Anti Tb Meds

Front 1

a person with positive PPD skin test with no active disease (meaning no granuloma) the DOC would be?

Back 1

INH

Front 2

If a perons has a positive PPD test with active disease you treat how?

Back 2

greater then 6 month regiment on four drugs

Front 3

if poor compliance in tb treatment what happens?

Back 3

resistance occurs very quickly... poor commpliance happens alot in this disease

Front 4

What are the four drugs used in the long term treatment of TB and why do you do this?

Back 4

INH
Rifampin
Ethambutol
streptomycin

you do this do make sure resistnace doesn't occur

Front 5

MOA of INH (Isoniazid)?

Back 5

cidal, kills tb organism

Front 6

Isoniazid in general

Back 6

orally
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.

Front 7

Give isoniazid with what?

Back 7

B6 to prevent pyridoxine deficiency cause the drug inactivates it.

Front 8

INH toxicity?

Back 8

hypersentiive reactions like rashes and fever.
Drug interaction with phenytoin which delays its clearnace

Front 9

Rifampin MOA (RIF)

Back 9

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.

cidal

Front 10

RIF general

Back 10

orally
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

Front 11

RIF side effets

Back 11

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
warfarin

class C drug

Front 12

Ethambutol MOA

Back 12

interferes with cell wall synthesis
may allow other drugs to cross cell wall
static agent!

Front 13

Ethambutol general

Back 13

oral
adjust doses in renal failure, half excreted vai kidneys
does not penetrate csf well

Front 14

Ethambutol side effects

Back 14

optic neuritis
patient first wiill loose color vision
dose related
hyperuricemia can occur

Front 15

Pyrazinamide (PZA) MOA

Back 15

not really understood. maybe lowers ph to inhibit organism.
cidal
works intracelluarly

Front 16

PZA general

Back 16

orally
penetrates inflamed CNS
being used more was second line agent... deaths being reported though

Front 17

PZA side effects

Back 17

hyperuricemia
hepatoxicity in 2 months

Front 18

Streptomycin MOA

Back 18

inhibitor of protein synthesis
cidal
penetrates cell poorly active mainly against extracellular bacilli

Front 19

Streptomycin general

Back 19

2nd line drug for tb, plague, tularemia
IM use
can pentrate inflammed CNS ok
renally excreted so must adjust dose in renal failure

Front 20

Streptomycin toxicity

Back 20

ototoxicity
deafness can occur
increased risk with prolonged course and underlying renal failure

Front 21

LTBI treatment is now this?

Back 21

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.