Exam 5: Kays TB Flashcards
is latent TB infectious
NO
Standard therapy for TB
RIPE
Regimen 1 Intensive phase options for TB
Rifampin, INH, pyrazinamide, and ethambutol 7 days/week for 56 doses (8 weeks)
OR
5 days/week for 40 doses
Regimen 1 continuation phase: preferred
INH and rifampin 7 days/week for 126 doses (18 weeks) OR 5 days/week for 90 doses (18)
Regimen 1 continuation phase: alternative
INH and rifampin 3 times weekly for 54 doses (18 weeks)
regimen 2 intensive phase
INH, rifampin, pyrazinamide, and ethambutol three times weekly for 24 doses (8 weeks)
regimen 2 continuation phase
inh and rifampin 3 times weekly for 54 doses (18 weeks)
regimen 3 intensive phase
INH, rifampin, pyrazinamide, and ethambutol 7 days/week for 14 doses (2 weeks), then twice weekly for 12 doses (6 weeks)
regimen 3 continuation phase
INH and rifampin twice weekly for 36 doses (18 weeks)
Do not use _______ in HIV-infected patients or patients with smear-positive and/or cavitary disease
twice-weekly regimens
Administer ______ to patients receiving INH
pyridoxine (vit B6)
ART and TB therapy
2 weeks: CD4 <50
8-12 weeks: CD4 >50
Rifampin and dolutegravir relationship
dolutegravir may be administered BID rather than daily
FQ DOC in intensive stage
moxifloxacin
Treatment options of latent TB
- rifampin 600mg x4 month
- INH 900 + rifapentine 900 x12 w
- INH + rifampin x3 m
isoniazid metabolism
genetically determined
metabolized in liver
isoniazid dose adjustment
- decrease dose by 1/2 in severe hepatic insufficiency
2. Reduce dose in slow acetylators if renal failure
isoniazid AE
hepatitis
neurotoxicity
isoniazid drug interactions
inhibitor of CYP450
rifampin AE
hepatotoxicity
discoloration of body fluids
rifampin drug interactions
potent inducer of cyp 450
rifabutin vs rifampin
rifambutin has less induction of cyp p450 than rifampin
rifabutin AE
orange body fluids
arthralgias
uveitis
leukopenia
pyrazinamide AE
hepatotoxicity
hyperuricemia
