Anti Tuberculosis [All illustrations are associated with a TUBER (potato), symbolizing M. tuberculosis]
- Aminosalicylic acid [A mine sail-cycling]
- Competitive inhibitor of PABA in folate synthesis [foliage falling]
- Bacteriostatic
- Used infrequently because is poorly tolerated
- Ethionamide [ET "high" on a mite]
- Structural analog of isoniazid
- Causes GI irritation [irritated stomach], peripheral neuropathy [cyanotic neuron], and optic neuritis [blood-shot eyes from being "high"]
- Rifampin [reef amplifier pin] [pin with the electrical amplifier sign flag impales a tuber onto the reef]
- Effective against both Gram (-) and Gram (+) organisms [red & purple corals and "eyes" on the reef]
- Inhibits RNA synthesis by binding to the beta subunit of the bacterial DNA-dependent RNA polymerase ["RNA"]
- Eliminated into through bile and urine (turns urine and other bodily secretions orange [green bile and orange tinted urine seeping from reef]
- Accelerates activity of liver cytochrome P-450 enzymes, decreasing half-lives of many drugs [speedy liver]
- Ethambutol [ET-ham-boot-tall: ET eating ham in a tall boot]
- Oral administration [ET is eating ham with a potato]
- Penetrates CNS and used in treatment of tuberculous meningitis
- Used in combination with other antimycobacterial drugs
- Causes optic neuritis, leading to loss of visual acuity and red-green color discrimination [ET's eyes are red and green]
- Isoniazid [isonicotinic acid sitting on ass (iso-on-ass-sit)]
- Most potent anti-tubercular medication [yellow "power" glow]
- Always used in conjuction with other drugs in order to prevent resistance
- Disrupts mycolic acid in cell wall of mycobacteria. M. tuberculosis loses it's red acid-fast property after treatment [potato skin is cracking and red flecks are popping off from the tuber]
- Bacteriostatic for mature bacilli, bactericidal for rapidly dividing bacteria
- May cause peripheral neuritis [cyanotic neuron], caused by a relative pyridoxine deficiency (isoniazid is a synthetic analog of pyridoxine), and is treated with pyridoxine supplementation [pyramid vitamin B6 running away]
- Eliminated by the liver via acetylation.
- Depresses liver P450 function and is associated with potentially fatal hepatitis [hungry liver is damaged]
- Patients are either fast or slow acetylators, resulting in bimodal (2-peaked) distribution for half lives of isoniazid in different patients [bimodal elimination curves on buttocks]
- Can induce seizures in prone individuals [seizure shock wave]
- Pyrazinamide [pyramid razor mite]
- Bactericidal to dividing bacilli, with unknown mechanism of action
- May trigger attack of gout [brings on the goat]
- Used in combination with isoniazid and rifampin
- Cycloserine [Cyclops rhino]
- Disrupts cell wall synthesis associated with D-alanine
- Renal excretion [kidney impaled on rhino's horn]
- May cause peripheral neuropathy [cyanotic neuron in periphery]
- Good CNS penetration, may lower seizure threshold [epileptic tremors]
- Used infrequently because of adverse effects
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Visual Mnemonic - Anti Tuberculosis, Antimycobacterial: Aminosalicylic Acid, Ethionamide, Isoniazid, Rifampin, Ethambutol, Pyrazinamide, Cycloserine, M. Tuberculosis
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