TB

Question 1

Causative agent of TB

Answer 1

Mycobacterium tuberculosis

Question 2

3 environments of TB

Answer 2

Extracellular(free)- within lung cavities
Inside granulomas
With macrophages

Question 3

Treatment approach targets

Answer 3

growth phase of M. tuberculosis within granulomas

-growth is slow so therapy is long-lived

Question 4

Signs & Symptoms of TB include

Answer 4

appetite loss, fatigue
chest pain, hematemesis, productive prolonged cough
night sweats, pallor

Question 5

MOA rifampin

Answer 5

Inhibits RNA synthesis

Question 6

MOA isoniazid

Answer 6

Inhibits cell wall synthesis

Question 7

MOA ethambutol

Answer 7

Inhibits cell wall synthesis

Question 8

MOA Pyrazinamide

Answer 8

Disrupts plasma membrane and disrupts energy metabolism

Question 9

What is DOT

Answer 9

Directly Observed Therapy

• watch patient take medicine
• adherence

Question 10

Dose ethambutol

Answer 10

Ethambutol 400mg

4 tablets once a day

Question 11

Dose pyrazinamide

Answer 11

pyrazinamide 500mg

4 tablets once a day

Question 12

ADRs of rifamycins

Answer 12

Hepatic excretions (LFT elevation)
GI
CNS: confusion dizzy etc
Derm: rash
Hematologic

Question 13

ADRs fo ethambutol

Answer 13

optic neuritis
hepatotoxicity
GI

Question 14

ADRs of pyrazinamide

Answer 14

hyperuricemia
hepatotoxicity
loss of glycemic control
GI

Question 15

Drug interactions of rifamycins

Answer 15

2C8, 2C9, 3A4

strong inducer

Question 16

MOA of streptomycin

Answer 16

interruption of protein synthesis

Question 17

How is streptomycin administered?

Answer 17

IM injection

Question 18

ADRs of streptomycin

Answer 18

Nephrotoxicity
Neurotoxicity
Hypotension
Ototoxicity- CN8
   - Auditory & Vestibular

Question 19

What drug is used for resistant TB

Answer 19

Bedaquiline (sirturo)

Question 20

Dose streptomycin

Answer 20

Streptomycin 15mg/kg IM once a day

Question 21

Does streptomycin need to be renally adjusted?

Answer 21

Yes, at <50ml/min