Antitubercular agents (part 4) Flashcards
TB incubation period
2-10 weeks
Risk of progressive TB disease greatest in first ___ years?
2
what kind of immune response is caused by TB??
cell mediated
how long do TB cultures take?
6 weeks
what does TB diagnosis rely on?
AFB smear
TB sites
lungs, urinary tract, bone
primary TB
initial infection with the disease
reactivation of TB
patient infected in past has reactivation of disease
assume TB is contagious is they show which symptoms?
cough, undergoing cough inducing procedures, sputum smear is positive until 3 neg, pt needs to be on treatment at least 1 week, not responding to treatment
0.1cc of PPD with 5TU is injected to test what
to test for exposure
what will PPD show if positive
> 5mm induration
How much prophylaxis supply of INH medication do you give? dose?
1 month supply
dose: 300mg PO QD
Length of TB treatment
6-12 months
INH, RIF, PZA are commonly used in which patients?
pediatrics
EMB is not recommenced for which age group?
<13
Streptomycin is not recommended for use in which age group?
children
<5 yr old, what testing do they need?
color vision testing
do TB meds appear in breast milk?
yes, but do not discourage breakfeeding
pregnancy category for TB meds?
C, give because benefits outweigh risk, not shown to be toxic
We see prophylaxis TB patients every month, what do we monitor?
liver damage, fatigue, weakness, paresthesias of hands/feet, dark urine
who is at greatest risk for developing INH hepatitis?
> 35, drinkers, hs liver disease, taking meds that are toxic to the liver
if you see s/s of toxicity what do you do?
DC INH immediately
What do we monitor in patients for active tb?
chest xray at bassine then q6 months, sputum smear and culture at baseline then monthly until negative
which specific monitoring do we do with INH?
periodic ophthalmologic exams
which specific monitoring do we do with PZA?
blood glucose levels
which specific monitoring do we do with EMB?
color vision for red/green at baseline and q2-3 months
which specific monitoring do we do with SM?
audiogram prior to Tx then q2-3 month
Is INH bacteriostatic or cidil?
both
how does INH affect TB?
interferes with lipid and nucleic acid biosynthesis
INH adverse effects?
urine orange-red, fever, rash, abnormal LFTs
N/V, dizziness, slurring speech, blueing of vision, visual hallucination are all s/s of early or late INH overdose?
early
respiratory distress, CNS depression are all s/s of early or late INH overdose ?
late
do you take INH on an empty stomach?
yes, minimize alcohol consumption
which foods should you avoid when taking INH?
wine, hard cheese, liver, tuna, sauerkraut
Is Rifampin bacteriostatic or cidil?
both
which drug suppresses RNA synthesis?
Rifampin
if we give Rifampin at higher doses what s/s do we see
flu like symptoms, hematopoietic reactions
Do you take Rifampin on an empty stomach?
yes
Is Pyrazinamide bacteriostatic or cidil?
depends on dose
how are diabetic patients affected with PZA?
BS control is harder to control
most common adverse affects of PZA?
gout and hepatic toxicity
does PZA have a P450 interaction?
no
Is Ethambutol HCL (EMB) bacteriostatic or cidil?
cidial but only active against mycobacterium
optic neuritis, loss of acuity, loss of red-green discrimination are sever adverse effects of which drug?
Ethambutol HCL (EMB)
which may delay/reduce absorption of EMB?
aluminum salts
Do you takeEthambutol HCL (EMB) with or without food?
take with food
Is Cycloserine bacterial static or cidil?
both
when do you give Ethionamide?
when first line drugs fail
Should you take Ethionamide with or without food?
take with food
tremor, psychosis, somnolence, depression, confusion, vertigo, convulsions are adverse effects of which drug?
Cycloserine
