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13 Cards in this Set
- Front
- Back
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tuberculosis is treated in 2 phases, how long can each phase be? |
Phase 1 = 8 weeks
Phase 2 = 18 - 31 weeks
9 month therapy may be needed in there is a positive sputum culture after initial 2 months but is normally 6 months of treatment to ensure all organisms, including slow growing ones are removed |
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What are the drugs that you would or could use in the intial phase? |
Isoniazid Rifampicin Pyrazinamide Ethambutol
these would all be used together in combination treatment to ensure no resistant bacteria remain
NB one toxic side effect possibility of many of the TB drugs is Hepatitis |
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Which drugs would follow and be used in the continuation (2nd) phase of treatment? |
Isoniazid Rifampicin |
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What are the features of Isoniazid? |
Its bactericidal
Inhibits mycolic acid biosynthesis
Easily tolerated and inexpensive
Low toxicity
Overall only a 10% resistance rate |
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What are the features of Rifampicin? |
Bactericidal
Inhibits bacterial DNA-dependent RNA polymerase
Well tollerated |
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What are the features of Pyrazinamide? |
It is bactericidal although considered bacteriostatic
In combination with rifampicin it can allow for 6 month treatment instead of longer
can exacerbate gout and GI intolerance fairly common |
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what are the features of Ethambutol |
Bacteriostatic
inhibits arabinosyn transferase
Usually well tolerated single dose
Can cause optic neuritis, headaches, dissiness, confusion |
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Second line drugs are often used in multi-drug resistant TB (MDRTB), name some of these |
Fluoroquinolones Aminoglycosides Cycloserine PAS Ethionamine, Prothionamide Clofazamine |
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What does DOTS stand for? |
Directly Observed Short course treatment
which looks at 5 components to ensure TB treatment levels are adequate within an area
-Political commitment -Case detection through bacteriology -Standardised treatment -Effective drug supply -Monitoring and evaluation systems
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Which drug has the lowest risk of resistance? |
Rifampicin (10^-8) |
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Which drug is most resisted by TB? |
Cycloserine (10^-3) |
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Which relatively new drug has been approved for the treatment of MDRTB? |
Bedaquiline |
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Whay type of drug is Bedaquiline |
A dairyquinolone
Action limited to mycobacteria
Inhibits ATPase in mycobacterial cell wall which usually pumps protons out of the cell |
