Drugs used to treat TB Flashcards
What causes TB:
Mycobacterium TB
How is TB transmitted:
Via airborne droplets (cough/sneeze)
Where is TB inhaled:
alveoli
How can Tb spread to other parts of the body:
Via blood and lymphatic system=disseminated to organs
What are the classic symptoms of TB:
NIGHT SWEATS, productive cough, fever, weight loss, anorexia, positive AFB in the sputum
Drugs that are used to treat TB is defined as:
antitubercular
The first drug ever to treat TB was:
streptomycin
What may be given along with INH as INH blocks pyridoxine from being utilized in intracellular enzyme production:
B6 (pyridoxine) for deficiency and to PREVENT PERIPHERAL NEUROPATHY
When is prophylactic therapy given:
Individuals who have been in CLOSE CONTACT with TB pts ; PTS WITH HIV/AIDS that tested positive TST take a two month course of P and R; family members take a 6mo-year of INH
Why is single drug therapy of INH NOT recommended for TB Tx:
Ineffective in Tx TB d/t drug resistance developing in a short time unless a combination therapy is used instead of single drug therapy
Why is multi-drug therapy preferred in the Tx of TB:
Bacterial resistance is unlikely to occur; divided up into two phases=2mo and the 2nd phases is 4-7 mo=total Tx is 6-9 mo; reduced length of Tx
What may be given if MDR occurs during multi-drug therapy:
aminoglycosides or fluoroquinolones
What should be done prior to multi-drug therapy of TB:
susceptibility testing of the SPUTUM should be done prior to drug order to determine MDR; ordered if pt is not responding to Tx
Drugs that are chosen first d/t it’s effectiveness against TB are defined as and what are the names
First-line drugs (LESS TOXIC THAN SECOND-LINE DRUGS); INH, ethambutol, PZA, rifampin/rifabutin/rifapentine, streptomycin
Drugs that are not as effective as first-line drugs d/t being more toxic may be used in combination with first-line drugs for what reason and what are some names of those drugs:
to treat disseminated TB; paraaminosalicylic acid; kanamycin; cycloserine; ethionamide; capreomycin; PZA)
What is Isoniazid mechanism of action:
Bactericidal by inhibiting tubercle cell wall synthesis and blocks pyridoxine (B6)
What primary antitubercular drug causes liver damage:
INH-induced liver damage: MONITOR AST/ALT LABS
What is an example of a susceptibility test done on sputum that presents TB resistant to streptomycin:
may be sensitive to kanamycin
What type of TB pts are more likely to develop peripheral neuropathy when taking INH and how can that be prevented:
Malnourished, DM, alcoholics; prevented by taking pyridoxine (B6)
INH has 2 hypers and 2 hypos for adverse effects: What are they and what is the most important adverse effect of INH:
hyperglycemia, hyperkalemia, hypophosphatemia, hypocalcemia; peripheral neuropathy
What are the other side effects of INH:
HA; blood dyscrasias (abnormal quantity in the blood), paresthesias, GI distress, ocular toxicity
What is the adverse effect of rifampin
Body fluids turn orange, contact lens may stain orange
What are the other side effects of rifampin:
HA, blood dyscrasias, GI distress, ocular toxicity
What are the side effects of ethambutol:
Hallucinations, confusion, dizziness, joint pain
As part of the nsg assessment, you obtain pt TB hx by:
last PPD test and reaction; last CXR and result; allergy to antitubercular drugs
As part of the nsg assessment, you obtain a medical Hx by asking if they’ve had:
hepatic disease
What labs would you check for a TB pt:
Liver enzymes, BUN, electrolytes
How do you evaluate for S/S of peripheral neuropathy:
numbness/tingling of extremities
When are you to administer INH:
1 hour before meals or 2 hours after meals; B6 is given too
What are some pt teaching when taking INH therapy:
NO ANTACIDS; INH 1 HR BEFORE OR 2 HR AFTER MEALS; COMPLIANCE TO THERAPY; CHANGES TO BODY FLUIDS IF TAKING RIFAMPIN; avoid sunlight; report tingling/numbness
A pt is beginning to take INH and rifampin Tx for TB. The nurse gives what instructions: A) do not skip doses; B) take the drug TID with food; C) take drugs with an antiacid
A: don’t skip doses
A pt taking INH is worried about the side effects/adverse reactions. The nurse realizes which is a common adverse reaction of INH: A) ototoxicity; B) hepatotoxicity; C) nephrotoxicity; D) optic nerve toxicity
B: hepatotoxicity
A pt has just been dx w/TB and is to begin antitubercular therapy INH, rifampin, ethambutol. What should the nurse do? Select all that applies: A) encourage periodic eye exam; B) instruct pt to take meds with meals, C) suggest pt to take antacids with meals to avoid GI distress, D) advise pt to report numbness/tingling, E) alert pt that body fluids may develop a red-orange color, F) teach pt to avoid direct sunlight and to use sun block
A,D,E,F
