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Pulm > Pharm - TB > Flashcards

Pharm - TB Flashcards

1
Q

MOA isoniazid

A

Inhibits mycolic acid synthesis

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2
Q

AE isoniazid

A
  1. Hepatitis
  2. Inhibit CYP450
  3. Peripheral neuropathy
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3
Q

Interactions INH

A
  1. Aluminum antacids decrease absorption
  2. Inhibits cortisol metabolism
  3. GC’s decrease INH blood levels
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4
Q

What supplementation should to be given to pt on INH?

A

B6/pyridoxine = competes with pyridoxal phosphate, causing peripheral neuropathy

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5
Q

MOA rifampin

A

Inhibits DNA-dep RNA polymerase by binding Beta-subunit

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6
Q

AE rifampin

A
  1. Rust colored bodily fluids

2. CYP450 induction

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7
Q

Interactions rifampin

A

Probenecid increases rifampin levels; important since EMB and PZA can cause hyperuricemia so TB pt likely to need gout meds

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8
Q

MOA ethambutol

A

Inhibits arabinosyl transferase = inhibits cell wall synthesis

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9
Q

AE EMB

A
  1. Optic neuritis

2. Hyperuricemia

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10
Q

Interactions EMB

A

Aluminum antacids decrease EMB absorption

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11
Q

MOA pyrazinamide

A

Converted to pyrazinoic acid, decreasing pH below what is favorable for growth of TB

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12
Q

AE pyrazinamide

A
  1. Hepatitis
  2. Hyperuricemia
  3. Myaglia
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13
Q

MOA cycloserine

A

Analog of D-ala; inhibits L-ala racemase and D-ala synthetase

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14
Q

AE cycloserine

A
  1. Suicidal ideations
  2. Seizures
  3. Depression
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15
Q

CI cycloserine

A

Epilepsy

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16
Q

MOA ethionamide

A

Analog of INH; inhibits protein synthesis

17
Q

AE ethionamide

A
  1. GI
  2. Neuro
  3. Hepatotoxicity
18
Q

What supplementation should be given with ethionamide?

A

B6 - remember it’s an INH analog

19
Q

MOA capreomycin

A

Unknown

20
Q

AE capreomycin

A
  1. Nephrotoxicity

2. Ototoxicity

21
Q

Which TB drug can be used alone?

A

Ethionamide

22
Q

Which TB drugs require concomitant B6?

A

INH and ethionamide

23
Q

Which TB drugs cross CSF and placenta?

A

INH, EMB, PZA, cycloserine

24
Q

Which TB drugs should you avoid with antacids?

A

INH, EMB

25
Q

Which TB drugs are both bacteriocidal and bacteriostatic?

A

INH
PZA
Cycloserine
Ethionamide

26
Q

Only bacteriocidal?

A

RIF

27
Q

Only bacteriostatic?

A

EMB

Capreomycin

28
Q

Rifampin vs. rifapentine

A

Rifapentine has longer T1/2 = once weekly dosing

Also less induction of CYP450

29
Q

Rifampin v. rifabutin

A

Rifabutin has least induction of CYP of the rafamycins

30
Q

Which TB drug is N-acetylated?

A

INH

31
Q

Resistance to RIF develops because of:

A

Change in beta-subunit of DNA-dep RNA polymerase

32
Q

Which TB drug necessitates back up birth control?

A

RIF (remember it INDUCES CYP450 = lower OC blood levels)

33
Q

Active TB must be treated for a minimum of:

A

24 weeks

34
Q

Latent vs. active TB tx

A 
Latent = 3 months of INH + rifapentine
Active = 24 weeks of RIPE or RIPS
35
Q

What is CI for tx of LTBI?

A

RIF + PZA due to liver toxicity

Pulm (33 decks)

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