TB Drugs

Question 1

Rifampin

Answer 1

inhibits bacterial DNA

broad spectrum, gram negative, lipid soluble

Question 2

Rifampin absorption

Answer 2

well absorbed if taken on an empty stomach. with food or shortly after a meal will decrease the rate and extent of absorption.

Question 3

Rifampin AE

Answer 3

heptatoxicity, most likely in ppl who drink. monitor closely.
discolors body fluids (pee, sweat, spit and tears)
GI issues, rare: flu like syms.

Question 4

Isoniazid

Answer 4

highly selective TB drug.

treats active and latent TB.

Question 5

Isoniazid AE

Answer 5

hepatotoxicity from toxic metabolites. mostly happens in old folks. monitor AST/ALT. no drinking!
peripheral neuropathy, symmetic parethesias.

Question 6

Isoniazid D-D interactions

Answer 6

phenytoin, carbamazepine, diazepam, triazolam

Question 7

Rifapentine

Answer 7

analog of rifampin. long acting. taken orally, unaffected by food.

Question 8

Rifapentine AE

Answer 8

rash, GI, reddish pee, sweat, pee and tears.

Question 9

Rifapentine D-D

Answer 9

can decrease levels of other drugs, esp. BC and NNRTIs (think about HIV patients!)

Question 10

Pyrazinamide

Answer 10

well absorbed after oral admin.
AE: liver issues. Most hepatotoxic– check AST and ALT levels.
nongouty polyarthralgias– 40%

Question 11

Ethambutol

Answer 11

bacteriostatic! will be given this if resistant to isoniazid/rifampid.

Question 12

Ethambutol pharm

Answer 12

oral admin. widely distributed but not through CSF.

Question 13

Ethambutol AE

Answer 13

optic neuritis– blurred vision, constriction of the visual field. disturbance of color discrimination.

Question 14

treating LTBI

Answer 14

Isoniazid alone– taken for a long time. risk for liver damage
Isoniazid + rifapentine– taken 1x week for 3 months. DOT.
Rifampin– daily for 4 mos.

Question 15

1st line active TB

Answer 15

isoniazid, rifampin, pyrazinamide, ethambutol.

Question 16

1st line active TB that can be given im or iv

Answer 16

isoniazid, rifampin.