TB Pharmacology

Question 1

5 drugs for TB

Answer 1

Isoniazid (INH)
Rifampin
Ethambutol
Pyrazinamide
Streptomycin

Question 2

What is Isoniazid (INH)

Answer 2

most widely used TB med (1st line)

Question 3

MOA of Isoniazid

Answer 3

Disrupts cell wall synthesis essential functions of mycobacteria

Question 4

How is Isoniaid (INH) given

Answer 4

PO

Question 5

S/E of Isoniazid (INH)

Answer 5

peripheral neuropathy, hepatotoxicity,
optic neuritis/visual disturbances,
hyperglycemia

Question 6

What should people avoid when taking Isoniazid

Answer 6

antacids = reduce in drug absorption

Question 7

what happens when isoniazid is given with rifampin

Answer 7

increase CNS and hepatotoxicity

Question 8

what happens when isoniazid is given with phenytoin

Answer 8

increase the effects of pehytoin

Question 9

What is the black box warning for isoniazid

Answer 9

increased risk of heptitis -> often given with pyridoxine (vitmain B6)

Question 10

what is Rifampin used for

Answer 10

First-line

Used for lots of mycobacterial infections and other clinical uses

Question 11

MOA of Rifampin

Answer 11

Inhibits protein synthesis via attacking the hydrocarbon ring structure

Question 12

S/E of Rifampin

Answer 12

hepatitis, hematologic disorders, red-brown discoloration of the urine and other body fluids

Question 13

Rifampin decreases effects of what

Answer 13

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

Question 14

how is rifampin administered

Answer 14

PO/IV

Question 15

What is Ethambutol

Answer 15

1st line bacteriostatic

Question 16

MOA of Ethambutol

Answer 16

diffusing into the mycobacteria and suppresses RNA synthesis, which inhibits protein synthesis

Question 17

S/E of ethambutol

Answer 17

retrobulbar neuritis

blindness

Question 18

how is ethambutol given

Answer 18

PO

Question 19

ethambutol is usually in combo with what

Answer 19

INH and rifampin

Question 20

Who do we not use ethambutol with

Answer 20

children less than 13

Question 21

what is pyrazinamide (PZA)

Answer 21

Bacteriostatic or bactericidal depending on drug concentration

Question 22

T/F pyrazinamide is used in combo with other meds

Answer 22

TRUE

Question 23

MOA of pyrazinamide

Answer 23

unknown, but thought to inhibit lipid and nucleic acid synthesis

Question 24

S/E of pyrazinamide

Answer 24

hepatotoxicity

hyperuricemia

Question 25

route of pyrazinamide

Answer 25

PO

Question 26

pyrazinamide is contraindicated in what

Answer 26

severe hepatic disease or acute gout

Question 27

Who is pyrazinamide not for

Answer 27

pregnant people in US [may see other countries use in pregnancy]

Question 28

What is Streptomycin

Answer 28

very 1st drug ever available for TB

Question 29

MOA of streptomycin

Answer 29

aminoglycoside– interfering with normal protein synthesis causing production of faulty proteins within the bacteria

Question 30

S/E of Streptomycin

Answer 30

ototoxicity,
nephrotoxicity,
blood dyscrasias

Question 31

what route is streptomycin given

Answer 31

IM injection

Question 32

what should be cautioned with streptomycin

Answer 32

Careful with people on anticoagulants– can increase bleeding