Antitubercular Drugs · Pharmacology

Pyrazinamide is unique among first-line antitubercular drugs because its activity is greatest in which environment?

  1. Alkaline environment of the extracellular space
  2. Acidic environment within macrophage phagolysosomes
  3. Neutral pH of the cerebrospinal fluid
  4. Oxygen-rich cavitary lesions of the upper lung lobes
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Correct answer: Acidic environment within macrophage phagolysosomes

Pyrazinamide is a prodrug converted to pyrazinoic acid by mycobacterial pyrazinamidase, and it is most active at low pH. This makes it especially effective against intracellular bacilli that persist inside the acidic phagolysosomes of macrophages.

Difficulty: Medium Question 5 of 20

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