Edition, Pages 563, 700


Q. 4

A tuberculosis patient with only rifampicin resistance will be treated under which category as per RNTCP 2010 guidelines?

 A

Cat I

 B

Cat II

 C

Cat III

 D

Cat IV

Q. 4

A tuberculosis patient with only rifampicin resistance will be treated under which category as per RNTCP 2010 guidelines?

 A

Cat I

 B

Cat II

 C

Cat III

 D

Cat IV

Ans. D

Explanation:

Patients with are not MDR but have any Rifampicin resistance will also be treated with Cat IV regimen (Cat IV regimen is for MDR TB).

Ref: http://health.bih.nic.in/Docs/Guidelines-DOTS-Plus.pdf.


Q. 5

A known sputum positive pulmonary tuberculosis patient currently on INH, rifampicin, pyrizinamide and ethambutol is found to be HIV positive. His CD4 count is 100 /dl and viral load is more than 50,000 copies/ml. Which of the following antiretroviral drug should be avoided in this patient?

 A

Indinavir

 B

Lamivudin

 C

Ritonavir

 D

Efavirenz

Q. 5

A known sputum positive pulmonary tuberculosis patient currently on INH, rifampicin, pyrizinamide and ethambutol is found to be HIV positive. His CD4 count is 100 /dl and viral load is more than 50,000 copies/ml. Which of the following antiretroviral drug should be avoided in this patient?

 A

Indinavir

 B

Lamivudin

 C

Ritonavir

 D

Efavirenz

Ans. C

Explanation:

Ritonavir a protease inhibitor should be avoided from the treatment of HIV, in a patient receiving rifampicin as a part of antituberculosis treatment regime. Rifampin is a potent hepatic enzyme inducer. When this is co administered with a protease inhibitor, it decrease the availability of the drug upto 80%. This resulting low concentration of the drug promotes the development of drug resistance and treatment failure.

Ref: Antiretroviral Therapy By Erik De Clercq, Page 347


Q. 6

Treatment of choice for HIV and TB along with Rifampicin is?

 A

Saquinavir

 B

Nevirapine

 C

Ritonavir

 D

Amprenavir

Q. 6

Treatment of choice for HIV and TB along with Rifampicin is?

 A

Saquinavir

 B

Nevirapine

 C

Ritonavir

 D

Amprenavir

Ans. C

Explanation:

Initial guidance from the CDC stated that use of rifampin was contraindicated for persons taking nonnucleoside and protease inhibitors. But subsequent data have supported the use of rifampin with certain combinations of antiretroviral agents. These include ritonavir and efavirenz with nucleoside/tide reverse transriptase.

Ritonavir has a high affinity for several isoforms of cytochrome P450, and its use can result in large increases in the plasma concentrations of drugs metabolized by this pathway. Rifampicin is metabolized by the pathway and hence ritonavir used with rifampicin in TB and HIV.

Rifabutin could be used with most protease inhibitors, including atazanavir and fosamprenavir, provided the dose of rifabutin is reduced. Conversely, efavirenz can reduce concentrations of rifabutin, necessitating an increase in the dose of rifabutin.

Ref: Infectious Diseases in Critical Care edited by Jordi Rello, Martin H. Kollef, Emilio Díaz, Alejandro Rodríguez, 2007, Page 429 ; Harrison’s 17th ed chapter 182

Q. 7

During the treatment with rifampicin some patients will have mild elevation in the bilirubin with normal transaminases.This is due to:

 A

Hemolysis

 B

Transient cholestasis with bile duct injury

 C

Microsomal enzyme induction

 D

Hepatic adaptation

Q. 7

During the treatment with rifampicin some patients will have mild elevation in the bilirubin with normal transaminases.This is due to:

 A

Hemolysis

 B

Transient cholestasis with bile duct injury

 C

Microsomal enzyme induction

 D

Hepatic adaptation

Ans. D

Explanation:

One form of hepatic adaptation includes drug induced hyperbilirubinemia , it is seen with rifampicin,flavaspidic acid,cyclosporine.

Ref : Schiff’s diseases of liver , Edition -11 , Page – 715.

