TB Flashcards
MDR-TB involves resistance to what drugs?
Isoniazid
Rifampin
What is classification of Mantoux PPD test?
> 5mm: pos if HIV pt
10mm: pos for immigrants
15: pos for anyone without risk factors
What are S&S of TB?
fatigue, weight loss, fever, night sweats, and productive cough
What is the treatment for active TB?
“RIPE”
Rifampin, Isoniazid, Pyrazinamide, Ethambutol X 8 weeks
+
INH + RIF for 16 weeks
T/F Combination therapy is required to treat TB?
TRUE
What is Intensive phase vs continuation phase of tx?
Intensive;
RIPE
Continuation phase: INH + RIF
What is the minimum phase of tx for active TB?
at least 6 months
which drugs prevent TB resistance?
Rifampin and Isoniazid
T/F Monotherapy is only acceptable in latent TB?
TRUE
What is drug therapy in latent TB? (4)
INH + Rifapentine
RIF alone
INH alone
INH + RIF
What is first line tx for active and latent TB?
Isoniazid
What is MOA of isoniazid?
blocks the synthesis of mycolic acid
What are ADE of isoniazid?
Hepatotoxicty
Vitamin B-6 pyridoxine deficiecny: peripheral neuropathy
T/F you should increase dietart folate and niacin, mg in pt taking isoniazid
yes, to reduce chance of getting B-6 deficency
What parameters would you monitor in isoniazid?
GFR
LFT’s
vitamins
what is MOA of Rifampin?
blocks RNA synthesis by blocking dna dependent rna polymerase
What is clinical use of Rifampin?
Latent and active TB
What are ADE of Rifampin?
turns body fluids orange
hepatitis
nephritis
Flu like syndrome with intermittent dosing
T/F Rifampin crosses the placenta and can cause post natal hemorhage
True
T/F Rifampin and Isoniazid are used in tx of pregnant women even if the risk of neonatal damage is moderate to high
True
T/F Rifambutin is like Rifampin but it has fewer drug interactions and less P450 involvement?
True
What is the clinical application of Rifabutin? Is it more or less potent than Rifampin?
- used for M. avium infection in AIDS pt and can be used for TB
- Less potent
What is the clinical application of Rifampentin? Is it more or less potent than Rifampin?
- it is longer acting and used for continuation phase of tx in HIV neg patients
- just as potent as rifampin
What is MOA of pyrazinamide ?
MOA unknown but it is a sterilzing agent
believed to work by converting into pyrazinoic acid into which lower the pH
