TB Meds Flashcards
What are First Line Meds?
RIPE 1. rifampin, rifabutin, rifapentine 2. Isoniazid 3. Pyrazinamide 4. Ethambutol
What are a few of the second line meds?
streptomycin, cycloserine, p-aminosalicyclic acid, levofloxacin, moxifloxacin, gatifloxacin, capreomycin etc.
Isoniazid (INH) MOA
MOA: inhibit bacterial cell wall synth.
Isoniazid cidal or static?
- Bactericidal
Isoniazid .. why does it interact with other drugs?
P450 2C9 inhibitor
Isoniazid 2 common ADRs
peripheral neuropathy, elevated LFT
Isoniazid intoxication sx:
resp. distress, cns depression, metabolic acidosis, hyperglycemia
Rifampin MOA
inhibits DNA dependent RNA polymerase
Rifampin static or cidal?
bactericidal
Rifampin for what pt ages?
for patients 12 yo +
Rifampin ADRS
red orange body fluids , GI, flatulence, CDAD etc
Rifampin interacts with drugs why?
STRONG 3A4 inducer - interacts with oral contraceptives, INH, warfarin and many others
Rifapentine MOA and static or cidal?
MOA: inhibits DNA dependent RNA polymerase, cidal
What four patient populations can you NOT use Rifapentine with?
Pregnant, HIV, kids under 2, or resistant M. tb
Rifapentine induces which 2 p450 enzymes?
3A4, 2C9
Rifapentine ADR
colored body fluids, hepatotoxicity, hyperbilirubinemia, cdad
Pyrazinamide: indication and 2 contraindications
for active TB in adults and kids. Contraindicated with gout or severe liver disease
Pyrazinamide: elimination?
urine excretion
Pyrazinamide 3 ADR
hyperuricemia (stops renal excretion uric acid), increased LFT, rash
Ethambutol MOA
inhibits metabolite synthesis, impairs cell metabolism and stops reproduction. (Only works on mycobacteria)
Ethambutol indication
used in combo TB therapies never a monotherapy option
Ethambutol ADRs
decreased visual acuity, optic neuritis, optic neuropathy, hyperuricemia, GI, confusion, etc
What is the one drug interaction with ethambutol?
aluminum containing antacids