Q. 8

OCP failure by rifampicin is due to –

 A

Decreased absorption of OCP

 B

Increased binding of OCPs by rifampicin and reduced free drug concentration

 C

Increased metabolism of drug

 D

Increased chances of ovulation due to rifampicin

Q. 8

OCP failure by rifampicin is due to –

 A

Decreased absorption of OCP

 B

Increased binding of OCPs by rifampicin and reduced free drug concentration

 C

Increased metabolism of drug

 D

Increased chances of ovulation due to rifampicin

Ans. C

Explanation:

Ans. is ‘c’ i.e., Increased metabolism of drug


Q. 9

Which of the following antimicrobial agent do not require reduction in dose in patient with renal failure-

 A

Rifampicin

 B

Fluconazole

 C

Vancomycin

 D

Imipenem

Q. 9

Which of the following antimicrobial agent do not require reduction in dose in patient with renal failure-

 A

Rifampicin

 B

Fluconazole

 C

Vancomycin

 D

Imipenem

Ans. A

Explanation:

Ans. is ‘a’ i.e., Rifampicin

Antimicrobials that do not require dose reduction in renal failure Cephalosporins                                                    

Fluoroquinolones

  • Cefoperazone                       o Trovafloxacin
  • Ceftriaxone                          o Grepafloxacin
  • Cefopiramide                       o Pefloxacin

Macrolides                                    o Moxifloxacin

o Erythromycin

o Clarithromycin

o Azithromycin                    Other (Miscellaneous)

Tetracycline                             o Clindamycin

o Docycycline                           o Chloramphenicol

Minocycline                             o Metronidazole

Antitubercular                          o Linezolid

o Rifampicin                             o Quinupristin/Dalfopristin

o Rifapentine                         o Nafcillin/Oxacillin

o Rifabutin                             o Penicillins


Q. 10

Anti tubercular drug which reaches inside of caseous material is ?

 A

Isoniazid

 B

Rifampicin

 C

Pyrazinamide

 D

b and a

Q. 10

Anti tubercular drug which reaches inside of caseous material is ?

 A

Isoniazid

 B

Rifampicin

 C

Pyrazinamide

 D

b and a

Ans. D

Explanation:

Ans. is ‘b > a’ i.e., Rifampicin > Isoniazid

“Isoniazide penetrates well into caseous material and persists in therapeutic concentration” — Goodman & Gillman “Rifampicin is the only bactericidal drug active against non-dividing bacteria in caseous lesions” — KDT

o Thus, both INH and rifampicin reach into the caseous material.

o But, rifampicin is the most effective drug in caseous material as it is bactericidal aganist both dividing and dormant (non-dividing) bacterial. Whereas, INH is effective (cidal) only on dividing bacteria but is static for non-dividing (dormant) bacteria.


Q. 11

The drug inhibiting DNA-dependent RNA polymerase in Mycobacteria is –

 A

INH

 B

Rifampicin

 C

Ciprofloxacin

 D

Ethionamide

Q. 11

The drug inhibiting DNA-dependent RNA polymerase in Mycobacteria is –

 A

INH

 B

Rifampicin

 C

Ciprofloxacin

 D

Ethionamide

Ans. B

Explanation:

Ans. is ‘b’ i.e., Rifampicin

Mechanism of action of important antitubercular drugs

o Rifampicin —> Inhibits DNA dependent RNA synthesis by inhibiting RNA polymerase.

o INH  —> Inhibits synthesis of mycolic acid which is a component of mycobacterial cell wall. o Pyrazinamide —> Inhibits synthesis of mycolic acid.

o Streptomycin —> Inhibits protein synthesis (translation).

o Ethambutol —> Inhibits incorporation ofmycolic acid into bacterial cell wall by inhibiting arbinosyltransferase.


Q. 12

Which of the following is most active against both dormant & non-dormant bacilli –

 A

Pyrazinamide

 B

Rifampicin

 C

Streptomycin

 D

INH

Q. 12

Which of the following is most active against both dormant & non-dormant bacilli –

 A

Pyrazinamide

 B

Rifampicin

 C

Streptomycin

 D

INH

Ans. B

Explanation:

Ans. is ‘b’ i.e., Rifampin

  • Isoniazid is bacteriostatic for resting bacilli, but is bactericidal for rapidly dividing microorganisms.

o The bactericidal action of rifampicin covers all subpopulations of TB bacilli.


