AntiTB

Question 1

What type of growth is Mycobacterium Tuberculosis?

Answer 1

slow growing

Question 2

What type of bacteria is TB?

Answer 2

acid fast bacteria

Question 3

How is TB transmitted?

Answer 3

by aerosolized particles/inhaled

Question 4

What tries to ingest and kill TB?

Answer 4

macrophages and neutrophils

Question 5

What is active TB?

Answer 5

mycobacterium replicate and create lesions (cavities) that destroy lung architecture

Question 6

Who is active TB more common in?

Answer 6

patients that are immunocompromised

Question 7

What is latent TB?

Answer 7

body can fight mycobacterium

TB cannot spread to others in this stage

Patient will have positive TB test

Can develop active infection

Question 8

What is reactivation of TB?

Answer 8

renewed multiplication of tubercle bacilli that have been dormant following control of a primary infection

Question 9

Symptoms of Active TB?

Answer 9

Bad cough that lasts 3 weeks or longer
Pain in the chest
Coughing up blood or sputum
Weakness or fatigue
Weight loss
No appetite
Chills, fevers, sweating at night

Question 10

Does latent TB have symptoms?

Answer 10

NO

Question 11

Where is TB most common?

Answer 11

in developing countries

Question 12

What are major impediments to successful therapy?

Answer 12

cost

compliance

Question 13

What are MDR-TB resistant to?

Answer 13

Isoniazid

Rifampin

Question 14

What is XDR-TB resistant to?

Answer 14

Isoniazid
Rifampin
Fluoroquinolones
Amikacin
Kanamycin
Capreomycin

Question 15

What is the MOA of Rifampin?

Answer 15

inhibits RNA polymerase

Question 16

What are the ADRs of Rifampin?

Answer 16

Hepatotoxicity
CYP 450 inducer
Discoloration of Body fluids
Flu like syndrome

Question 17

What must you monitor with Rifampin use?

Answer 17

LFTs

levels of drugs metabolized by CYP 450

Question 18

How long is a patient on Rifampin for?

Answer 18

9 months

Question 19

What is the MOA for Rifapentine?

Answer 19

inhibits RNA polymerase

Question 20

What are the ADRs of Rifapentine?

Answer 20

Hepatitis
CYP 450 inducer
orange discoloration of bodily fluids

Question 21

What must you monitor with Rifapentine?

Answer 21

LFTs

levels of drugs metabolized by CYP 450

Question 22

What is the MOA of Rifabutin?

Answer 22

inhibits RNA polymerase

Question 23

What are the ADRs of Rifabutin?

Answer 23

Nausea/Vomiting
Rash
Neutropenia
Burred vision
Orange colored secretions
induces CYP 450
hepatitis
myalgias

Question 24

What must you monitor with Rifabutin?

Answer 24

LFTs

Question 25

What does Rifabutin have that the other two don't?

Answer 25

Milder induction of CYP 450

Question 26

When is Isoniazid bacteriocidal?

Answer 26

to actively dividing bacteria

Question 27

When is isoniazid bacteriostatic?

Answer 27

to resting organisms

Question 28

What is the MOA of Isoniazid?

Answer 28

inhibits the synthesis of mycolic acid

Question 29

What are the ADRs of Isoniazid?

Answer 29

``` Hepatotoxicity Peripheral Neuropathy Anemia optic neuritis Seizures Impairment of Memory Hallucinations ```

Question 30

What does Isoniazid cause depletion of?

Answer 30

B6

Question 31

What must you coadminister with isoniazid?

Answer 31

Pyridoxine

Question 32

What must you monitor with Isoniazid?

Answer 32

LFTs

Question 33

What is the MOA of Ethambutol?

Answer 33

inhibits the incorporation of mycolic acid into the cell wall

Question 34

What are the ADRs of Ethambutol?

Answer 34

``` Optic Neuritis Blurred Vision Constriction of the visual field Disturbance of color discrimination Hyperuricemia Renal dysfunction Thrombocytopenia ```

Question 35

What must you monitor with Ethambutol?

Answer 35

SCr CBC Uric Acid

Question 36

What must you dose adjust for with Ethambutol?

Answer 36

Renal

Question 37

What Anti-TB drug is the only one you don't need to monitor LFTs with?

Answer 37

Ethambutol

Question 38

What are the ADRs of Pyrazinamide?

Answer 38

``` Hepatotoxicity Nongouty polyarthralgias Hyperuricemia Nausea/Vomiting Photosensitivity ```

Question 39

What must you monitor with Pyrazinamide?

Answer 39

LFTs | Uric acid

Question 40

What must you dose adjust for with Pyrazinamide?

Answer 40

Renal

Question 41

What are the two fluoroquinolones used to treat TB?

Answer 41

Moxifloxacin | Levofloxacin

Question 42

MOA of Moxi and Levo?

Answer 42

inhibit DNA gyrase

Question 43

What are the ADRs of Moxi and Levo?

Answer 43

``` Qtc prolongation tendinopathy Delirium Hypo/hyperglycemia Delirium in elderly Decreases seizure threshold ```

Question 44

What must you monitor with Moxi and Levo?

Answer 44

QTc

Question 45

What must you adjust for with Levo but not Moxi?

Answer 45

renal

Question 46

What is the MOA of Aminoglycosides?

Answer 46

binds to 30S ribosomal subunit

Question 47

What are the ADRs of Aminoglycosides?

Answer 47

Ototoxicity | Nephrotoxicity

Question 48

What must you monitor with Aminoglycosides?

Answer 48

SCr, BUN, Amikacin levels (trough?)

Question 49

What is the MOA of Capreomycin?

Answer 49

inhibition of protein synthesis

Question 50

What are the ADRs of capreomycin?

Answer 50

kidney damage hearing loss tinnitus Balance

Question 51

What must you monitor with Capreomycin?

Answer 51

SCr | BUN

Question 52

What must you dose adjust for with Capreomycin?

Answer 52

Renal

Question 53

How would you treat Active TB?

Answer 53

with a minimum 2 drug regimen