Antimycobacterial Agent Flashcards
Recall which organ systems can be damaged by TB
Lungs
but can also infect the brain, kidneys, or spine.
Recall the tests available to screen for TB
- TB skin tests (Purified Protein Derivative or PPD)
- TB blood tests (interferon-Gamma Release Assays - IGRAs)
Recall the tests available to confirm the diagnosis of TB
- Chest x-ray
- Sputum microbiology
culture –> takes a couple of weeks
Nucleic acid amplification (NAA) –> 1 or 2 days
Explain how direct observation therapy (DOT) is used for TB treatment
a trained health care worker provides the prescribed TB drugs and watches the patient swallow every dose
List 1st-line TB medications
***More effective and less toxic!
Isoniazid, rifampin
Rifapentine, rifabutin, pyrazinamide, ethambutol
List 2nd-line TB medications
Levofloxacin, kanamycin, amikacin, capreomycin, etc.
List the drugs to which multidrug-resistant TB (MDR TB) is resistant
isoniazid, rifampin
List the drugs to which extensively drug-resistant TB (XDR TB) is resistant
isoniazid, rifampin,
fluoroquinolones
Recite the side effects of isoniazid
Isoniazid is bactericidal!
peripheral neuropathy
hepatotoxicity
optic neuritis
anemia
Recite the side effects of rifampin
Rifampin is a broad-spectrum antibiotic!
hepatotoxicity
orange urine
GI disturbances
Describe the potential drug interactions of rifampin
- drugs metabolized by P450 enzyme –> rifampin can hasten metabolism
- oral contraceptives
- warfarin
- drugs for HIV infection
–> interfered!
Recite the side effects of pyrazinamide
bactericidal!
- hepatotoxicity
- non-gouty arthralgias
- hyperuricemia
- photosensitivity
Explain the role of ethambutol in the treatment of tuberculosis (TB)
ethambutol is active only against one type of mycobacteria (tubercle bacilli) that are resistant to isoniazid and rifampin
