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Pharm II > Tuberculosis > Flashcards

Tuberculosis Flashcards

1
Q

mycobacterium are ___ (slow/fast) growing microbes

A

slow

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2
Q

mycobacterium require ____ (short/long) therapy

A

long

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3
Q

2 methods for determining if pt has latent TB

A
  1. TST (intradermal injection of PPD)

2. IGRA (blood test, WBC will release interferon gamma if latent TB)

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4
Q

what does “acid fast bacilli” mean

A

mycobacterium resist decolorizing by dilute acid used in staining protocols (high content of mycolic acid in cell wall)

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5
Q

treatment for latent TB (3 different treatments)

A
  1. isoniazid alone taken daily for 6 or 9 months
  2. isoniazid plus rifapentine taken weekly for 12 wks
  3. can’t take isoniazid? take rifampin daily for 4 months
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6
Q

risk of treating pt with active TB with isoniazid only

A

would promote emergence of resistant bacilli

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7
Q

1st line therapy meds to treat active TB infections

A 
isoniazid
rifampin
pyrazinamide
ethambutol
rifamycin
rifapentine
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8
Q

2nd line therapy meds to treat active TB infections

A

cycloserine
ethionamide
capreomycin
para-amino salicylic acid (PAS)
the aminoglycosides (streptomycin, amikacin, kanamycin)
the quinolones (levofloxacin, moxifloxacin)

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9
Q

TB drugs only available in IM or IV route

A

capreomycin
streptomycin
amikacin
kanamycin

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10
Q

4 drugs given as induction therapy for active TB

A

isoniazid
rifampin
pyrazinamide
ethambutol

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11
Q

minimum length of therapy for active TB infection

A

6 months

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12
Q

when is 2nd line drug therapy used for active TB

A

TB is MDR or XDR (extensively drug resistant)

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13
Q

MDR-TB is defined as a strain resistant to which drugs?

A

isoniazid

rifampin

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14
Q

XDR-TB is defined as a strain resistant to which drugs?

A

isoniazid
rifampin
all fluroquinolones
at least one of the injectable second-line anti-TB drugs (amikacin or capreomycin)

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15
Q

what is DOT?

A

daily observed therapy

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16
Q

what is intermittent dosing?

A

dosing 2 or 3 times a week rather than every day

17
Q

drug selection for active TB based upon which 2 factors?

A
  1. patterns of drug resistance in the community

2. the immunocompetence of the patient

18
Q

difference between induction phase and continuation phase

A

induction: initially tx, eliminate actively dividing tubercle bacilli
continuation: eliminate persistent intracellular bacteria

19
Q

5 main meds for active TB

A 
isoniazid (INH)
rifampin
ethambutol
pyrazinamide (PZA)
pyridoxine
20
Q

TB meds that cause liver toxicity (3)

A

INH
rifampin
PZA

21
Q

a major SE of this TB med id optic neuritis

A

ethambutol

22
Q

this TB med can turn urine an orange-reddish color or stain contact lenses

A

rifampin

23
Q

pyridoxine (vit B6) is given to prevent peripheral neuropathy caused by this TB drug

A

INH

24
Q

pt with ETOH use disorder or with liver disease should not take these TB meds (3)

A

INH
rifampin
pyrazinamide

25
Q

pt on oral contraceptive should use another form of BC with this TB med

A

rifampin

26
Q

pt on these TB meds should have their liver enzymes (AST, ALT) checked

A

INH, rifampin, pyrazinamide

27
Q

this TB med should NOT be given with food as it decreases absorption

A

rifampin

28
Q

significant drug-drug interactions occur with the HIV meds and this TB drug (certain protease inhibitors and NNRTIs)

A

rifampin

29
Q

routine eye exams should be done to assess for color discrimination and visual acuity when taking this TB drug

A

ethambutol

30
Q

this TB drug may be given alone for tx of latent TB infection

A

INH

31
Q

typical drug regimen for someone with active TB

A

usually initiated with a 4-drug regimen; INH and rifampin are almost always included

32
Q

what would indicate that a TB drug should be discontinued because of hepatotoxicity

A 
signs of hepatitis (jaundice, anorexia, malaise, fatigue, nausea)
abnormal AST (3-5x tx baseline levels)
33
Q

pt being treated for active TB should see improvements:

clinical manifestations decrease within ______
CXR manifestations show improvement within ______
sputum culture become negative in over 90% of pt after ______

A

2 weeks

3 months

3 months

Pharm II (3 decks)

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