Antitubercular Drugs Flashcards by Nicholas Baker

What causes TB?

Mycobacterium tuberculosis

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T/F: Antitubercular drugs treat all forms of mycobacterium?

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What most commonly denotes a TB infection?

nodular accumulations of macrophages, lymphocytes with clear boundaries and a cheesy consistency

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T/F: TB can’t infect virtually every tissue and organ of the body

F: TB can infect virtually every tissue and organ in the body

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How are tubercle bacilli spread?

droplets via coughing or sneezing that are inhaled

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How is TB spread around the hosts body?

via the lymphatic system

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What is dormancy?

when an individual may test positive for exposure but are not necessarily infectious

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What country has one of the lowest rates of active TB?

Canada

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What demographic has a higher incidence of TB infections in Canada?

Indigenous peoples

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What drugs is Multidrug-resistant tuberculosis resistant to?

both isoniazid (isonicotine hydrazine [INH]) and rifampin.

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How long do close contacts need to be treated for?

6-9 months

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What is the primary drug used to treat TB worldwide?

isoniazid

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What are the two phases of TB therapy?

Initial intensive phase with two medications

Continuation phase with three or more medications

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What are First-line drugs of TB therapy?

isoniazid: primary drug
ethambutol hydrochloride
pyrazinamide
rifampin

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What are the Second-line drugs of TB therapy?

amikacin sulphate
levofloxacin hemihydrate
moxifloxacin hydrochloride

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What Antitubercular drug is a protein wall synthesis inhibitor?

Rifampin

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What Antitubercular drug is a cell wall synthesis inhibitor?

Isoniazid

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Where and how is Isoniazid metabolized? What needs to be watched for?

metabolized in the liver, via acetylation, watch for slow acetylators

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What are the AEs of Isoniazid?

Peripheral neuritis, hepatotoxicity, hyperglycemia, discoloration of body fluids (see rifampin)

What may be needed for peripheral neuropathy?

Vitamin B6

What demographic is Ethambutol hydrochloride contradicted in?

children under 13 yo

What are the AEs of Ethambutol hydrochloride?

May cause visual changes (optic neuritis, blindness, altered color perception)

What route is Ethambutol hydrochloride available in?

oral

What other mycobacterial disease is Ethambutol hydrochloride used to treat?

Leprosy

What conditions is Pyrazinamide contradicted in?

severe liver disease and gout

What patient population is Pyrazinamide not often used in?

Pregnant patients due to lack of evidence

What are the AEs of Rifampin?

May experience discolouration of: Skin, sweat, tears, urine, feces, sputum, saliva, cerebrospinal fluid, and tongue hepatitis; hematological disorders

What other diseases in Rifampin effective against?

meningococcus, Haemophiles influenza B and leprosy

What is Purified Protein Derivative?

a diagnostic agent given ID used to detect TB; also known as TB skin test

How do you now that a patient had TB after a skin test?

Induration (when the soft tissue of different parts of the body, especially the skin, becomes thicker and harder due to an inflammatory process caused by various triggering factors)

What is Bacille Calmette-Guérin (BCG)?

an injection of inactivated Mycobacterium bovis

Where is BCG normally used?

In First Nations communities of Canada and around the world

T/F: BCG prevents TB infection?

F: BCG is used to reduce active TB by 60-80% and preventing severe cases

T/F: BCG can cause a false-positive of TB skin test?

What is the major effect of Antitubercular drugs?

reduction of cough in around two weeks

Can TB be cured? if so how long dose it take for a successful treatment of TB?

Yes, most cases of TB can be cured; usually taking 6-12 months possibly 24 months of several antibiotic, and antitubercular drugs

What dose the effectiveness of antitubercular therapy depend on?

Type of infection Adequate dosing Sufficient duration of treatment Adherence to drug regimen Selection of an effective drug combination

What needs to be obtained during antitubercular drug therapy?

medical history and assessments liver function for INH patients contraindications

What is a **critical** nursing priority of TB patients

education

What education point is important to emphasize to patients during teaching?

they are contagious during the initial period of illness—instruct them in proper hygiene and prevention of the spread of infected droplets.

What shouldn't patients use while taking Antitubercular drugs?

alcohol, or OTC drugs (check with prescriber)

What should patients taking Rifampin be told in regard to their excretions?

urine, stool, saliva, sputum, sweat, or tears may become reddish orange; even contact lenses may be stained.

What drug may be used to combat Neurological diseases caused by INH?

Pyridoxine

Should TB meds be given with food? Why?

yes, to reduce upset GI

What AEs should patients be instructed to report?

fatigue, nausea, vomiting, numbness and tingling of the extremities, fever, loss of appetite, depression, and jaundice, altered colour perception, changes in visual acuity

what dose aerobic mean?

requires oxygen