Which second-line agent is an analog of D-alanine and inhibits cell wall synthesis, but is limited by CNS toxicities like seizures and psychosis?
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Correct answer: Cycloserine
Cycloserine inhibits alanine racemase and ligase, preventing the incorporation of D-alanine into the peptidoglycan pentapeptide. Its use is restricted due to significant neuropsychiatric side effects.
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