Q. 13

The most effective antitubercular drug against slow multiplying intracellular mycobacteria ‑

 A

Rifampicin

 B

Isoniazid

 C

Pyrazinamide

 D

Ethambutol

Q. 13

The most effective antitubercular drug against slow multiplying intracellular mycobacteria ‑

 A

Rifampicin

 B

Isoniazid

 C

Pyrazinamide

 D

Ethambutol

Ans. A

Explanation:

Ans. is ‘a’ i.e., Rifampicin

o Isoniazid is bacteriostatic for resting bacilli, but is bactericidal for rapidly dividing microorganisms. — G & G

o The bactericidal action of rifampicin covers all subpopulations of TB bacilli.


Q. 14

ATT causing orange colour urine is –

 A

Rifampicin

 B

Isoniazid

 C

Ethambutol

 D

Pyrazinamide

Q. 14

ATT causing orange colour urine is –

 A

Rifampicin

 B

Isoniazid

 C

Ethambutol

 D

Pyrazinamide

Ans. A

Explanation:

Ans. is ‘a’ i.e., Rifampicin

Adverse effects of Rifampicin

o Intermittent dosing in Rif. ampicin i.e., (Less than twice weekly either as a part of regimen or through poor compliance) promotes certain effects which are

Flu like syndrome (chills, fever headache, malaise wheezing)                                    Thrombocytopenia

Acute hemolytic anaemia                                                                                       Abdominal syndrome

Acute renal failure sometimes with hemolysis                                                           Cutaneous syndrome

  • These adverse reactions usually does not require drug withdrawl.

o Other adverse effects of Rifampicin which are dose related

Hepatitis                                         Respiratory syndrome

Urine and secretions may become orange red but this is harmless.


Q. 15

Contact lens staining occurs in which ATT drug?

 A

INH

 B

Rifampicin

 C

Pyrizinamide

 D

Thioacetazone

Q. 15

Contact lens staining occurs in which ATT drug?

 A

INH

 B

Rifampicin

 C

Pyrizinamide

 D

Thioacetazone

Ans. B

Explanation:

Ans. is ‘b’ i.e., Rifampicin

Rifampicin cuases permamnent staining of contact lens; hence use of contact lens should be discontinued.


Q. 16

Which of the following is the major side effect of rifampicin?

 A

Renal failure

 B

Hepatotoxicity

 C

Bone marrow suppression

 D

Blood dyscrasias

Q. 16

Which of the following is the major side effect of rifampicin?

 A

Renal failure

 B

Hepatotoxicity

 C

Bone marrow suppression

 D

Blood dyscrasias

Ans. B

Explanation:

Ans. is ‘b’ i.e., Hepatotoxicity


Q. 17

Which of the following antitubercular drugs do not need to be adjusted in presence of renal failure ‑

 A

Rifampicin

 B

INH

 C

Ethambutol

 D

Pyrazinamide

Q. 17

Which of the following antitubercular drugs do not need to be adjusted in presence of renal failure ‑

 A

Rifampicin

 B

INH

 C

Ethambutol

 D

Pyrazinamide

Ans. A

Explanation:

Ans. is ‘a’ i.e., Rifampicin

o Antitubercular drugs which do not require dose adjustment in renal failure :

       Rifampicin                     Rifabutin          Rifapentine


Q. 18

MDR tuberculosis is defined by –

 A

Resistance to all first and second line anti-tubercular agents

 B

Resistance to any three first line anti-tubercular agents

 C

Resistance to all first line and any three classes of second line anti-tubercular agents

 D

Resistance to isoniazid and rifampicin

Q. 18

MDR tuberculosis is defined by –

 A

Resistance to all first and second line anti-tubercular agents

 B

Resistance to any three first line anti-tubercular agents

 C

Resistance to all first line and any three classes of second line anti-tubercular agents

 D

Resistance to isoniazid and rifampicin

Ans. D

Explanation:

Ans. is ‘d’ i.e., Resistance to isoniazid and rifampicin

o MDR is defined as resistance INH and rifampicin with or without resistence to other drugs. XDR is defined as resistance to INH and rifampicin as well as to all fluoroquinolones and one of injectable drugs (capreomycin, kanamycin, amikacin).


