TB Pharmacology Flashcards
5 drugs for TB
Isoniazid (INH) Rifampin Ethambutol Pyrazinamide Streptomycin
What is Isoniazid (INH)
most widely used TB med (1st line)
MOA of Isoniazid
Disrupts cell wall synthesis essential functions of mycobacteria
How is Isoniaid (INH) given
PO
S/E of Isoniazid (INH)
peripheral neuropathy, hepatotoxicity,
optic neuritis/visual disturbances,
hyperglycemia
What should people avoid when taking Isoniazid
antacids = reduce in drug absorption
what happens when isoniazid is given with rifampin
increase CNS and hepatotoxicity
what happens when isoniazid is given with phenytoin
increase the effects of pehytoin
What is the black box warning for isoniazid
increased risk of heptitis -> often given with pyridoxine (vitmain B6)
what is Rifampin used for
First-line
Used for lots of mycobacterial infections and other clinical uses
MOA of Rifampin
Inhibits protein synthesis via attacking the hydrocarbon ring structure
S/E of Rifampin
hepatitis, hematologic disorders, red-brown discoloration of the urine and other body fluids
Rifampin decreases effects of what
Decreases effects of beta blockers, benzos, cyclosporins, anticoagulants, antidiabetics, phenytoin, theophylline
be careful and tell patients they must make their HCP/pharmacist they are on this med
how is rifampin administered
PO/IV
What is Ethambutol
1st line bacteriostatic
MOA of Ethambutol
diffusing into the mycobacteria and suppresses RNA synthesis, which inhibits protein synthesis
S/E of ethambutol
retrobulbar neuritis
blindness
how is ethambutol given
PO
ethambutol is usually in combo with what
INH and rifampin
Who do we not use ethambutol with
children less than 13
what is pyrazinamide (PZA)
Bacteriostatic or bactericidal depending on drug concentration
T/F pyrazinamide is used in combo with other meds
TRUE
MOA of pyrazinamide
unknown, but thought to inhibit lipid and nucleic acid synthesis
S/E of pyrazinamide
hepatotoxicity
hyperuricemia
route of pyrazinamide
PO
pyrazinamide is contraindicated in what
severe hepatic disease or acute gout
Who is pyrazinamide not for
pregnant people in US [may see other countries use in pregnancy]
What is Streptomycin
very 1st drug ever available for TB
MOA of streptomycin
aminoglycoside– interfering with normal protein synthesis causing production of faulty proteins within the bacteria
S/E of Streptomycin
ototoxicity,
nephrotoxicity,
blood dyscrasias
what route is streptomycin given
IM injection
what should be cautioned with streptomycin
Careful with people on anticoagulants– can increase bleeding
