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Pharm Test 3 > Anti-Mycobacterial Agents (week 10) > Flashcards

Anti-Mycobacterial Agents (week 10) Flashcards

1
Q

What are the four Antimycobacterial Agents?

A

Isoniazid (INH)
Rifampin (RIF)
Pyrazinamide (PZA)
Ethambutol (EMB)

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2
Q

Reaction of TB after immunosuppression, HIV infection, or smoking

A

Secondary TB

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3
Q 
Positive Skin Test 
Negative Chest Xray
Does not feel sick
Not infectious
Requires treatment to prevent
A

Latent TB

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4
Q 
Positive skin test 
Abnormal chest Xray
Positive sputum 
Feels sick
Contagious 
Requires treatment for the disease
A

Active TB

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5
Q

Why does TB treatment happen in multiple waves?

A

Because slow-growing microbes that show up after the first dose

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6
Q

How many drugs do you start with for Active TB?

A

Four drugs

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7
Q

Why are multiple drugs used over the course of TB Treatment?

A

Because of Resistance

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8
Q

What does Multi-drug Resistance mean?

A

Resistant to both isoniazid and Rifampin

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9
Q

What is Extensively drug-resistant TB?

A

Resistant to Isoniazid and Rifampin

All fluoroquinolone

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10
Q

First 8 weeks of treatment
Most bacilli killed during this phase
4 drugs used

A

Intensive Phase of TB Treatment

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11
Q

After first 8 weeks of treatment
Bacilli remaining after intensive phase
At least 2 drugs

A

Continuation Phase of TB treatment

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12
Q

Surviving TB might cause TB later

A

Relapse of TB treatment

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13
Q

What is Directly observed therapy (DOT) used for?

A

Patient non-adherence

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14
Q

What do you assess to see if TB treatment is working?

A

Bacteriologic evaluation of sputum
Clinical Evaluation
Chest Radiographs

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15
Q

What combination of drugs should not be offered for those who have Latent TB?

A

Rifampin and Pyrazinamide

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16
Q

What is Isoniazid (INH) used for?

A

Must use in combination for active TB infection

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17
Q

What is the MOA of Isoniazid (INH)?

A

Selective for mycobacteria, kills cells wall

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18
Q

How is Isoniazid metabolized?

A

Acetylation

19
Q

What are common adverse effects of Isoniazid (INH)?

A

Peripheral neuropathy

20
Q

What are some serious side effects of Isoniazid (INH)?

A

Black Box Warning - Hepatotoxicity

21
Q

What do you want to know in the PMH before administering Isoniazid (INH)?

A

Acute liver disease or hx of INH hepatotoxicity

Rate of Acetylation

22
Q

How is Isoniazid administered?

A

PO

IM

23
Q

How do you take Isoniazid?

A

Empty stomach, either 1 hour before meals or 2 hours after

24
Q

What is the antidote to Isoniazid (INH)?

A

Pyridoxine (Vitamin B6)

25
Q

What is Rifampin used for?

A

Active TB

Prevention of disease caused by influenza B

26
Q

What is the MOA of Rifampin?

A

Inhibits synthesis of RNA and therapy causing defective proteins

27
Q

What are some common side effects of Rifampin?

A

Red/Orange discoloration of tears and urine

28
Q

What are some serious side effects of Rifampin?

A

Hepatotoxicity

CNS symptoms

29
Q

What are some drugs that interact with Rifampin?

A

Protease inhibitors and delavirdine

CYP3A4 inducers

30
Q

How is Rifampin administered?

A

Oral

IV

31
Q

How do you take Rifampin?

A

Oral - 1 hour before a meal or 2 hours after

IV - slow infusion

32
Q

What is Pyrazinamide used for and what is the MOA?

A

TB

Unknown

33
Q

What are common side effects of Pyrazinamide?

A

Hyperuricemia

Arthralgia, Myalgia (body aches)

34
Q

What are serious side effects of Pyrazinamide?

A

Hepatotoxicity

Articular gout

35
Q

What do you want to know about PMH before administering Pyrazinamide?

A

Severe liver disease or acute gout

36
Q

How is Pyrazinamide administered?

A

Oral

Once a day, on a empty stomach

37
Q

What should you take for arthralgia?

A

NSAID

38
Q

What is Ethambutol (Myambutol) used for?

A

Initial treatment of TB

39
Q

What is the MOA Ethambutol (Myambutol)?

A

Unknown

40
Q

What are the common side effects of Ethambutol (Myambutol)?

A

Hyperuricemia

41
Q

What are the serious side effects of Ethambutol (Myambutol)?

A

Optic neuritis

42
Q

What kind of baseline info should you have before administering Ethambutol (Myambutol)?

A

Baseline eye test

43
Q

What should you know in the PMH before administering Ethambutol (Myambutol)?

A

Optic neuritis

44
Q

How is Ethambutol administered?

A

Oral

Take once a day

Pharm Test 3 (15 decks)

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