Q. 19

All are true about rifampicin EXCEPT ‑

 A

Microsomal enzyme inducer

 B

Used in treatment of meningiococcal meningitis

 C

May cause OCP failure

 D

Bactericidal in nature

Q. 19

All are true about rifampicin EXCEPT ‑

 A

Microsomal enzyme inducer

 B

Used in treatment of meningiococcal meningitis

 C

May cause OCP failure

 D

Bactericidal in nature

Ans. B

Explanation:

Ans. is ‘b’ i.e., Used in treatment of meningiococcal meningitis

o Rifampicin is used for prophylaxis of meningococal meningittis (not for treatment).

o Other three options are correct.


Q. 20

Fastest acting drug in leprosy is –

 A

Rifampicin

 B

Dapsone

 C

Clofazimine

 D

Ethionamide

Q. 20

Fastest acting drug in leprosy is –

 A

Rifampicin

 B

Dapsone

 C

Clofazimine

 D

Ethionamide

Ans. A

Explanation:

Ans. is `a’ i.e., Rifampicin

“Rifampicin is the most active agent for leprosy”.


Q. 21

In leprosy, the best bacteriocidal agent is‑

 A

Clofazimine

 B

Dapsone

 C

Rifampicin

 D

Ethionamide

Q. 21

In leprosy, the best bacteriocidal agent is‑

 A

Clofazimine

 B

Dapsone

 C

Rifampicin

 D

Ethionamide

Ans. C

Explanation:

Ans. is ‘c’ i.e., Rifampicin


Q. 22

Dineshbhali Shah suffering from AIDS is on Zidovudine, lamivudine and Indnavir therapy. He develops pulmonary tuberculosis for which treatment is to be started. Which of the following should be avoided in him?

 A

Rifampicin

 B

INH

 C

Ethambutol

 D

Pyrazinamide

Q. 22

Dineshbhali Shah suffering from AIDS is on Zidovudine, lamivudine and Indnavir therapy. He develops pulmonary tuberculosis for which treatment is to be started. Which of the following should be avoided in him?

 A

Rifampicin

 B

INH

 C

Ethambutol

 D

Pyrazinamide

Ans. A

Explanation:

Ans. is ‘a’ i.e., Rifampicin

Rifampicin induces metabolism of ritonavir, indinavir and saquinavir, thus it should not be used with these drugs. Rifabutin can be used.


Q. 23

The most effective drug against M. leprae is:

 A

Dapsone

 B

Rifampicin

 C

Clofazamine

 D

Prothionamide

Q. 23

The most effective drug against M. leprae is:

 A

Dapsone

 B

Rifampicin

 C

Clofazamine

 D

Prothionamide

Ans. B

Explanation:

B ie Rifampcin


Q. 24

Drug of choice for chemoprophrlaxis in meningococcal meningitis is –

 A

Tetracycline

 B

Rifampicin

 C

Streptomycin

 D

Erythromycin

Q. 24

Drug of choice for chemoprophrlaxis in meningococcal meningitis is –

 A

Tetracycline

 B

Rifampicin

 C

Streptomycin

 D

Erythromycin

Ans. B

Explanation:

Ans. is ‘b’ i.e., Rifampicin 

Chemoprophvlaxis

o Meningococcal meningitis is the only type of bacterial meningitis that occurs in epidemic form.

o Close contacts of index case (such as other household member, infants in day-care centers, or military recrutis) are at increased risk for developing meningococcal disease. casual contacts such as schoolmates do not appear to be

at increased risk.

  • Chemoprophylaxis is indicated only for close contacts.
  • Sulfonamides, once widely employed in chemoprophylaxis, should no longer be used for that purpose because approximately 25% of meningococcal isolates are now resistant to sulfonamide.

o Rifampicin is the drug of choice to accomplish prophylaxis in close contacts. The recommended dose in adults is either 600 mg orally every 12 hours for 2 days or 600 mg orally once daily for 4 days (total 4 doses). o Other drugs for chemoprophylaxis are ceftriaxone, ciprofloxacin, Azithromycin, minocycline.


Q. 25

Dose of rifampicin in RNTCP is- 

 A

600 mg

 B

450 mg

 C

300 mg

 D

100 mg

Q. 25

Dose of rifampicin in RNTCP is- 

 A

600 mg

 B

450 mg

 C

300 mg

 D

100 mg

Ans. B

Explanation:

Ans. is ‘b i.e., 450 mg 

o Under RNTCP Doses of first line antitubercular drugs are :- INH-600mg; rifampicin-450mg; pyrazinamide-1500 mg; ethambuto1-1200mg; and streptomycin-750mg.

o All drugs are given three times in a week, e.g. 450mg rifampicin is given three times in a week.


