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50 Cards in this Set
- Front
- Back
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primary drugs for tb
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isoniazid (INH)
rifampin (RIF) |
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route of isoniazid
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oral
im iv (in NS only) |
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how is inh cleared
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liver>> kidneys
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toxicity of inh
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hepatotoxicity
peripheral neurpathy |
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route of rifampin
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oral
IV |
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how is rifampin cleared
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liver >> kidneys
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toxicity of rifampin
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hepatotoxicity
flu like symptoms |
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rifampin is concentration/time dependent
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concentration
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t/f
rifampin is a cyp 3a4 substrate |
f
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what's used instead of rif for hiv pts
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rifabutin
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route of rifabutin (rbn)
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oral
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how is rifabutin cleared
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lever >>> kidneys
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toxicity of rifabutin
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neutropenia
thrombocytopenia uveitis |
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what's is rifabutin used w/
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ritonavir
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Pilocarpine
Mech |
Cholinomimetics: Direct agonist
Bethanechol - used for post-op ilues and urinary retention Carbachol - used for Glaucoma, pupillary contraction, and release of intraocular pressure (along with Echothiophate and Physostigmine) Pilocarpine - direct agonist: used for producing sweat, tears, and saliva Methacholine - used to diagnose asthma |
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pyrazinavide (PZA)
is a --- drug used in the first --- mos |
primary
2 |
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route of pza
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oral
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how is pza cleared
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liver
then metabolites via kidneys |
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toxicity of pza
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hepatotoxicity
elevated uric acid joint aches muscle aches |
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how do you check for noncompliance of pza
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there should be a rise in uric acid
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ethambutol is the -- drug
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4th drug
in case of resistance |
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route of ethambutaol (emb)
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oral
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how is emb cleared
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kidneys >> liver
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toxicity of emb
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ocular toxicity
rashes |
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streptomycing is the -- drug in case of resistance
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4th
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toxicity of stretomycing
----toxicity |
ototoxicity
nephrotoxicity cation loss |
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amikcin, capreomycin, and kanamycin's role in tb
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drug resistance
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other drugs for drug resistance
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levofloxacin (oral, iv)
moxifloxacin (oral, iv) ethionamide (oral) p-aminosalicyclic (oral) cycloserine (oral) |
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toxicity of levo
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caffeine like effects
gi tendonitis |
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toxicity of moxi
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caffeine like effects
gi tendonitis |
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ethioamide toxicity
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gi upset
hypothyroidism |
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p-aminosalicyclic acid toxicity
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gi upset
hypothyroidism |
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cycloserine toxicity
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lack of concentration
altered behavior |
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how many drugs for latent tb
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4
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tx of latent tb:
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1. inh 300 mg qd for 9 months or 900 mg 2 x week dopt
2. rif 600 mg + pza 25 mg/kg qd for 2 months 3. rif 600 mg qd for 4 months 4. emb 15 mg/kg qd + levo 750 mg qd for 6-12 mo or pza 25 mg/kg qd + levo 750 mg q d for 6-12 mo |
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what can u sub rif 600 mg for
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rbn 300 mg
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tx for tb
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1.. isoniazid 300 mg 5 x week
2. rifampin 600 mg 5 x week 3. pyrazinamide 1500 mg 5 week x 2 months 4. ethambuttol 1200 mg 5 x weekly until tb drug susceptibility documented alt to ethambutol: streptomycin 900 mg 5 x week |
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after 4 drugs of tx for tb what's given?
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1. isoniazid 300 mg 5 x week
2. rifampin 600 mg 5 x week for at least 6 mo provided pt responds to 1st 2 mo of tx |
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who do you extend tx to 9 mo for
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if pos bl cultures at 2 months or delayed clincal response
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who do you extend tx for 9-12 mo for
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meningitis
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who do you extend tx for 6-9 mo for
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bone TB
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t/f
ok to add a single drug to a failing regimen |
f
never add a single agent |
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t/f
ok to start w/ INH and RIf |
f
need to start w/ 4 drugs |
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t/f
duration of tx is 6 mo |
t
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how long does mdr-tb tx continue for
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18-30 mo
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inducers:
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rifapentine
rifbutin carbamzepine phenytoin efavirenz nevirapine st. john's wort |
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inhibitors
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clarithromycin
erthyromicn fluconazole itraconazaole ketoconazole aprenavir indinavir nelfinavir ritonavir saquinavir delavirdine (PI's) |
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what pi's can you give rifabutin w/
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lopinavir/ritonavir
atazanavir |
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t/f
ok to use rifabutin and rifampin w/ efavirenz |
t
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when should you suspect mdr tb
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sputum smears pos for AFB
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