TB Self Study Flashcards
Unique qualities about mycobacterium is that they are ____ growing microbes, making it necessary for ____ drug therapy.
slow, long
Which two methods are used to determine if a patient has latent tuberculosis?
1) PPD skin test
2) Interferon gamma release assay, blood test
Why are mycobacterium often referred to as “acid fast bacilli”?
Because mycobacterium resists discoloration when exposed to acid/ethanol in staining procedures.
What drugs are used to treat latent TB?
Isoniazid and Rifapentine
What is the minimum number of drugs used to treat TB?
The minimum number of drugs used to treat TB is two. Active TB infections are treated using 4-7 drugs.
Why is TB always treated with two or more drugs?
Since treatment takes a long time, spontaneous mutations conferring drug resistance are probable. By always using two or more drugs, the chances of two mutations in the same bacteria conferring resistance to both drugs in nil.
What are the first line drugs? (6)
Isoniazid Rifampin Rifapentine Rifabutin Pyrazinamide Ethambutol
Isoniazid
MOA
Inhibits mycobacterial cell wall synthesis and interferes with metabolism.
Rifampin
MOA
Inhibits RNA synthysis
Ethambutol
MOA
Obstructs formation of the cell wall.
Pyrazinamide
MOA
Unknown
Isoniazid
Side Effects
- Peripheral neuropathy, pyridoxine (B6) can be given to prevent PN
- Liver toxicity
Isoniazid
Interactions
CYP450 Inhibitor: Phenytoin, diazepam, carbamazepine
Isoniazid
Patient Teaching/Testing
Report symptoms of hepatitis.
Encourage alcohol abstinence.
Monitor liver enzymes
Rifampin
Side Effects
- Red/orange discoloration of body fluids
- Liver toxicity
Rifampin
Interactions
CYP450 Inducer: Oral contraception, warfarin, protease inhibitors and NNRTI’s for HIV
Rifampin
Patient Teaching/Testing
Take on an empty stomach.
Report symptoms of hepatitis.
Encourage alcohol abstinence.
Monitor liver enzymes.
Ethambutol
Side Effects
Optic Neuritis
Ethambutol
Interactions
Aluminum containing antacids
Ethambutol
Patient Teaching/Testing
Educate patient to report alteration to vision (Blurred vision, constriction of the visual field, color discrimination problems).
Test for color discrimination and visual acuity before and during treatment.
Stop drug if optic neuritis occurs.
Pyrazinamide
Side Effects
- Polyarthralgia: pain in multiple joints; treat with NSAIDS
- Liver toxicity