TB treatment Flashcards
How do you manage latent TB?
If worried about hepatotoxicity:
- 3 months of isoniazid (with pyridoxine) and rifampicin
If worried about interactions with rifampicin (HIV and transplant patients):
- 6 months isoniazid (with pyridoxine)
How do you manage active TB?
RIPE - R - Rifampicin 450mg (<50kg), 600mg (≥50kg) 6 months - I - Isoniazid 300mg 6 months - P - Pyrazinamide 1.5g (<50kg), 2g (≥50kg) 2 months - E - Ethambutol 15mg/kg 2 months
What are the side effects of rifampicin?
- Red/orange coloured body fluids
- Hepatits
- Skin reactions
- Flu syndrome
- GI symptoms
- Thrombocytopenia
- Reduced effect of drugs metabolised by cytochrome P450 enzymes (OCP)
What are the side effects of isoniazid?
- Hepatitis
- Skin reactions
- Peripheral neuropathy
What are the side effects of pyrazinamide?
- Hepatitis
- Flushing
- GI symptoms
- Arthralgia
- Hyperuricaemia (gout)
- Skin reactions
What are the side effects of ethambutol?
- Retrobulbar neuritis
Can result in blindness -> stop treatment
Eye-thambutol - Arthralgia
What do you need to give with isoniazid?
Pyridoxine (vitamin B6) for peripheral neuropathy
- Im-so-numb-azid
How long do you continue treatment for if there are meningeal/CNS symptoms?
10 months
How long do patients need to isolate for before they are established onto treatment?
- 2 weeks