Review Clinical Considerations for Tuberculosis

Question 1

What are the first-line drugs for tuberculosis?

Answer 1

isoniazid, rifampin, rifabutin, pyrazinamide, ethambutol

These drugs are primarily used in the initial treatment of tuberculosis.

Question 2

What are the second-line drugs for tuberculosis?

Answer 2

fluoroquinolones (levofloxacin, moxifloxacin), para-aminosalicylic acid, ethionamide, bedaquiline

These drugs are used for treating resistant cases of tuberculosis.

Question 3

Fill in the blank: The first-line drug isoniazid is used to treat _______.

Answer 3

tuberculosis

Question 4

True or False: Rifabutin is a second-line drug for tuberculosis.

Answer 4

False

Question 5

List the first-line drugs for tuberculosis.

Answer 5

• isoniazid
• rifampin
• rifabutin
• pyrazinamide
• ethambutol

Question 6

List the second-line drugs for tuberculosis.

Answer 6

• fluoroquinolones (levofloxacin, moxifloxacin)
• para-aminosalicylic acid
• ethionamide
• bedaquiline

Question 8

What is the pharmacological approach for prophylaxis of pulmonary Mycobacterium avium complex (MAC) infections?

Answer 8

Prophylactic therapy typically involves macrolide antibiotics:
* Clarithromycin: 500 mg orally twice daily
* Azithromycin: 1,200 mg orally once weekly

Recommended for individuals at heightened risk, such as HIV patients with CD4 counts below 50 cells/mm³.

Question 9

What is the standard treatment protocol for active pulmonary MAC disease?

Answer 9

Combination antibiotic therapy including:
* Clarithromycin: 500 mg orally twice daily
* Ethambutol: 15 mg/kg orally once daily

Additional antibiotics may include rifabutin, ciprofloxacin, or amikacin depending on severity and tolerance.

Question 10

What is the minimum duration of treatment for active MAC infections?

Answer 10

At least 12 months

Treatment should continue until culture-negative sputum results and significant clinical and radiographic improvement are achieved.

Question 11

True or False: Prophylactic therapy is not recommended for individuals with advanced immunosuppression.

Answer 11

False

Prophylaxis is specifically recommended for these individuals to reduce the incidence of MAC infections.

Question 12

Fill in the blank: For prophylaxis of MAC infections, Clarithromycin is administered at _______ mg orally twice daily.

Answer 12

500

This dosage is part of the prophylactic regimen for those at risk.

Question 13

What are the criteria for extending the treatment duration for active MAC infections?

Answer 13

Treatment should extend until:
* Culture-negative sputum results
* Significant clinical and radiographic improvement

This is crucial for complete eradication and to minimize relapse risk.

Question 14

What type of antibiotics are primarily used for prophylaxis against MAC infections?

Answer 14

Macrolide antibiotics

These include Clarithromycin and Azithromycin.

Question 15

What is the role of Ethambutol in the treatment of active pulmonary MAC disease?

Answer 15

It is administered at 15 mg/kg orally once daily as part of the combination therapy

It helps suppress the mycobacteria and prevent resistance.