Side effects and patient teaching for TB meds

Question 1

basic understanding of tb
- caused by mycobacterium tuberculosis
transmission
- persons to person via droplets
- coughing, sneezing, talking

patients at risk
- immunocompromised
- living or working in high-risk residential setting
- injecting illegal drugs
- Healthcare workers with high-risk patients

symptoms
- cough, fever, night sweats
- gi distress, weight loss
- positive acid-fast bacilli in the sputum or bloody sputum

prophylaxis is recommended for those with
- close contact with active tb
- HIV positive, immunosuppressed
- conversion from negative to positive tb
- latent TB infection
- injection drug users
- a recent immigrant from a high-prevalence country

antitubercular therapy
effectiveness depends on
- type of infection
-adeqaute dosing
- sufficient duration of treatment
-adherence to drug regimen
- selection of an effective rug combination

problems
- drug resistant organisms
- drug toxicity
- patient nonadherence

Question 2

wat are the first line of drug medications we use for patients with TB?
(5)

Answer 2

isoniazid
rifampin
rifapentine
pyrazinamide
ethambutol

Question 3

usually for the first 2 months how many medications are patients taking

usually for the next 4-7 months of medication regimen, how many are they taking?

Answer 3

4 drugs

2 drugs

Question 4

isoniazid (INH)
route of adminstration
food or no food?

function ?

side effects (4)

how do we fix one of the symptoms?

Answer 4

oral
best taken empty stomach

inhibits bacterial cell wall synthesis

photosensitivity, tinnitus, peripheral neuropathy, hepatotoxicity

vitamin b6 ( pyridoxine )

Question 5

pyrazinamide
route of administration?
food or no food?

side effects?

Answer 5

oral
no need to take on empty stomach

hepatitis, elevated liver enzymes, jaundice, n/v/d, photosensitivity

Question 6

ethambutol
side effects?

Answer 6

damange to the eye causing blurred or changed vision, changes in color vision

Question 7

rifampin
food or no food?
side effects?

CAUTION FOR WHO and WHAT TO DO?

Answer 7

best on empty stomach
discoloration of bodily fluids, makes everything orange, NORMAL!

oral contraceptives to become ineffective, use another form of birth control

Question 8

for all of these medications, what time of test are we going to be doing ?

INH and Ethambutol need regular checks on what?

Answer 8

liver function!

eye exams

Question 9

these patients are not allowed to drink what?

Answer 9

alcohol or any heavy liver medications like acetaminophen

Question 10

oral prepration may be given with meals to reduce gi upset, even though medications are recommended to be given __before or __after meals?

Answer 10

1 before
2 after meals

Question 11

HIV - latent tb can turn into active disease quickly
course of treatment is longer

pregnancy
- INH, rifampin and ethambutol are safe
- INH for 9 months