5.4 Antimycobacterial

Question 1

What is Latent TB?

Answer 1

Pt don’t feel sick and do not have any symptoms
- Not contagious

Question 2

What is the testing to diagnose latent TB in adults aged 18-65?

Answer 2

Mantoux

Question 3

What is treatment in neonates who have been in close contact with people with TB

Answer 3

1. Isoniazid with pyridoxine

Question 4

What is drug treatment in pts with HIV, <65years with TB?

Answer 4

3 months of isoniazid with pyridoxine and rifampicin

OR

6 months of isoniazid with pyridoxine

Question 5

Treatment for pts with active TV without CNS involvement?

Answer 5

1. Isoniazid with pyridoxine, rifampicin, pyrazinamide and ethambutol for 2 months
2. Isoniazid with pyridoxine and rifampicin for a further 4 months

Question 6

Treatment for pts with active TV with CNS involvement?

Answer 6

1. Isoniazid with pyridoxine, rifampicin, pyrazinamide and ethambutol for 2 months
2. Isoniazid with pyridoxine and rifampicin for a further 10 months

Question 7

What steroids are offered to pts with active TB of the CNS

Answer 7

Dexamethasone or prednisolone - initially high dose over 4 to 8 weeks

Question 8

What is the treatment in in the initial phases [2 months] of TB?

Answer 8

Rifampicin
Isoniazid
Pyrazinamide
Ethambutol

Question 9

What is the treatment in the continuation phase [4 months] of TB?

Answer 9

Rifampicin
Isoniazid

Question 10

What are key points about rifampicin?

Answer 10

• Enzyme inducer = no oral contraceptives
• Hepatotoxicity
  Colours soft contact lenses
  -Urine red/orange

Question 11

What are key points about isoniazid?

Answer 11

• enzyme inhibitor
• hepatotoxicity
• peripheral neuropathy; overcome by concomitant pyridoxine

Question 12

What are key points about pyrazinamide?

Answer 12

Hepatotoxicty

Question 13

What are key points about ethambutol?

Answer 13

Visual changes