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Clinical Pharmacology II > AntiTB > Flashcards

AntiTB Flashcards

1
Q

What type of growth is Mycobacterium Tuberculosis?

A

slow growing

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2
Q

What type of bacteria is TB?

A

acid fast bacteria

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3
Q

How is TB transmitted?

A

by aerosolized particles/inhaled

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4
Q

What tries to ingest and kill TB?

A

macrophages and neutrophils

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5
Q

What is active TB?

A

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

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6
Q

Who is active TB more common in?

A

patients that are immunocompromised

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7
Q

What is latent TB?

A

body can fight mycobacterium

TB cannot spread to others in this stage

Patient will have positive TB test

Can develop active infection

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8
Q

What is reactivation of TB?

A

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

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9
Q

Symptoms of Active TB?

A 
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
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10
Q

Does latent TB have symptoms?

A

NO

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11
Q

Where is TB most common?

A

in developing countries

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12
Q

What are major impediments to successful therapy?

A

cost

compliance

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13
Q

What are MDR-TB resistant to?

A

Isoniazid

Rifampin

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14
Q

What is XDR-TB resistant to?

A 
Isoniazid
Rifampin
Fluoroquinolones
Amikacin
Kanamycin
Capreomycin
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15
Q

What is the MOA of Rifampin?

A

inhibits RNA polymerase

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16
Q

What are the ADRs of Rifampin?

A

Hepatotoxicity
CYP 450 inducer
Discoloration of Body fluids
Flu like syndrome

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17
Q

What must you monitor with Rifampin use?

A

LFTs

levels of drugs metabolized by CYP 450

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18
Q

How long is a patient on Rifampin for?

A

9 months

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19
Q

What is the MOA for Rifapentine?

A

inhibits RNA polymerase

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20
Q

What are the ADRs of Rifapentine?

A

Hepatitis
CYP 450 inducer
orange discoloration of bodily fluids

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21
Q

What must you monitor with Rifapentine?

A

LFTs

levels of drugs metabolized by CYP 450

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22
Q

What is the MOA of Rifabutin?

A

inhibits RNA polymerase

23
Q

What are the ADRs of Rifabutin?

A 
Nausea/Vomiting
Rash
Neutropenia
Burred vision
Orange colored secretions
induces CYP 450
hepatitis
myalgias
24
Q

What must you monitor with Rifabutin?

A

LFTs

25
Q

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

A

Milder induction of CYP 450

26
Q

When is Isoniazid bacteriocidal?

A

to actively dividing bacteria

27
Q

When is isoniazid bacteriostatic?

A

to resting organisms

28
Q

What is the MOA of Isoniazid?

A

inhibits the synthesis of mycolic acid

29
Q

What are the ADRs of Isoniazid?

A 
Hepatotoxicity
Peripheral Neuropathy
Anemia
optic neuritis
Seizures
Impairment of Memory
Hallucinations
30
Q

What does Isoniazid cause depletion of?

A

B6

31
Q

What must you coadminister with isoniazid?

A

Pyridoxine

32
Q

What must you monitor with Isoniazid?

A

LFTs

33
Q

What is the MOA of Ethambutol?

A

inhibits the incorporation of mycolic acid into the cell wall

34
Q

What are the ADRs of Ethambutol?

A 
Optic Neuritis
Blurred Vision
Constriction of the visual field
Disturbance of color discrimination
Hyperuricemia
Renal dysfunction
Thrombocytopenia
35
Q

What must you monitor with Ethambutol?

A

SCr
CBC
Uric Acid

36
Q

What must you dose adjust for with Ethambutol?

A

Renal

37
Q

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

A

Ethambutol

38
Q

What are the ADRs of Pyrazinamide?

A 
Hepatotoxicity
Nongouty polyarthralgias
Hyperuricemia
Nausea/Vomiting
Photosensitivity
39
Q

What must you monitor with Pyrazinamide?

A

LFTs

Uric acid

40
Q

What must you dose adjust for with Pyrazinamide?

A

Renal

41
Q

What are the two fluoroquinolones used to treat TB?

A

Moxifloxacin

Levofloxacin

42
Q

MOA of Moxi and Levo?

A

inhibit DNA gyrase

43
Q

What are the ADRs of Moxi and Levo?

A 
Qtc prolongation
tendinopathy
Delirium
Hypo/hyperglycemia
Delirium in elderly
Decreases seizure threshold
44
Q

What must you monitor with Moxi and Levo?

A

QTc

45
Q

What must you adjust for with Levo but not Moxi?

A

renal

46
Q

What is the MOA of Aminoglycosides?

A

binds to 30S ribosomal subunit

47
Q

What are the ADRs of Aminoglycosides?

A

Ototoxicity

Nephrotoxicity

48
Q

What must you monitor with Aminoglycosides?

A

SCr, BUN, Amikacin levels (trough?)

49
Q

What is the MOA of Capreomycin?

A

inhibition of protein synthesis

50
Q

What are the ADRs of capreomycin?

A

kidney damage
hearing loss
tinnitus
Balance

51
Q

What must you monitor with Capreomycin?

A

SCr

BUN

52
Q

What must you dose adjust for with Capreomycin?

A

Renal

53
Q

How would you treat Active TB?

A

with a minimum 2 drug regimen

Clinical Pharmacology II (25 decks)

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