Antimicrobials (TB) and anemia drugs

Question 1

Isoniazid (INH) MOA

Answer 1

disrupts cell wall synthesis

Question 2

Isoniazid SE

Answer 2

Peripheral neuropathy, hepatotx, optic neuritis/visual prob, hyperglycemia; BLACK BOX–HEPATITIS

Question 3

Isoniazid NC

Answer 3

• PO
• monitor liver enzymes
• avoid antacids–dec drug abs
• inc CNS and hepatotox when taken with rifampin
• can inc fx phenytoin
• give with vit B6 for black box

Question 4

Rifampin MOA

Answer 4

Inhibit pro synth via attack hydrocarbon ring structure

Question 5

Rifampin SE

Answer 5

Hepatitis, hematological dx, red-brown discolored urine and fluids

Question 6

Rifampin NC

Answer 6

• be careful when give with isonizid
• CYP inducer (dec effect beta block, benzos, cyclopsorins, anticaogs, antidaibetics, phenytoin, theophylline)
• may need higher doses of these (not CI)
• PO or IV

Question 7

First line drugs for TB

Answer 7

isoniazid and rifampin

Question 8

Ethambutol MOA

Answer 8

Diffuse into mycobacteria and suppress RNA synth which index pro synthesis

Question 9

Ethambutol SE

Answer 9

blindness, retrobulbar neuritis

Question 10

Ethambutol NC

Answer 10

• Only PO
• give with INH and rifampin
• not for kids under 13 age

Question 11

Pyrazinamide MOA

Answer 11

Inhibit lipid and nucleic acid synth

Question 12

Pyrazinamide SE

Answer 12

hepatotoxicity, hyperuricemia

Question 13

Pyrazinamide NC

Answer 13

• used with other meds
• CI with gout and hyperuricemia
• PO
• not for preg

Question 14

Streptomycin class

Answer 14

Aminoglycosides

Question 15

Streptomycin MOA

Answer 15

interfere with pro synth and cause faulty proteins

Question 16

Streptomycin SE

Answer 16

Ototox, nephrotoxic, blood dyscrasias

Question 17

Streptomycin NC

Answer 17

• IM only (daily)
• can inc bleeding (careful with anticoags)

Question 18

Ferrous sulfate, ferrous gluconate, iron dextran indications

Answer 18

Tx and prevent IDA, treat blood loss

Question 19

Ferrous sulfate, ferrous gluconate, iron dextran SE

Answer 19

GI–nausea, heartburn, constipation, metallic taste, stain teeth (straw), fatal iron tox OD (in kids, liver fail), leading cause poison death in kids; black or dark green stool, malodorous

Question 19

ferrous sulfate and ferrous gluconate NC

Answer 19

• ferrous–oral
• iron dextran–parenteral
• dec abs with antacids–don’t take with antacids or Ca supps
• inc abs with vit C
• not great abs
• deferoxamine drug tx iron tox (chelate the iron to form compound excreted in stool)
• often in mutivit or supp (preg)
• stain teeth

Question 20

Iron dextran NC

Answer 20

• parenteral iron
• give test dose
• BLACK BOX–epi available bc can cause allergic rxn (anaphylaxis)
• IM form–stains so ztrack

Question 21

cyanocobalamin indications

Answer 21

Low b12, pernicious anemia, bariatric surgery pt need 1 mg daily, surgery with stomach removed, pt with severe def or neuro sx

Question 22

cyanocobalamin SE and NC

Answer 22

• well tolerated, pain or red at site
• IM, not IV
• weekly inject then gradually to monthly
• supplement with diet

Question 23

Folic acid supplements SE and NC

Answer 23

• well tolerated
• supp with diet
• tablets 1-5mg
• OTC recc dose 400 mcg

Question 24

Epoetin alpha class and MOA

Answer 24

Erythropoietin stim agent; Stim erythropoiesis; inc hgb and reticulocyte counts

Question 25

Epoetin alpha indications

Answer 25

Only index when hgb under 10g/dL unless on dialysis; CKD

Question 26

Epoetin alpha SE

Answer 26

HTN, serious CV events (inc H&H), can progress certain cancers, injection site prob, bone pain, HA; BLACK BOX for freezing it, mixing with other meds

Question 27

Epoetin NC

Answer 27

• IV and IVP, and SQ
• BLACK BOX when given over 10g bc clotting risk
• weekly monitor
• don’t want hgb over 11
• CI in uncontrolled HTN bc epogen may worsen high BP
  Hgb levels can rise in 2 weeks

Question 28

Antidote for iton

Answer 28

Deferoxamine–chelating agent