Antituberculosis Drugas Flashcards
How can we promote medication adherence?
- Directly observed therapy (DOT)
- Intermittent dosing schedules
Treatment for Drug Sensitive TB
- Induction phase: 2 month duration
Drugs: Isoniazid, rifampin, pyrazinamide, ethambutol
Goal: eliminate actively dividing tubercle bacilli - Continuation phase: 4 month duration
Drugs: Isoniazid and Rifampin
Goal: eliminate intercellular persisters
Single agent resistance
Resistance to either isoniazid or rifampin. Will use other three drugs for treatment.
- 18-24 months taking these drugs
MDR or XDR TB
Much harder to manage, treatment prolonged, prognosis poorer, more toxicity
Rifampin can’t be given with NRTI’s or PI because the effectiveness of those HIV drugs will be diminished
Treatment for latent TB
Isoniazid daily for 9 months
Isoniazid and rifapentine taken weekly for three months
First line agents for TB
Isoniazid, rifampin, rifapentine, rifabutin, pyrazinamide, ethambutol
Second line agents for TB
Always used in combo with first line agents. These are more expensive and less effective
ISONIAZID
- Primary agent
- Excreted through urine w inactive metabolites
- Adverse: Teach patient signs of hepatitis, caution using with alcoholism, peripheral neuropathy, report numbing and tingling, B6 will fix numbing and gait issues, GI symptoms
RIFAMPIN
- Bactericidal. Take on empty stomach.
- Expect orange urine
- Hepatitis is an adverse affect
- Drug interactions with contraceptives and warfarin
RIFAPENTINE
- Long acting, so good for latent TB
- Best given with food
RIFABUTIN
- Close chemical relative to rifampin
- Preferred for HIV patients
- Risk of uveitis
PYRAZINAMIDE
- Initial combo therapy for active TB
- Adverse: Hepatotoxicity, non gouty polyathralgias (pain in multiple joints)
ETHAMBUTOL
- Bacteriostatic
- Adverse: Optic neuritis which clears upon discontinuation of treatment
BEDAQUILINE
-New drug, this is used if no other previous treatment is working
