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Pharmacology > TB > Flashcards

TB Flashcards

1
Q

MDR-TB involves resistance to what drugs?

A

Isoniazid

Rifampin

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2
Q

What is classification of Mantoux PPD test?

A

> 5mm: pos if HIV pt
10mm: pos for immigrants
15: pos for anyone without risk factors

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3
Q

What are S&S of TB?

A

fatigue, weight loss, fever, night sweats, and productive cough

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4
Q

What is the treatment for active TB?

A

“RIPE”
Rifampin, Isoniazid, Pyrazinamide, Ethambutol X 8 weeks
+
INH + RIF for 16 weeks

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5
Q

T/F Combination therapy is required to treat TB?

A

TRUE

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6
Q

What is Intensive phase vs continuation phase of tx?

A

Intensive;
RIPE
Continuation phase: INH + RIF

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7
Q

What is the minimum phase of tx for active TB?

A

at least 6 months

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8
Q

which drugs prevent TB resistance?

A

Rifampin and Isoniazid

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9
Q

T/F Monotherapy is only acceptable in latent TB?

A

TRUE

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10
Q

What is drug therapy in latent TB? (4)

A

INH + Rifapentine
RIF alone
INH alone
INH + RIF

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11
Q

What is first line tx for active and latent TB?

A

Isoniazid

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12
Q

What is MOA of isoniazid?

A

blocks the synthesis of mycolic acid

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13
Q

What are ADE of isoniazid?

A

Hepatotoxicty

Vitamin B-6 pyridoxine deficiecny: peripheral neuropathy

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14
Q

T/F you should increase dietart folate and niacin, mg in pt taking isoniazid

A

yes, to reduce chance of getting B-6 deficency

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15
Q

What parameters would you monitor in isoniazid?

A

GFR
LFT’s
vitamins

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16
Q

what is MOA of Rifampin?

A

blocks RNA synthesis by blocking dna dependent rna polymerase

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17
Q

What is clinical use of Rifampin?

A

Latent and active TB

18
Q

What are ADE of Rifampin?

A

turns body fluids orange
hepatitis
nephritis
Flu like syndrome with intermittent dosing

19
Q

T/F Rifampin crosses the placenta and can cause post natal hemorhage

A

True

20
Q

T/F Rifampin and Isoniazid are used in tx of pregnant women even if the risk of neonatal damage is moderate to high

A

True

21
Q

T/F Rifambutin is like Rifampin but it has fewer drug interactions and less P450 involvement?

A

True

22
Q

What is the clinical application of Rifabutin? Is it more or less potent than Rifampin?

A
  • used for M. avium infection in AIDS pt and can be used for TB
  • Less potent
23
Q

What is the clinical application of Rifampentin? Is it more or less potent than Rifampin?

A
  • it is longer acting and used for continuation phase of tx in HIV neg patients
  • just as potent as rifampin
24
Q

What is MOA of pyrazinamide ?

A

MOA unknown but it is a sterilzing agent

believed to work by converting into pyrazinoic acid into which lower the pH

25
Q

T/F the total amount of time to give pyrazinamide is no more than 6 months

A

TRUE

26
Q

What should you monitor in pyrazinamide?

A

GFR and LFT’s

27
Q

ADE of pyrazinamide?

A

Hyperurecemia

Hepatotoxicity

28
Q

What is MOA of ethambutol?

A

blocks arabinosyl transferase an stops production arabinoglycan

29
Q

What is clinical indication of ethambutol?

A

It is given as part of RIPE for two months but only given until drug sensitivities are known

30
Q

What are ADE of ethambutol? (3)

A
  • optic neuritis
  • color blind, scotoma
  • hepatoxicity
31
Q

How many drugs are used to tx MDR-TB?

A

5

32
Q

What is the 5 drug regimen tx for MDR-TB?

A
  1. choose levo or moxi
  2. add both bedaquiline and linezolid
  3. add both clofazamine and Cycloserine
33
Q

What do you do if you cant give a 5 drug regimen in MDR-TB and pt is susceptible to ?

A

IM injection of Amikacin or Streptomycin

34
Q

What do you use if you want to give oral MDR-TB abx?

A

use delamanid, pyrazinamide, ethambutol

35
Q

Which drugs are no longer used for MDR-TB?

A

Azithro, Augmentin, Capreomycin

36
Q

What is MOA of Bedaquiline?

A

blocks proton transfer for the generation of energy in TB bacteria

37
Q

T/F Bedaquiline is the first drug to be approved in a new class of anti-TB drugs in over 40 years

A

TRUE

38
Q

What is black bx warning of bedaquiline?

A

increased mortality

QT prolongation

39
Q

What test should run before starting bedaquline

A

ECG

40
Q

What should you monitor in bedaquiline?

A

serum transaminases, LFT’s

Pharmacology (47 decks)

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