tb pharm

Question 1

isoniazid (INH)

Answer 1

most widely used
moa: disrupt cell wall synthesis
PO

Question 2

isoniazid: SE

Answer 2

peripheral neuropathy, hepatotoxicity (need working liver - metabolize drug, monitor enzymes), optic neuritis/visual disturbances, hypergly
avoid antacids - reduce abs
when given with rifampin - increase CNS and hepatotox s
given with phenytoin - increase effects of pheny
black box: increased risk of hepatitis, given with pyridoxine (B6) to counteract this

Question 2

antitubercular drugs

Answer 2

treat all infections caused by mycobacterium
1st: primary
2nd: complicated cases, resistant
4 course broadspectrum while testing for resistance

Question 3

rifampin

Answer 3

1st line
used for lots of mycobacterial infections and other uses
moa: inhibit protein synthesis via attacking hydrocarbon ring
PO or IV

Question 4

rifampin SE

Answer 4

hepatitis, hematologic disorders, red-brown discoloration of urine and other body fluids
decrease effects of beta blockers, benzos, cyclosporins, anticoag, antiDM, phenytoin, theophylline -> need good hx, make sure doctors know and pharmacist, may need higher doses
CYP activator

Question 5

ethambutol

Answer 5

1st line bacteriostatic
moa: diffuse into mycobacteria and suppress RNA synthesis - which inhibits protein synthesis
PO only
usually in combo with INH and rifampin
not for children <13

Question 6

ethambutol SE

Answer 6

retrobulbar neuritis (back of eye), blindness, see ophthalmologist

Question 7

pyrazinamide

Answer 7

bacteriostatic or cidal depending on []
combo with other meds
moa: unknown, thought to inhibit lipid and nucleic acid synthesis
SE: hepatotox, hyperuricemia
PO
CI: severe hepatic disease or acute gout
not for preg in us - maybe other countries

Question 8

streptomycin

Answer 8

moa: aminoglycoside - interfere with normal p synthesis causing faulty proteins in bacteria
SE: ototoxicity, nephrotox, blood dyscrasias
IM injection - daily
careful with anticoag - can increase bleeding