Drugs Used to Treat Pulmonary Tuberculosis (Izard)

Question 1

General things to do when treating TB?

Answer 1

Monitor serum concentrations
Liver function tests
Test for Hep B/C

Question 2

Goal of TB treatment?

Answer 2

Decrease disability and death

Decrease active spread of disease

Question 3

TB drugs available?

Answer 3

R ifampin
I soniazid
P yrazinamide
E thambutol

Question 4

Rifampin indication?

Answer 4

TB and meningococcal carriers

Question 5

Rifampin contraindication?

Answer 5

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

Question 6

Rifampin warnings

Answer 6

Liver dysfunction

Question 7

Rifampin precautions

Answer 7

patients with DM

Question 8

Rifampin drug interactions

Answer 8

CYP-450 enzymes -> accelerates elimination of drugs that undergo this pathway

Question 9

Isoniazid MOA

Answer 9

inhibits synthesis of mycolic acids (essential component of bacterial cell wall).

Question 10

Isoniazid indication

Answer 10

TB that is susceptible

Question 11

Isoniazid contraindications

Answer 11

acute liver disease

Question 12

Isoniazid black box warning?

Answer 12

fatal hepatitis may occur.

Question 13

Isoniazid drug interactions?

Answer 13

Food
Acetaminophen 
Carbamazepine
Valproate
Theophylline

Question 14

Pyrazinamide indications

Answer 14

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.

Question 15

Pyrazinamide contraindications

Answer 15

Pts with severe hepatic damage
With acute gout
history of DM

Question 16

Ethambutol MOA

Answer 16

oral chemotherapeutic agent that is specifically effective against actively growing microorganisms of the genus Mycobacterium

Question 17

Ethambutol indication

Answer 17

TB, in conjunction with other TB drugs

Question 18

Ethambutol contraindications

Answer 18

Optic neuritis

Pts who report visual side effects or changes in vision

Question 19

Ethambutol precaution

Answer 19

Patients under 13

Question 20

Streptomycin indications

Answer 20

moderate to severe infections caused by Mycobacterium TB.

Non-tb infections as well

Question 21

Streptomycin contraindications

Answer 21

Hypersensitivity to aminoglycosides.

Question 22

Streptomycin precautions

Answer 22

Prescribing in the absence of a proven or strongly suspected bacterial infection. leads to drug resistance

Question 23

Streptomycin Adverse reactions

Answer 23

Paresthesia of face
angioneurotic edema
Vestibular ototoxicity
eosinophilia

Question 24

Streptomycin warnings?

Answer 24

Ototoxicity

Question 25

Streptomycin black box warning

Answer 25

Risk of severe Neurotoxic reactions is sharply increased in patients with impaired renal function of pre-renal azotemia