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Melissa's Pharm 2 > T3-TB Medications > Flashcards

T3-TB Medications Flashcards

1
Q

TB is technically called a _____.

A

Myobacterium

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2
Q

What are the two ways in which TB is different from your typical bacterial infection?

A
  1. VERY SLOW GROWING infection–harder to kill microbes that aren’t very metabolically active
  2. Lives inside and even replicates inside of phagocytes (phagocytes would normally attack and kill TB, but TB has figured out a way to avoid being destroyed)
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3
Q

__ of humans on the planet have TB.

A

1/3

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4
Q

In terms of deaths caused by infectious disease, TB is #__. Number one is HIV/AIDs

A

2

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5
Q

What is one of the first things you do as a new RN at a hospital?

A

Get fit tested with an N95 mask

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6
Q

What do you have to wear when testing someone with TB, or with clients have already been diagnosed?

A

N95 mask

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7
Q

What does TB primarily affect?

A

The lungs

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8
Q

Can TB spread to other organs besides the lungs?

A

Yes

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9
Q

TB can be ___ or ____.

A

Latent or active

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10
Q

Most people, when they become infected have a robust enough immune system that it keeps the TB under control. Does that mean the microbes are out of the body?

A

No, but it keeps them from going crazy

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11
Q

Do HIV/Aids patients have a latent or active version of TB?

A

ACTIVE- their immune system isn’t strong enough to keep the TB under control

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12
Q

Some unlucky patients who had latent TB, all of a sudden their latent TB turns to active. Why?

A

Unknown reasons

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13
Q

What are the clinical manifestations of ACTIVE TB?

A
  1. Low grade fever
  2. Dry cough –that may progress to a bloody cough (mucopurulent cough with hemoptysis)
  3. Night sweats
  4. Fatigue
  5. Weight loss
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14
Q

The clinical manifestations of ACTIVE TB seem fairly harmless, but give active TB long enough and it will ______, making them look like Swiss cheese.

A

Chew up your lungs

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15
Q

What are the 4 treatment challenges with TB?

A

Adherence
Drug resistance
Toxicities
Cost

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16
Q

What can we do to help with adherence of antibiotics to clients who have TB?

A

Give higher doses 2-3 times a week and have someone from the health department observe/administer these doses

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17
Q

What do we do to help with the resistance of TB?

A

Give a bare minimum of 2 different drugs–can actually give up to 7 different drugs

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18
Q

Many TB drugs run the risk of causing _____. Why?

A

Hepatotoxicity–this is a big concern since they have to take the drug for SO LONG

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19
Q

Is nonresistant TB cheaper or more expensive cost wise than resistant TB?

A

CHEAPER

20
Q

What are the two major drugs given for TB?

A

Isoniazid

Rifampin

21
Q

Does isoniazid have any other indications besides TB?

A

NO

22
Q

____ is the best drug out there for TB. It is the primary agent. Practically everyone with TB takes it unless they happen to have a strain resistant to this particular drug.

A

Isoniazid

23
Q

If your TB is latent, what drug do you get?

A

Isoniazid; however its probably best to still take two drugs

24
Q

If you add two drugs (one isoniazid and one other) to a patient with a latent TB infection, it will decrease treatment time from ___ to ___.

A

9 months to 3 months

25
Q

If your TB is active, can you only take isoniazid?

A

NO. you will be on multiple drugs!

26
Q

What is the most common adverse effect of isoniazid?

A

Peripheral neuropathy

27
Q

When someone taking isoniazid develops peripheral neuropathy, it is typically going to be ____. What are they going to report?

A

Symmetric

Numbness, tingling, or pain in their fingers or toes–may also see issues with balance or clumsiness

28
Q

Why does peripheral neuropathy happen?

A

Deficiency in vitamin B6

29
Q

If a patient has peripheral neuropathy and we give them Vit. B6, will it reverse the problem?

A

Yes

30
Q

If a patient is at risk for peripheral neuropathy already and they are prescribed isoniazid, what do we do ? What types of at risk patients am I referring to?

A

Prophylactically give them Vit. B6; patients who are diabetic or alcoholic

31
Q

What is the other major effect of isoniazid?

A

Hepatotoxicity

32
Q

What is the biggest risk factor for hepatotoxicity if a patient is taking isoniazid?

A

Advanced age- if you are above 65, the rate is about 8%

33
Q

In regards to hepatotoxicity, before a patient begins isoniazid, we must get a baseline ___ level. Why?

A

AST level—if the level goes up 3-5x their original value when taking isoniazid, then the prescriber will probably stop the drug

34
Q

Rifampin is a _____ antibiotic.

A

Broad-spectrum

35
Q

Rifampin can even kill ___.

A

MRSA!!

36
Q

How does Rifampin work?

A

Inhibiting protein synthesis

37
Q

With isoniazid it doesn’t matter if the client takes it with food or not. Should you take rifampin with food?

A

NO; food decreases absorption!!! Client must take on an empty stomach!

38
Q

Just like isoniazid, we see ____ with this drug.

A

Hepatotoxicity

39
Q

What do we need a baseline level of before giving Rifampin?

A

AST level

40
Q

AST level will increase in a lot of clients (14%) but the actual number of cases that turn into something problematic is quite low ___.

A

Less than 1%

41
Q

What is the weird thing Rifampin can do?

A

Cause your secretions (urine, sweat, saliva, tears) to turn a red-orange color

PATIENT TEACHING!!!

42
Q

Rifampin causes secretions to turn red-orange. Is this harmless or dangerous?

A

Harmless

43
Q

Can patients on rifampin wear contacts?

A

No; Rifampin will permanently stain them

44
Q

Isonozid and Rifampin cause CYP interactions and disrupt the metabolism of lots of other drugs. What must the prescribe do if clients are on these drugs AND other medications?

A

Run all of their meds through an interaction checker and see if there are any interactions with them

45
Q

Which drug is an inhibitor? What does that mean? What drug could be a real problem if taken with this TB med?

A

Isoniazid-inhibits the enzymes to eat up the substrate so the levels RISE; Phenytoin since it has a NARROW therapeutic range

46
Q

What drug is an inducer? What does that mean? What drugs could be a real problem i taken with this TB med?

A

Rifampin; induces the enzymes to chop up the substrates quicker so levels are REDUCED; Anti-seizure, anti-rejection meds, BC, HIV, Warfarin

Melissa's Pharm 2 (32 decks)

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