Pharm: Pulmonary TB Flashcards
What are 1st line agents for active TB?
Rifampin
Isoniazid
Pyrazinamide
Ethambutol
sometimes streptomycin
When would you switch to 2nd line agents when treating TB
if there is drug resistance
What else should you do when a patient is on anti-TB therapy?
monitor liver function tests
Test for Hep B and C in those with risk factors
What is the goal of TB treatment?
Decrease disability/death
Decrease active spread of the dz
What is a contraindication for rifampin?
contraindicated in those recieving anti-virals bc rifampin decreases plasma concentrations of those drugs (viral resistance or decreased effectivity)
What are warnings associated with rifampin?
Liver disfunction
Induces CYP450 - lots of drug interactions
Caution in patients with DM bc management more difficult
What is the MOA of isoniazid?
Inhibhits synthesis of mycoloic acids (essential component of bacterial cell wall) so supresses actively growing intracellular and extracellular TB organisms
What are some contraindications of isoniazid?
drug-induced hepatitis
intolerable side effects (fever, chills, arthritis, acute liver dz)
What is the black box warning associated with isoniazid?
severe/fatal hepatitis
What are contraindications of pyrazinamide?
severe hepatic damage
acute gout
What are some warnings associated with pyrazinamide?
hepatitis
hyperuricemia/acute gouty arthritis
caution in pts with DM bc management may be more difficult
What are contraindications of ethambutol?
optic neuritis
those with visual side effects/changes in vision
What are some AEs for streptomycin?
vestibular ototoxicity
Parasthesias of face
rash
angioneurotic edema
What is the black box warning for streptomycin?
Ototoxicity
Severe neurotoxic reactions (esp in those with impaired renal function or pre-renal azotemia)
