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21 Cards in this Set

  • Front
  • Back
a person with positive PPD skin test with no active disease (meaning no granuloma) the DOC would be?
If a perons has a positive PPD test with active disease you treat how?
greater then 6 month regiment on four drugs
if poor compliance in tb treatment what happens?
resistance occurs very quickly... poor commpliance happens alot in this disease
What are the four drugs used in the long term treatment of TB and why do you do this?

you do this do make sure resistnace doesn't occur
MOA of INH (Isoniazid)?
cidal, kills tb organism
Isoniazid in general
penetrates tissue well including CNS for Tb meningitis
metabolized by liver no adjustmenet
Hepatitis is major concern!! can kill.
Make sure they don't have alcohol or cirrohsis issues
warn patient about this

acetylation process so people can be slow or fast acetylators.
Give isoniazid with what?
B6 to prevent pyridoxine deficiency cause the drug inactivates it.
INH toxicity?
hypersentiive reactions like rashes and fever.
Drug interaction with phenytoin which delays its clearnace
Rifampin MOA (RIF)
interferes with DNA synthesis of TB bacteria by binding to the DNA dependent RNA polymerase. This prevents enzyme from binding to DNA and thereby prevents subsequent DNA transcription. RIF does not bind to RNA polymerase of eukaryotic cells.

RIF general
excreted through liver into bile into feces with small amount in urine

no dosage adjustmetns for moderate renal failure

pentrates CSF so good for Tb meningitis also
RIF side effets
urine, tear, sweat and salivia will turn red orange and contact lenses may discolor

effects P450 system
increasing hepatic excretion of drugs like:
oral contraceptives

class C drug
Ethambutol MOA
interferes with cell wall synthesis
may allow other drugs to cross cell wall
static agent!
Ethambutol general
adjust doses in renal failure, half excreted vai kidneys
does not penetrate csf well
Ethambutol side effects
optic neuritis
patient first wiill loose color vision
dose related
hyperuricemia can occur
Pyrazinamide (PZA) MOA
not really understood. maybe lowers ph to inhibit organism.
works intracelluarly
PZA general
penetrates inflamed CNS
being used more was second line agent... deaths being reported though
PZA side effects
hepatoxicity in 2 months
Streptomycin MOA
inhibitor of protein synthesis
penetrates cell poorly active mainly against extracellular bacilli
Streptomycin general
2nd line drug for tb, plague, tularemia
IM use
can pentrate inflammed CNS ok
renally excreted so must adjust dose in renal failure
Streptomycin toxicity
deafness can occur
increased risk with prolonged course and underlying renal failure
LTBI treatment is now this?
Non-hiv = 9 months of INH
prior 2 month RIF-PZA combo should be used with caution cause of hepatic damages
IF INH-PZA used must monitor carefully.