Drugs used to treat TB

Question 1

What causes TB:

Answer 1

Mycobacterium TB

Question 2

How is TB transmitted:

Answer 2

Via airborne droplets (cough/sneeze)

Question 3

Where is TB inhaled:

Answer 3

alveoli

Question 4

How can Tb spread to other parts of the body:

Answer 4

Via blood and lymphatic system=disseminated to organs

Question 5

What are the classic symptoms of TB:

Answer 5

NIGHT SWEATS, productive cough, fever, weight loss, anorexia, positive AFB in the sputum

Question 6

Drugs that are used to treat TB is defined as:

Answer 6

antitubercular

Question 7

The first drug ever to treat TB was:

Answer 7

streptomycin

Question 8

What may be given along with INH as INH blocks pyridoxine from being utilized in intracellular enzyme production:

Answer 8

B6 (pyridoxine) for deficiency and to PREVENT PERIPHERAL NEUROPATHY

Question 9

When is prophylactic therapy given:

Answer 9

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

Question 10

Why is single drug therapy of INH NOT recommended for TB Tx:

Answer 10

Ineffective in Tx TB d/t drug resistance developing in a short time unless a combination therapy is used instead of single drug therapy

Question 11

Why is multi-drug therapy preferred in the Tx of TB:

Answer 11

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

Question 12

What may be given if MDR occurs during multi-drug therapy:

Answer 12

aminoglycosides or fluoroquinolones

Question 13

What should be done prior to multi-drug therapy of TB:

Answer 13

susceptibility testing of the SPUTUM should be done prior to drug order to determine MDR; ordered if pt is not responding to Tx

Question 14

Drugs that are chosen first d/t it’s effectiveness against TB are defined as and what are the names

Answer 14

First-line drugs (LESS TOXIC THAN SECOND-LINE DRUGS); INH, ethambutol, PZA, rifampin/rifabutin/rifapentine, streptomycin

Question 15

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:

Answer 15

to treat disseminated TB; paraaminosalicylic acid; kanamycin; cycloserine; ethionamide; capreomycin; PZA)

Question 16

What is Isoniazid mechanism of action:

Answer 16

Bactericidal by inhibiting tubercle cell wall synthesis and blocks pyridoxine (B6)

Question 17

What primary antitubercular drug causes liver damage:

Answer 17

INH-induced liver damage: MONITOR AST/ALT LABS

Question 18

What is an example of a susceptibility test done on sputum that presents TB resistant to streptomycin:

Answer 18

may be sensitive to kanamycin

Question 19

What type of TB pts are more likely to develop peripheral neuropathy when taking INH and how can that be prevented:

Answer 19

Malnourished, DM, alcoholics; prevented by taking pyridoxine (B6)

Question 20

INH has 2 hypers and 2 hypos for adverse effects: What are they and what is the most important adverse effect of INH:

Answer 20

hyperglycemia, hyperkalemia, hypophosphatemia, hypocalcemia; peripheral neuropathy

Question 21

What are the other side effects of INH:

Answer 21

HA; blood dyscrasias (abnormal quantity in the blood), paresthesias, GI distress, ocular toxicity

Question 22

What is the adverse effect of rifampin

Answer 22

Body fluids turn orange, contact lens may stain orange

Question 23

What are the other side effects of rifampin:

Answer 23

HA, blood dyscrasias, GI distress, ocular toxicity

Question 24

What are the side effects of ethambutol:

Answer 24

Hallucinations, confusion, dizziness, joint pain

Question 25

As part of the nsg assessment, you obtain pt TB hx by:

Answer 25

last PPD test and reaction; last CXR and result; allergy to antitubercular drugs

Question 26

As part of the nsg assessment, you obtain a medical Hx by asking if they’ve had:

Answer 26

hepatic disease

Question 27

What labs would you check for a TB pt:

Answer 27

Liver enzymes, BUN, electrolytes

Question 28

How do you evaluate for S/S of peripheral neuropathy:

Answer 28

numbness/tingling of extremities

Question 29

When are you to administer INH:

Answer 29

1 hour before meals or 2 hours after meals; B6 is given too

Question 30

What are some pt teaching when taking INH therapy:

Answer 30

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

Question 31

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

Answer 31

A: don’t skip doses

Question 32

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

Answer 32

B: hepatotoxicity

Question 33

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

Answer 33

A,D,E,F