What is a live-attenuated vaccine?

Answer: Attenuated vaccine has microbe with selective deletions of genes involved in pathogenesis. Organisms replicate in the host, greatly increasing antigenic stimulation.

Methemoglobinemia occurs when the ferrous (Fe2+) form of iron in hemoglobin is oxidized to the ferric (Fe3+) form and cannot bind O2. What are the clinical manifestations of methemoglobinemia?

Answer: Dyspnea, headaches, dizziness, altered mental status with cyanosis of extremities, and darkened blood. Treat with methylene blue.

Which antibiotic is a PABA analog with a side effect profile that includes hemolysis and methemoglobinemia?

Answer: Dapsone

Name the three drugs commonly used in the treatment of leprosy:

1. Dapsone

2. Rifampin

3. Clofazimine

What are important side effects of INH?

Answer: Hepatotoxicity (avoid alcohol), peripheral neuropathy (vitamin B6 depletion), sideroblastic anemia (vitamin B6 depletion)

What is the mechanism of action for INH?

Answer: Although not proven, it is thought to inhibit mycolic acid synthesis

What are some common side effects of rifampin?

Answer: Red-orange urine, induces P450 potentially leading to impaired efficacy of other drugs, GI symptoms, headache, fever, rash