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PR - INFECTIONS > TB DRUGS > Flashcards

TB DRUGS Flashcards

1
Q

Rifampicin dose

A
  • If less than 50kg
    450 mg OD
  • If more than 50kg
    600mg OD
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2
Q

Rifampicin - CI

A
  • Acute porphyrias
  • Jaundice
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3
Q

Rifampicin - SE

A

Common SE:
- N + V
- Thrombocytopenia

Specific:
- Psychosis
- Flu like symptoms with intermittent therapy
- Resp e.g. SOB
- Colours soft contact lenses AND urine red/orange

Enzyme Inducer - CYP450 INTERACTION!!!!

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4
Q

Can Rifampicin be used in hepatic impairment?

A
  • Should avoid or do not exceed 8mg/kg daily
  • Monitor weekly for 2 weeks, then fornightly for 6 weeks
  • Counsel pt to report signs of hepatotoxicty
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5
Q

What are the monitoring
requirements if on Rifampicin?

A
  1. Renal - before
  2. Hepatic - before
    - fever, malaise, vomiting, jaundice
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6
Q

Rifampicin - counselling

A
  • Can colour soft contact lenses
  • Urine orange/red - harmless
  • Empty stomach
  • Report: signs of hepatotoxicity
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7
Q

Rifampicin - interactions

A

CYP enzyme inducer
- Increases enzyme activation, drugs are metabolised more = less effective
- e.g. hormonal contraception

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8
Q

Rifampicin - pregnancy

A
  • Pregnancy = high doses are teratogenic in 1st trimester, increased risk of neonatal bleeding in 3rd trimester.
  • BF = safe (amount too small to be harmful)
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9
Q

What is the dose of Isoniazid in Tuberculosis?

A

300mg od

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10
Q

What are the contraindications for use of Isoniazid?

A
  • DILI
  • Tyramine rich food
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11
Q

Isonazid - SE

A
  • liver toxicity
  • peripheral neuropathy
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12
Q

Peripheral neuropathy RF

A
  • Diabetes
  • Alcohol dependence
  • Chronic renal failure
  • Pregnancy
  • Maltnutrition
  • HIV
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13
Q

Isoniazid - how to take

A

30-60 mins before food

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14
Q

Isoniazid - pregnancy + BF

A

Pregnancy = not known to be harmful
BF = risk of convulsions and neuropathy, monitor infant for toxicity

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15
Q

Who is more likely to get Hepatitis with isoniazid?

A
  • Common in those aged over 35 years old
  • Those with a daily alcohol intake
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16
Q

What are the monitoring requirements for isoniazid?

A

renal/ hepatic function

17
Q

What should patients taking isoniazid be counselled on with regards to hepatic disorder?

A

To seek medical attention if symptoms occur:
- Persistent nausea
- Vomiting
- Malaise
- Jaundice occurs

18
Q

What is the dose of Pyrazinamide in
Tuberculosis?

A
  • If less than 50kg: 1.5 g OD
  • If more than 50kg: 2g OD
19
Q

What are the contraindications for use of Pyrazinamide?

A
  • Acute attack of gout in adults
20
Q

In which patients should Pyrazinamide be used with caution?

A
  • Diabetes
  • Gout
21
Q

What are the side-effects of
Pyrazinamide?

A
  • Gout aggravated
  • Hepatic disorders
22
Q

What are the monitoring requirements for Pyrazinamide?

A
  • Renal function
  • Hepatic function
23
Q

What should patients taking Pyrazinamide be counselled on?

A

To seek medical attention if symptoms of hepatic disorder occur:
1. Perisistent nausea
2. Vomiting
3. Malaise
4. Jaundice

24
Q

What are the contraindications for use of Ethambutol?

A
  • Optic neuritis
  • Poor vision
25
Q

What is the dose of Ethambutol in Tuberculosis?

A

15mg/kg OD

26
Q

What are the side-effects of Ethambutol?

A
  • Visual impairment
  • Hyperuricaemia
  • Ocular toxicity
27
Q

In which patient groups is Ethambutol cautioned, provide an explanation?

A
  • Elderly and young children
  • because they may not be able to report vision changes as easily as an adult
28
Q

What can increase the risk of optic nerve damage with Ethambutol?

A
  • Overdose
  • Renal impairment
29
Q

What are the monitoring requirments with Ethambutol?

A
  1. Plasma-Ethambutol concentration
    - Peak should be 2-6mg/L
    - Trough should be less than 1mg/L
  2. Renal function
    - Before treatment
  3. Visual activity
    - Using Snellen Chart
    - Before treatment
30
Q

What should patients taking Ethambutol be counselled on?

A
  • If deterioration in vision occurs, to discontinue treatment and seek medical advise
  • Could be ocular toxicity which is a main side-effect
31
Q

will early discontinuation of ethambutol recover eyesight

A

Early discontinuation of the drug is almost always followed by recovery of eyesight

32
Q

Side effects - GENERAL

A

Liver toxicity = rifampicin, isoniazid + pyrazinamide
Peripheral neuropathy = isoniazid
Ocular toxicity = ethambutol
Orange/red secretions = Rifampicin

32
Q
A
33
Q
A

PR - INFECTIONS (41 decks)

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