TB I

Question 1

5 goals of TB treatment

Answer 1

• Cure the patient of TB
• Prevent transmission of TB to others
• Prevent the development of
  acquired resistance
• Prevent relapse
• Prevent death from TB or its
  complications

Question 2

When is combination therapy for TB used?

Answer 2

It is used in the intensive phase and in the continuation phase
It is a combination tablet

Question 3

Which drug inhibits the synthesis of mycolic acid layer of the mycobacterial cell wall?

Answer 3

Isoniazid

Question 4

Which drug inhibits the synthesis of arabinogalactan layer of the mycobacterial cell wall?

Answer 4

Ethambutol

Question 5

Which drug is converted to an acid in the cytoplasm of the mycobacterium, and acidify the intracellular environment and compromise the integrity of the cell membrane?

Answer 5

Pyrazinamide

Question 6

Which druginhibits mycobacterial RNA synthesis by binding to and inhibiting the enzyme RNA polymerase?

Answer 6

Rifampicin

Question 7

Which drug is effective in dormant mycobacteria?

Answer 7

Pyrazinamide

Question 8

Which drug is bactericidal for intra and extracellular bacteria and has sterilising activity?

Answer 8

Rifampicin

Question 9

Which drug is bacteriostatic, and is only bactericidal at hight doses?

Answer 9

Ethambutol

Question 10

Which drug has excellent early bactericidal activity?

Answer 10

Isoniazid

Question 11

Which drug is mycobactericidal for intracellular mycobacteria in an acidic medium?

Answer 11

Pyrazinamide

Question 12

Which drug is most useful in the intensive phase?

Answer 12

Pyrazinamide

Question 13

In adults, What drugs are used for 1st line TB treatment in the intensive phase of (extra) pulmonary TB? They are used for how long?

Answer 13

Rifampicin
* Isoniazid
* Pyrazinamide
* Ethambutol

For 2 months

Question 14

In adults, Which drugs are used in the continuation phase of (extra) pulmonary TB Tx? How long is the continuation phase?

Answer 14

Rifampicin
Isoniazid

4 months

Question 15

In adults, What is the treatment for severe/complicated TB in the intensive phase? How long is this phase?

Answer 15

Rifampicin
Isoniazid
Pyrazinamide
Ethambutol

2 months

Question 16

In adults, What is the treatment for severe/complicated TB in the continuation phase? How long is this phase?

Answer 16

Rifampicin
Isoniazid

7 MONTHS

Question 17

In children < 8yrs & < 30kg, What drugs are used for 1st line TB treatment in the intensive phase of (extra) pulmonary TB? They are used for how long?

Answer 17

Rifampicin
Isoniazid
Pyrazinamide

2 months

Question 18

In children < 8yrs & < 30kg, What drugs are used for 1st line TB treatment in the continuation phase of (extra) pulmonary TB? They are used for how long?

Answer 18

Rifampicin
Isoniazid

4 months

Question 19

In children < 8yrs & < 30kg, What drugs are used for 1st line TB treatment in the intensive phase of severe/complicated TB? They are used for how long?

Answer 19

Rifampicin (R)
* Isoniazid (H)
* Pyrazinamide (Z)
* Ethambutol (E)

2 months

Question 20

in children < 8yrs & < 30kg, What drugs are used for 1st line TB treatment in the continuation phase of severe/complicated TB? They are used for how long?

Answer 20

Rifampicin
Isoniazid

7 months

Question 21

When monitoring patients on TB treatment what is the most important thing to assess for?

Answer 21

Assess for side effects

Question 22

Which drugs need hepatotoxicity monitoring?

Answer 22

Rifampicin
Isoniazid
Pyrazinamide

Question 23

When monitoring liver function, what should you check for?

Answer 23

Check for drug-induced liver injury (DILI)

Question 24

Which patients are at high risk for hepatotoxicity? (7)

Answer 24

Chronic infectious hepatitis
Pre-existing liver disease
MDR TB patients
High levels of alcohol consumption
Other hepatotoxic drugs
HIV+
Females and elderly

Question 25

What to check for when screening for hepatotoxicity?

Answer 25

New onset abdominal pain
N & V
Jaundice
Dark urine

Question 26

What to check for in blood labs when screening for hepatotoxicity?

Answer 26

Check bilirubin and transaminase levels.
If 5x the upper limit / 3x the upper limit with jaundice - means the patient has hepatotoxicity