Q. 26

Which of the following is / are 1st line antitubercular drugs in children –

 A

lsoniazid

 B

Rifampicin

 C

Pyrazinamide 

 D

All

Q. 26

Which of the following is / are 1st line antitubercular drugs in children –

 A

lsoniazid

 B

Rifampicin

 C

Pyrazinamide 

 D

All

Ans. D

Explanation:

Ans. is All

First line anti-tubercular drugs are same in children and adults —> INH, rifampicin, Ethambutol, pyrazinamide, and streptomycin.


Q. 27

The most rapidly bactericidal drug for M-Leprae is‑

 A

Dapsone

 B

Clofazimine

 C

Ethionamide

 D

Rifampicin

Q. 27

The most rapidly bactericidal drug for M-Leprae is‑

 A

Dapsone

 B

Clofazimine

 C

Ethionamide

 D

Rifampicin

Ans. D

Explanation:

Ans. is ‘d’ i.e., Rifampicin 

o Rifampicin is the only drug that is highly bactericidal against M. leprae.


Q. 28

For treatment of paucibacillary leprosy drugs used are –

 A

Rifampicin & dapsone

 B

Rifampicin, dapsone, steroids

 C

Rifampicin, clofazimine, dapsone

 D

None

Q. 28

For treatment of paucibacillary leprosy drugs used are –

 A

Rifampicin & dapsone

 B

Rifampicin, dapsone, steroids

 C

Rifampicin, clofazimine, dapsone

 D

None

Ans. A

Explanation:

Ans. is ‘a’ i.e., Rifampicin & dapsone 


Q. 29

Multi drug resistant tuberculosis is defined as resistance to?

 A

INH and Pyrizinamide

 B

INH and Rifampicin

 C

Rifampicin and Pyrizinamide

 D

Resistance to all first line drugs

Q. 29

Multi drug resistant tuberculosis is defined as resistance to?

 A

INH and Pyrizinamide

 B

INH and Rifampicin

 C

Rifampicin and Pyrizinamide

 D

Resistance to all first line drugs

Ans. B

Explanation:

Answer is B (INH and Rifampicin):

130.Resistant Tuberculosis is defined by resistance to INH and Rifampicin.

Multi-Drug Resistant Tuberculosis (MDR-TB) is defined as disease caused by strain of M. Tuberculosis that is resistant to both Isoniazid (INN) and Rifampicin – the most efficacious of the.first line Anti-TB drugs’ –Harrison


Q. 30

Toxic amblyopia is produced by:

 A

INH

 B

Rifampicin

 C

Ethambutol

 D

Pyrazinamide

Q. 30

Toxic amblyopia is produced by:

 A

INH

 B

Rifampicin

 C

Ethambutol

 D

Pyrazinamide

Ans. B

Explanation:

Ans. Rifampicin


Q. 31

Which antitubercular agent is associated with side effects as respiratory syndrome, cutaneous syndrome, Flu syndrome and abdominal syndrome:

March 2010

 A

Isoniazid

 B

Rifampicin

 C

Pyrazinamide

 D

Ethambutol

Q. 31

Which antitubercular agent is associated with side effects as respiratory syndrome, cutaneous syndrome, Flu syndrome and abdominal syndrome:

March 2010

 A

Isoniazid

 B

Rifampicin

 C

Pyrazinamide

 D

Ethambutol

Ans. B

Explanation:

Ans. B: Rifampicin

During therapy, rifampicin is usually well-tolerated, however, adverse side-effects are common in intermittent rifampicin intake.

  • Respiratory syndrome-breathlessness which may be associated with shock and collapse
  • Cutaneous syndrome-Flushing, pruritis, rash, redness and watering of the eyes.
  • Flu syndrome-Chills, fever, headache, malaise and bone pain
  • Abdominal syndrome-nausea, vomiting, abdominal cramps

Other include febrile reaction, eosinophilia, leucopenia, thrombocytopenia, purpura, haemolysis and shock, hepatotoxicity and nephrotoxicity.

Gastrointestinal adverse reactions may be severe leading to pseudomembranous colitis.

Neurotoxic effects include confusion, ataxia, blurring of vision, dizziness and peripheral neuritis. A common toxic effect is red skin with orange discolouration of body fluids.


