TB

Question 1

Standard regimen for TB

Answer 1

2RHEZ/4RH

Rifampicin 10 mg/kg, up to 600 mg/day
Isoniazid 5 mg/kg, up to 300 mg/day
Ethambutol 15-20 mg/kg, up to 1600 mg/day
Pyrazinamide 20-25 mg/kg, up to 2000 mg/day
Pyridoxine 10-25 mg/day

Question 2

Alternative regimen for TB

Answer 2

2HPMZ/2HPM

Isoniazid
Rifapentine 1200 mg/day
Moxifloxacin 400 mg/day
Pyrazinamide

Question 3

Pyrazinamide sparing TB regimen

Answer 3

For patients >70 y.o.

9 months of 2RHE/7RH

Rifampicin
Isoniazid
Ethambutol

Question 4

Indications for 9 months or longer TB treatment

Answer 4

• Baseline cavitation or extensive disease AND +ve TB culture after 2 months
• Slow radiological improvement
• HIV with low CD4 count and not on anti-retroviral treatment
• Poor DM control

MSK involvement (9 months)
TB meningitis (12 months)

Question 5

Renal dosing adjustment for TB

Answer 5

Only E/Z when CrCl <30

• Pyrazinamide 25-35 mg/kg 3TW
• EthambuAtol 20-25 mg/kg 3TW

Question 6

ADR of rifampicin

Answer 6

GI upset
Orange colouration of body fluids
Flu like symptoms, SOB
Thromboctopenic purpura, hemolytic anemia
Flushing, pruritus

Question 7

ADR of isoniazid

Answer 7

GI upset
Peripheral neuropathy, optic neuritis
Hepatotoxicity
Toxic psychosis
Enzyme inhibitor

Question 8

ADR of ethambutol

Answer 8

Pruritus
Optic neuritis
Peripheral neuritis

Question 9

ADR of pyrazinamide

Answer 9

GI upset
Heptotoxicity
Arthralgia, hyperuricemia