Drugs Used to Treat Pulmonary Tuberculosis (Izard) Flashcards
General things to do when treating TB?
Monitor serum concentrations
Liver function tests
Test for Hep B/C
Goal of TB treatment?
Decrease disability and death
Decrease active spread of disease
TB drugs available?
R ifampin
I soniazid
P yrazinamide
E thambutol
Rifampin indication?
TB and meningococcal carriers
Rifampin contraindication?
Patients receiving ritonavir-boosted saquinavir due to increased risk of severe hepatocellular toxicity
patients receiving -avir drugs, rifampin can decrease plasma concentrations, causing viral resistance
Rifampin warnings
Liver dysfunction
Rifampin precautions
patients with DM
Rifampin drug interactions
CYP-450 enzymes -> accelerates elimination of drugs that undergo this pathway
Isoniazid MOA
inhibits synthesis of mycolic acids (essential component of bacterial cell wall).
Isoniazid indication
TB that is susceptible
Isoniazid contraindications
acute liver disease
Isoniazid black box warning?
fatal hepatitis may occur.
Isoniazid drug interactions?
Food Acetaminophen Carbamazepine Valproate Theophylline
Pyrazinamide indications
initial treatment of active TB in adults and children when combined with other antituberculosis drugs
Current CDC recommendation is a six month regimen for initial treatment of active TB, consisting of isoniazid, rifampin, and pyrazinamide given for 2 months, followed by isoniazid and rifampin for 4 months.
Pyrazinamide contraindications
Pts with severe hepatic damage
With acute gout
history of DM
Ethambutol MOA
oral chemotherapeutic agent that is specifically effective against actively growing microorganisms of the genus Mycobacterium
Ethambutol indication
TB, in conjunction with other TB drugs
Ethambutol contraindications
Optic neuritis
Pts who report visual side effects or changes in vision
Ethambutol precaution
Patients under 13
Streptomycin indications
moderate to severe infections caused by Mycobacterium TB.
Non-tb infections as well
Streptomycin contraindications
Hypersensitivity to aminoglycosides.
Streptomycin precautions
Prescribing in the absence of a proven or strongly suspected bacterial infection. leads to drug resistance
Streptomycin Adverse reactions
Paresthesia of face
angioneurotic edema
Vestibular ototoxicity
eosinophilia
Streptomycin warnings?
Ototoxicity
Streptomycin black box warning
Risk of severe Neurotoxic reactions is sharply increased in patients with impaired renal function of pre-renal azotemia
