Pulm: Drugs for TB

Question 1

What is an adverse effect of all the TB drugs?

Answer 1

Hepatotoxicity

-measure LFTs (AP, bilurubin, AP, ALT, AST)

Question 2

What are the drugs to treat TB?

Answer 2

Rifampin
Isoniazid
Pyrazinamide
Ethambutol

Question 3

Indications for Rifampin

Answer 3

TB and meningitis (Niesseria or H. Flu)

Question 4

What does rifampin do to CytP450?

Answer 4

Induces
-so can decrease the concentrations of other drugs

–he lists -navir drugs, so it would decrease the antiviral efficacy

Question 5

MOA of Isoniazid

Answer 5

inhibits synthesis of mycoloic acid, which is a component of TB cell wall

Question 6

What BB warning is there for isoniazid?

Answer 6

hepatotoxicit

Question 7

What adverse reactions are most common for isoniazid?

Answer 7

CNS
-peripheral neuropathy, seizures

Drug-food interactions
-acetaminophen, carbamazepine, valproate

Question 8

What are some contraindications to pyrazinamide?

Answer 8

Hepatic damage and gout (worsens both)

Question 9

Adverse effects of Ethambutol?

Answer 9

Optic neuritis

-decreases visual acuity

Question 10

What age is the cut off for ethambutol?

Answer 10

13 years +

Question 11

Indications for streptomycin?

Answer 11

Moderate to severe susceptible TB infections

Question 12

Should you prescribe streptomycin by itself all willy-nilly?

Answer 12

No, there is a lot of resistance to it.

Question 13

Adverse effects of streptomycin

Answer 13

Ototoxicity,**

paresthesia, fever, urticaria (+ more)

Question 14

What is the black box warning for Streptomycin?

Answer 14

Those with impaired renal function will have more of a risk of neurotoxic reactions