TB Flashcards
What are the high-risk indications for TB testing?
Individuals at high risk of TB exposure or infection.
What are the TB diagnostic tests?
IGRA (Interferon Gamma Release Assay), TB Skin Test (TST/PPD), Chest X-ray, Sputum culture.
What vaccine is used for TB prevention?
BCG (Bacille Calmette-Guérin).
What should be used if a false-positive TST is suspected?
IGRA test.
Why is TB treatment long-term?
TB bacteria grow slowly, require prolonged exposure to antibiotics to be fully eradicated.
What are the risks of TB treatment?
Toxicity, poor adherence, and drug resistance.
How many drugs are used for active TB treatment?
Always at least 2 drugs.
What are the primary drugs for active TB treatment?
Isoniazid (INH) & Rifampin.
What is Directly Observed Therapy (DOT)?
A strategy where healthcare workers ensure medication intake, given at least 5 out of 7 days per week.
What is Self-Administered Therapy (SAT)?
TB treatment without supervision.
How long is the intensive phase of TB treatment?
8 weeks.
Which drugs are included in the 6- or 9-month regimen’s intensive phase?
Isoniazid + Rifampin + Pyrazinamide + Ethambutol.
Which drugs are included in the 4-month regimen’s intensive phase?
Isoniazid + Rifapentine + Pyrazinamide + Moxifloxacin.
How long is the continuation phase of TB treatment for the 6-/9-month regimen?
18-31 weeks (total treatment: 26-39 weeks).
Which drugs are used in the continuation phase of the 6-/9-month regimen?
Isoniazid + Rifampin.
How long is the continuation phase of the 4-month regimen?
9 weeks (total treatment: 17 weeks).
Which drugs are used in the continuation phase of the 4-month regimen?
Isoniazid + Rifapentine + Moxifloxacin.
What are the three preferred regimens for latent TB treatment?
1) Isoniazid + Rifapentine weekly for 3 months, 2) Rifampin daily for 4 months, 3) Isoniazid + Rifampin daily for 3 months.
What are the optional latent TB treatment regimens?
Isoniazid daily for 6-9 months (DOT or SAT), Isoniazid twice weekly for 6-9 months (DOT).
What is the primary agent for TB treatment and prevention?
Isoniazid (INH).
What are the major adverse effects of INH?
Peripheral neuropathy, hepatotoxicity, CNS effects, GI upset, dry mouth, urinary retention.
What is always given with INH to prevent neuropathy?
Pyridoxine (Vitamin B6) 50-200mg/day.
What are the symptoms of INH hepatotoxicity?
Anorexia, malaise, fatigue, nausea, jaundice.
What should be monitored in patients taking INH?
Liver function tests (LFTs).
What CNS effects can INH cause?
Optic neuritis, seizure, dizziness, ataxia, depression, agitation, memory impairment, hallucinations, psychosis.
What are the drug interactions of INH?
CYP450 inhibitor; increases phenytoin levels.
How should INH be taken?
1 hour before or 2 hours after a meal with a full glass of water.
What is the main counseling point for Rifampin and Rifapentine?
Take on an empty stomach.
What are the major adverse effects of Rifampin and Rifapentine?
Hepatotoxicity, discoloration of body fluids, GI effects, skin reactions, rare flu-like symptoms.
What are the drug interactions of Rifampin and Rifapentine?
Potent CYP450 inducer (reduces effectiveness of many drugs).
What are the adverse effects of Pyrazinamide?
Hepatotoxicity, polyarthralgias, GI upset, rash, photosensitivity with dermatitis.
What should be avoided with Pyrazinamide?
Alcohol and tyramine-containing foods.
What are the adverse effects of Ethambutol?
Optic neuritis, allergic reactions, GI upset, confusion, rare peripheral neuropathy, renal damage, thrombocytopenia.
How is TB treatment monitored for effectiveness?
Sputum culture, chest X-ray, and clinical evaluation.
How often is a sputum culture performed?
Monthly until 2 consecutive specimens are negative.
When should a repeat chest X-ray be done?
After 2 months of treatment.
What clinical symptoms should be monitored during TB treatment?
Fever, malaise, anorexia, and cough at every clinic visit.
