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18 Cards in this Set
- Front
- Back
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Drugs use in initial phase? |
8 weeks: Pyrazinamide Ethambutol Rifampicin Isoniazid |
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Drugs used in continuation phase? |
18 weeks: Rifampicin Isoniazid |
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Isoniazid method of action? |
Inhibits biosynthesis of Mycolic acid |
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Isoniazid dose? |
5mg/kg |
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Isoniazid problems? |
Hepatitis - 3% Resistance - overall = 10% Peripheral Neuropathy - countered by Vit B6 Nausea, Rash etc. |
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Rifampicin method? |
Inhibits RNA polymerase |
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Rifampicin dose? |
10mg/ml |
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Rifampicin Problems? |
Hepatitis -esp. if patients have predisposition Itch & rash Urine, sweat, tears turn orange CYP450 induction = Increased drug clearance -> Decreased effect of Warfarin, Antiretrovirals |
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Pyrazinamide Method? |
Inhibits fatty acid synthetase I in M. tb |
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Pyrazinamide dose? |
15-30 mg/kg/day |
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Pyrazinamide Effect? |
Speeds up sterilising effects of INH & Rifampicin |
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Pyrazinamide Problems? |
Hepatitis risk GI intolerance common Hyperuricemia which predisposes gout Joint pain, blood changes etc. |
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Ethambutol Method? |
Inhibits Arabinosyn transferase (used in cell wall synthesis) |
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Ethambutol effect? |
Mainly resistance prevention |
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Ethambutol problems? |
Optic neuritis Headaches, dizziness, confusion GI toxicity - hepatotoxicity etc. |
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Treatment problems? |
Long course Multiple drugs Resistance Side effects can be severe Patients feeling better after a couple of weeks so stop taking meds to avoid side effects Intolerance |
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What is DOTS? |
Directly Observed Short Course Treatment |
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Aims of DOTS? |
Political commitment + increased & sustained funds Standardised treatment & support for patients Better case detection via quality-assured bacteriology (e.g. better labs, better resistance surveillance) Effective drug supply & management system Monitoring & evaluation system & impact measurement |