Q. 32

Maximum sterilising action is shown by which anti TB drug ‑

 A

Rifampicin

 B

INH

 C

Pyrazinamide

 D

Streptomycin

Q. 32

Maximum sterilising action is shown by which anti TB drug ‑

 A

Rifampicin

 B

INH

 C

Pyrazinamide

 D

Streptomycin

Ans. A

Explanation:

Ans. is ‘a’ i.e., Rifampicin

There are three main properties of antitubercular drugs :-

  1. Bactericidal activity (tuberculocidal activity).
  2. Sterilizing activity.
  3. Ability to prevent resistance

Bactericidal activity

  • Isoniazid and rifampicin are the most powerful bactericidal drugs, active against all populations of TB bacilli. Pyrazinamide and streptomycin are also bactericidal against certain populations of TB bacilli.

Sterilizing activity

  • Sterilizing acitivity is the ability to kill all the bacilli in lesions as rapidly as possible.
  • Rifampicin is the most potent sterilizing antitubercular drug. Pyrazinamide is also having sterilizing action.

To prevent resistance

  • Ethambutol and thioacetazone are used in association with more powerful drugs to prevent emergence of resistance.

Q. 33

Flu like syptoms is side effect of which anti TB drug ‑

 A

NH

 B

Rifampicin

 C

Pyrzinamide

 D

Streptomycin

Q. 33

Flu like syptoms is side effect of which anti TB drug ‑

 A

NH

 B

Rifampicin

 C

Pyrzinamide

 D

Streptomycin

Ans. B

Explanation:

Ans. is ‘b’ i.e., Rifampicin


Q. 34

Which anti TB drug is avoided in HIV patient ‑

 A

INH

 B

Rifampicin

 C

Pyrazinamide

 D

Streptomycin

Q. 34

Which anti TB drug is avoided in HIV patient ‑

 A

INH

 B

Rifampicin

 C

Pyrazinamide

 D

Streptomycin

Ans. B

Explanation:

Ans. is ‘b i.e., Rifampicin

  • All HIV-infected TB patients are candidates for ART, and the optimal timing for its initiation is as soon as possible and within the first 8 weeks of anti-TB therapy.
  • Rifampin, a potent inducer of enzymes of the cytochrome P450 system, lowers serum levels of many HIV protease inhibitors and some non- nucleoside reverse transcriptase inhibitors-essential drugs used in ART.
  • In such cases, rifabutin, which has much less enzyme- inducing activity, has been recommended in place of rifampin. However, dosage adjustment for rifabutin and/or the antiret- roviral drugs may be necessary.

Q. 35

XDR TB is resistance to ‑

 A

Isoniazid

 B

Isoniazid + Rifampicin

 C

Isoniazid + Rifampicin + Ethambutol

 D

Isoniazid + Rifampicin + Kanamycin

Q. 35

XDR TB is resistance to ‑

 A

Isoniazid

 B

Isoniazid + Rifampicin

 C

Isoniazid + Rifampicin + Ethambutol

 D

Isoniazid + Rifampicin + Kanamycin

Ans. D

Explanation:

Ans.is d i.e., Isoniazid + Rifampicin + Kanamycin

Treatment of multidrug resistance (MDR) TB

MDR-TB is defined as resistance to at least both INH and rifampicin. Previously it was classified as Category IV under DOTS (DOTS-PLUS).

The treatment is given in two phases, the intestive phase (IP) and the continuation phase (CP). The total duration of treatment for regimen for MDR-TB is 24-27 months, depending on the IP duration.

Treatment regimen comprises :-

i) Intensive phase (6-9 months) : Six drugs : Kanamycin (Km), levofloxacin (Lvx), ethionamide (Eto), pyrazinamide (Z), ethambutol (E), and cycloserine (Cs).

ii) Continuation phase (18 months) : Four drugs : Levofloxaxcin, ethionamide, ethambutol and cycloserine.

Total duration of treatment is 24-27 months.

Treatment of extensive drug resistance (XDR) TB

XDR-TB is defined as resistance to any fluoroquinolone and at least one of the following three second-line drugs (capreomycin, kanamycin, amikacin), in addition to multidrug resistance.

The Regimen for XDR-TB would be of 24-30 months duration, with 6-12 months Intensive Phase (IP) and 18 months Continuation Phase (CP).

