Which of the following is not a first line antitubercular drug?

Correct Answer: A

Rationale: In the context of chemotherapy drugs for tuberculosis, the correct answer is A) Ciprofloxacin. This is because Ciprofloxacin is not a first-line antitubercular drug commonly used to treat tuberculosis. First-line drugs for tuberculosis treatment include Streptomycin, Pyrazinamide, and Ethambutol. Streptomycin is an aminoglycoside antibiotic that is effective against Mycobacterium tuberculosis, the bacteria that causes tuberculosis. Pyrazinamide is a bactericidal drug that is particularly active against dormant tuberculosis bacteria. Ethambutol is another first-line antitubercular drug that works by inhibiting the formation of the cell wall in the bacteria. Understanding the classification of antitubercular drugs is crucial for nurses and healthcare professionals, especially when managing patients with tuberculosis. It is essential to know which drugs are considered first-line treatments to ensure effective and appropriate therapy for patients. This knowledge also helps in preventing drug resistance and optimizing treatment outcomes.

Correct Answer: B

Rationale: In the treatment of tuberculosis, using a combination of chemotherapeutic agents is essential to prevent the development of resistance to the drugs. Tuberculosis is caused by Mycobacterium tuberculosis, a bacterium that can quickly develop resistance to single drugs through mutations. By using a combination of drugs, each with a different mechanism of action, the likelihood of the bacteria developing resistance is significantly reduced. This approach, known as combination therapy, is a cornerstone of tuberculosis treatment to ensure the effectiveness of the drugs over the course of the treatment. Option A, to obtain a bactericidal effect, is not the most important reason for using a combination of drugs in tuberculosis treatment. While achieving a bactericidal effect is important, preventing the development of drug resistance takes precedence due to the high risk of resistance in tuberculosis. Option C, to broaden the spectrum of activity, is not the primary reason for using combination therapy in tuberculosis. Tuberculosis is caused by a specific bacterium, and the focus is on preventing resistance rather than broadening the spectrum of activity. Option D, to reduce adverse effects of the drugs, is not the main rationale for using combination therapy in tuberculosis. While reducing adverse effects is important, the primary goal is to ensure the effectiveness of the treatment by preventing resistance. Educationally, understanding the rationale behind using combination therapy in tuberculosis treatment is crucial for healthcare professionals, especially those preparing for exams like the NCLEX. It highlights the importance of strategic drug combinations to combat resistant strains of bacteria effectively. This knowledge can inform clinical decision-making and improve patient outcomes in the management of tuberculosis and other infectious diseases.

Correct Answer: C

Rationale: In the context of treating new (untreated) sputum smear positive cases of pulmonary tuberculosis according to WHO guidelines, option C is the correct regimen. This option includes Isoniazid and Rifampin for the full 6-month duration, which are the cornerstone drugs for treating tuberculosis. Additionally, Pyrazinamide and Ethambutol/Streptomycin are added during the initial 2 months to effectively kill the bacteria and prevent resistance. Option A is incorrect because it lacks Pyrazinamide, which is crucial for the initial phase of treatment. Option B is incorrect as Thiacetazone is not recommended due to potential adverse effects. Option D is also incorrect because it lacks Ethambutol/Streptomycin, which are important for preventing resistance and improving treatment efficacy. In an educational context, understanding the rationale behind each drug in the regimen is essential for nurses and healthcare professionals to provide safe and effective care to patients with tuberculosis. Knowing the correct drug combinations, durations, and potential side effects can help prevent treatment failure and the development of multidrug-resistant tuberculosis strains.

Correct Answer: B

Rationale: The correct answer is B) Four first-line antitubercular drugs for 2 months followed by a longer continuation phase of 7 months with rifampin + isoniazid. This regimen is the standard treatment for Mycobacterium tuberculosis infection in a HIV-infected patient because it ensures effective treatment while considering the patient's immune status. Option A is incorrect because HIV-infected patients require a longer duration of treatment due to their compromised immune system. Option C is incorrect as not all five first-line antitubercular drugs are necessary for the treatment of Mycobacterium tuberculosis infection, and using unnecessary medications can increase the risk of adverse effects. Option D is incorrect because the combination of Clarithromycin, Ciprofloxacin, and Rifabutin is not the first-line treatment for tuberculosis and may not provide adequate coverage against the infection. Educationally, it is crucial for healthcare professionals to understand the specific treatment regimens for tuberculosis in HIV-infected patients to ensure optimal patient care and outcomes. This knowledge helps in tailoring treatment plans based on individual patient characteristics, such as immune status, to provide the most effective and safe care.

Correct Answer: D

Rationale: In the treatment of leprosy, multidrug therapy with dapsone, rifampin, and clofazimine is recommended by the World Health Organization as the treatment of choice for all forms of leprosy. This combination therapy has proven to be highly effective in treating leprosy, preventing the development of drug resistance, and reducing the risk of relapse. Option A) Multibacillary leprosy is incorrect because multidrug therapy is recommended for both multibacillary and paucibacillary forms of leprosy. Option B) Paucibacillary leprosy is incorrect as well because while this form of leprosy requires fewer drugs for treatment compared to multibacillary leprosy, the combination of dapsone, rifampin, and clofazimine is still the preferred treatment. Option C) Dapsone resistant leprosy is incorrect because even in cases of dapsone resistance, multidrug therapy including rifampin and clofazimine remains effective. Educationally, understanding the rationale behind using multidrug therapy for leprosy is crucial for nurses and healthcare professionals to provide optimal care to patients with this infectious disease. By knowing the appropriate treatment protocols, healthcare providers can help prevent the spread of leprosy, manage symptoms effectively, and improve patient outcomes.