Antitubercular Drugs Flashcards
Directly observed therapy (DOT)
Drug dose taken in from of the administrator
Extrapulmonary
Occurring outside of the lungs in the respiratory system
Gout
A metabolic disorder resulting in increased levels of Uris acid and causing severe joint pain
Latent TB
Inactive M. tuberculosis bacterium in the body, which is alive, but no infectious and can become active later
Multi drug-resistant M. tuberculosis (MDR-TB)
Bacterium that is resistant to a number of different drugs (can be expensive to treat)
Mycobacterium leprae
Bacterium that causes leprosy (chronic, communicable, disease infrequently seen in the US)
Mycobacterium tuberculosis
Bacterium that causes TB
Optic neuritis
Inflammation of optic nerve, causing a decrease in visual acuity and changes in color perception
Peripheral neuropathy
Numbness and tingling of the extremities
Vertigo
Feeling is a spinning or rotational motion, dizziness
Primary drugs
Provide foundation for treatment
Secondary drugs
Used for MDR-TB (more costly and toxic than primary drugs)
Secondary drugs ex
Certain flouroquinolones such as ciprofloxacin, ofloxacin, and levofloxacin, and rifampin and isoniazid
Anti tubercular MOA
Both bacteriostatic and bactericidal. Usually inhibit bacterial cell wall synthesis to slow multiplication rates
What to give for latent TB therapy
Isoniazid
Latent TB signs and symptoms
Doesn’t feel sick, PPD skin test or blood test is positive for TB infection, normal chest x-ray and negative sputum test, has TB bacteria, but it is inactive, can’t spread TB bacteria to others, needs treatment to prevent active disease at a later time
2 parts of standard treatment protocol for TB
Initial phase: drugs used to rapidly kill bacteria and prevent drug resistance, lasts 2 months
Continuing phase: lasts 4 months
Primary TB drugs ex
Rifampin, isoniazid,pyrazimamide, and ethambutol
Retreatment protocol
Using secondary drugs, usually 4+. These include ethionamide, aminosalicylic acid, cycloserine, and capreomycin, also oxofloxacin and ciprofloxacin
To treat MDR-TB
obedaquiline was developed (interferes with bacterial enzymes) but comes with increased risk of cariovascular death and patients should be monitored for prolonged QT intervals
Ethambutol adverse reactions (generalized )
Dermatitis and pruritus, joint pain, anorexia, nausea and vomiting
Ethambutol adverse reactions (sever reactions)
Anaphylactoid reactions, optic neuritis
Ethambutol contraindications, precaution and interactions
Not for people younger than 13, caution in pregnancy (cat B), caution in people with hepatic or renal impairment and in people with diabetic retinopathy and cataracts
Isoniazid generalized adverse reactions
More adverse reactions with higher doses, nausea and vomiting, epigastric diseases, fever, skin eruptions, hematologists changes, jaundice, hypersensitivity
Isoniazid toxicity
Peripheral neuropathy, and severe hepatitis
Isoniazid contraindications and precautions
Caution in pregnancy (cat C) or lactation and in patients with renal or hepatic impairment
Isoniazid interactions
Aluminum antacids result in reduced absorption, anticoagulants result in an increased risk of bleeding, phenytoin results in increased serum levels of phenytoin, and alcohol results in a higher chance of drug related hepatitis. When taken with foods containing tyramine (aged cheese, meats, bananas, yeast products, and alcohol) can result in hypertension, increased HR and palpitations
Pyrazinamide generalized side effects
Nausea, vomiting, diarrhea, myalgia (aches), and rashes
Pyrazinamide primary adverse reaction
Hepatoxicity
Pyrazinamide contraindications and precautions
Contraindicated with gout, and sever hepatic damage caution in pregnancy (cat C), and lactation and in patients with hepatic and renal impairment, HIV, and diabetes mellitus
Pyrazinamide interactions
Anti gout meds allopurinol, colchicine, or probenecid, cause pyrazinamide effectiveness to decrease
Rifampin adverse reactions
Nausea and vomiting, epic Astrid distress, heartburn, fatigue, vertigo, rash, reddish-orange discoloration of body fluids, hematologists changes, renal insufficiency
Rifampin contraindications and precautions
Caution in pregnancy (cat C) and lactation and in patients with renal or hepatic impairment
Rifampin interactions
Antiretrovirals result in decreased serum levels of antiretrovirals, digoxin results in decreased serum levels of digoxin, oral contraceptives result in decreased contraceptive effectiveness, isoniazid results in higher risk for hepatoxicity, oral anticoagulants result in an increased risk of bleeding, oral hypoglycemics result in decreased effectiveness of oral hypoglycemic agent, chloramphenicol results in an increased risk for seizures, phenytoin results in a decreased effectiveness in phenytoin, and verapmil results in decreased effectiveness of verapmil
Drugs to treat leprosy
Dapsone, clofazimine, rifampin, and ethionamide