Regimen is :-

i) Intensive phase (6-12 months) : Seven drugs : Capreomycin, PAS, moxifloxacin, high dose INH, clofazimine, Linezolid, amoxyclay.

ii) Continuation phase (18 months) : Six drugs : PAS, moxifloxacin, high dose INH, clofazimine, linezolid, amoxyclay.


Q. 36

MDR TB is defined as‑

 A

Resistance to INH and Ethambutol

 B

Resistance to Rifampicin and Ethambutol

 C

Resistance to Pyrazinamide and Rifampicin

 D

Resistance to INH and Rifampicin

Q. 36

MDR TB is defined as‑

 A

Resistance to INH and Ethambutol

 B

Resistance to Rifampicin and Ethambutol

 C

Resistance to Pyrazinamide and Rifampicin

 D

Resistance to INH and Rifampicin

Ans. D

Explanation:

Ans. is ‘d’ i.e., Resistance to INH and Rifampicin

Treatment of multidrug resistance (MDR) TB

  • MDR-TB is defined as resistance to at least both INH and rifampicin. Previously it was classified as Category IV under DOTS (DOTS-PLUS).
  • The treatment is given in two phases, the intestive phase (IP) and the continuation phase (CP). The total duration of treatment for regimen for MDR-TB is 24-27 months, depending on the IP duration. o Treatment regimen comprises :-
  1. Intensive phase (6-9 months) : Six drugs : Kanamycin (Km), levofloxacin (Lvx), ethionamide (Eto), pyrazinamide (Z), ethambutol (E), and cycloserine (Cs).
  2. Continuation phase (18 months) : Four drugs : Levofloxaxcin, ethionamide, ethambutol and cycloserine.
  3. Total duration of treatment is 24-27 months.

Treatment of extensive drug resistance (XDR) TB

  • XDR-TB is defined as resistance to any fluoroquinolone and at least one of the following three second-line drugs (capreomycin, kanamycin, amikacin), in addition to multidrug resistance.
  • The Regimen for XDR-TB would be of 24-30 months duration, with 6-12 months Intensive Phase (IP) and 18 months Continuation Phase (CP).

Regimen is :-

  1. Intensive phase (6-12 months) : Seven drugs : Capreomycin, PAS, moxifloxacin, high dose INH, clofazimine, Linezolid, amoxyclay.
  2. Continuation phase (18 months) : Sir drugs : PAS, moxifloxacin, high dose NH, clofazimine, linezolid, amoxyclay.

Q. 37

Rifampicin is obtained from –

 A

Sea fish

 B

Plant

 C

Leaves

 D

Bacteria

Q. 37

Rifampicin is obtained from –

 A

Sea fish

 B

Plant

 C

Leaves

 D

Bacteria

Ans. D

Explanation:

Ans. is `d’ i.e., Bacteria

Rifampin is a semisynthetic derivative of rifamycin, an antibiotic produced by Streptomyces mediterranei.


Q. 38

Which of the following drugs has the highest bactericidal activity against the micro-organism marked by a black arrow in the photomicrograph below? 

 A

Rifampicin.

 B

Clofazimine.

 C

Dapsone.

 D

Minocycline.

Q. 38

Which of the following drugs has the highest bactericidal activity against the micro-organism marked by a black arrow in the photomicrograph below? 

 A

Rifampicin.

 B

Clofazimine.

 C

Dapsone.

 D

Minocycline.

Ans. A

Explanation:

The micro-organism shown in the photomicrograph above represents Mycobacterium leprae.

Rifampicin has a high bactericidal activity against M. leprae. A single dose of 1500 mg appears to kill 99% of the organisms.


Q. 39

Gene responsible for resistance to rifampicin

 A

Rpo B gene

 B

Kat G gene

 C

Rpm B gene

 D

Emb B gene

Q. 39

Gene responsible for resistance to rifampicin

 A

Rpo B gene

 B

Kat G gene

 C

Rpm B gene

 D

Emb B gene

Ans. A

Explanation:

Ans. is ‘a’ i.e., Rpo B gene

ATT Drug Gene responsible for drug resistance
INH inhA and Kat G gene
Ethambutol emb B gene
Rifampicin rpoB gene
Pyrazinamide

pncA gene



This site uses Akismet to reduce spam. Learn how your comment data is processed.

%d bloggers like this:
Malcare WordPress Security