Tuberculosis

Question 1

mycobacterium are fast or slow growing microbes?

Answer 1

slowwww

Question 2

2 ways to test for latent TB

Answer 2

1. PPD skin test

2. blood tests (quantiferon gold*)

Question 3

tx for latent TB

Answer 3

3 tx:

1. isoniazid (daily 6-9 months)
2. isoniazid + rifapentine (q week for 12 weeks)
3. rifampin (daily 4 months)

Question 4

considering the 3 recommended tx for latent TB and dosing, what tx is most likely to have increased adherence?

Answer 4

isoniazid + rifapentine b/c 12 total doses vs hundreds!

Question 5

risk of treating active TB with isoniazid only…

Answer 5

could lead to resistant bacteria

Question 6

action of isoniazid on actively dividing mycobacterium

Answer 6

bactericidal

Question 7

action of isoniazid on resting/dormant mycobacterium

Answer 7

bacteriostatic

Question 8

what 4 drugs are typically given as INDUCTION therapy for active TB?

Answer 8

1. isoniazid
2. rifampin
3. pyrazinamide
4. ethambutol

Question 9

when would we use 2nd line drug therapy for TB?

Answer 9

when TB becomes resistant to 1st line drugs

Question 10

MDR-TB is resistant to which 2 drugs?

Answer 10

isoniazid + rifampin

Question 11

XDR-TB is resistant to which drugs (4)?

Answer 11

isoniazid + rifampin + fluroquinolones + at least 1 injectable 2nd line

Question 12

goal of induction phase tx for TB

Answer 12

get rid of ACTIVELY dividing extracellular bacilli to MAKE SPUTUM NONINFECTIOUS

Question 13

goal of continuation phase tx for TB

Answer 13

eliminate persistent intracellular bacilli

Question 14

TB meds that cause hepatotoxicity

Answer 14

1. isoniazid
2. rifampin
3. PZA (pyrazinamide)

Question 15

TB med with major SE of optic neuritis

Answer 15

ethambutol

= blurred vision, can’t discriminate colors

Question 16

TB med that can turn excretions orange-red color

Answer 16

rifampin

Question 17

B6 given to prevent peripheral neuropathy with this TB drug

Answer 17

isoniazid

“ISO tingly I’m buzzing like a B”

Question 18

TB meds to avoid with liver disease or ETOH use

Answer 18

1. isoniazid
2. rifampin
3. PZA (pyrazinamide)

Question 19

should use another form of BC with this TB med

Answer 19

rifampin

Question 20

TB meds to have liver enzymes checked with

Answer 20

1. isoniazid
2. rifampin
3. PZA

Question 21

DON’T give this TB med with food (decreases absorption)

Answer 21

rifampin

Question 22

drug-drug interactions with HIV meds with this TB drug

Answer 22

rifampin

Question 23

should give routine eye exams with this TB med

Answer 23

ethambutol (optic neuritis risk)

Question 24

after tx for active TB, patients should see improvement with clinical manifestations in _________ (time frame)

Answer 24

2 weeks

Question 25

after tx for active TB, CXR should improve within _______ (time frame)

Answer 25

3 months

Question 26

after tx for active TB, sputum cultures should become negative in most (90%) patients in ______ (time frame)

Answer 26

3 months