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14 Cards in this Set
- Front
- Back
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drugs for TB
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isoniazid
rifampin pyrazinamide ethambutol others: streptomycin, amikacin, fluoroquinolones |
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Isoniazid
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Isonizaid
Class: MOA: activated by catalase-peroxidase, inhibits long-chain fatty acid reductase involved in mycolic acid synthesis Use: M. tuberculosis, M. kansasii, prophylaxis and rx AE: hepatitis (age related, monitor hepatic enzymes).. peripheral neuritis (pyridoxine (B6 def), reversible.. seizures, hematologic toxicity, optic neuritis, hypersensitivity - rash/fever Contra: avium-intracellulaire Interaction: potentiate AE phenytoin - nystagmus/ataxia Admin: oral - impaired with food |
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Ethambutol
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Ethambutol
Class: static MOA: inhibit cell wall synthesis enzyme Use: M. tuberculosis, M. avium-intracellulaire - when resistant to other drugs AE: optic neuritis (dose dependent), impaired color vision (reversible) Contra: Interaction: Admin: |
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Pyrazinamide
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Pyrazinamide
Class: MOA: metab to pyrazinoic acid by susceptible mycobacteria - lowers pH to level that they can't grow Use: shortens course of rx - used w/ rifampin, isoniazid (given 1st 2 months) AE: hyperuricemia, gout, rash, joint ache, hepatitis, hematologic effects Contra: Interaction: Admin: |
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Rifampin
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Rifampin
Class: derivative rifamycin MOA: inhibit RNA synthesis, initiation step Use: most mycobacteria, staph, legionella, never use alone, prophylaxis of meningo and H. influenza, leprosy AE: hepatitis, hypersensitivity reactions, discoloration tears, saliva, urine, GI upset Contra: hepatic failure - jaundice Interaction: induce P450 enzymes, decrease t1/2 so need higher doses.. decreases levels of HIV drugs, warfarin, and others Admin: wide distribution, enterohepatic cycling, biliary excretion |
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drugs for M. avium intracellulaire
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Rifabutin
Azithromycin clarithromycin ethambutol ciprofloxacin |
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Dapsone
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Dapsone
Class: MOA: inhibit folic acid synthesis, bacteriostatic folate antagonists Use: long term leprosy rx AE: G6PD - hemolytic anemia, methemoglobinemia, peripheral neuropathy, erythema nodosa Contra: Interaction: Admin: |
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Clofazimine
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Clofazimine
Class: phenazine dye MOA: Use: leprosy - M. tuberculosis, M. leprae, M. avium-intracellulaire, enhances phagocytic activity of neutrophils/macrophages, rx erythema nodosum leprosum (type II hypersensitivity) AE: accumulated by macrophages, concentrated in liver, lungs, lymph nodes, spleen, other tissues Contra: Interaction: highly lipophilic, 55% bioavailable, excreted unchanged in bile and kidneys Admin: |
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Thalidomide
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Thalidomide
Class: MOA: stimulate human T cell - CD8+ Use: orphan drug for TB, leprosy, erythema nodosum leprosum AE: phocomelia (absence of limbs in pregnancy) Contra: Interaction: Admin: |
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drugs for leprosy
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sulfone,
rifampin, clofazimine, thalidomide |
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what do you use to rx tuberculoid leprosy
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dapsone + rifampin
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what do you use to rx lepromatous leprosy
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dapsone + rifampin + clofazimine
consider thalidomide |
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what do you give to prevent TB in neonates/children < 5 years old who are exposed?
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isoniazid for 3 months
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what do you give for latent TB?
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isoniazid for 9 months
alt: rifampin for 4 months if isoniazid resistant |
