Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Therapeutics 3 > Tuberculosis > Flashcards

Tuberculosis Flashcards

1
Q

What is the causitive pathogen of tuberculosis?

A

mybacterium tubercolsis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

How is tuberculosis transmitted?

A

actively infected patients WITH symptoms, not patients that have latent disease spread disease through aerosolized droplet nuclei

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Who is at risk for tuberculosis infection?

A

CLOSE CONTACT
- family members/household contact
- co-workers
- healthcare personnel
- nursing home residents
- persons experiencing homelessness
- persons who are incarcerated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the risk factors for active TB disease?

A
  • HIV/AIDS
  • immune system dysfunction
  • incarceration
  • homeless
  • alcoholism
  • malnutrition
  • IV drug use
  • renal failure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the clinical manifestations of active TB?

A
  • fatigue
  • fever and chills
  • anorexia
  • hemoptysis (vomiting blood)
  • weight loss
  • night sweats
  • cough
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What type of isolation is required for patients with active TB?

A

negative air flow isolation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What drugs are drug resistant TB organisms resistent to?

A

isoniazid or rifampin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How is drug resistant TB developed?

A
  • primary= transmission of drug-resistant organisms
  • secondary= development of resistance due to inadequate treatment, non-adhearance, or variation in pharmacokinetic parameters
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the risk factors for drug resistant TB?

A
  • exposure to person with known drug-resistant TB
  • exposure to person who experienced treatment failure or relapse
  • exposure to person born in a region with high resistace rates
  • exposure to persons who continue to have positive smears after 2 months of therapy
  • travel to areas with high resistance
  • non-adhearance to treatment
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the principles of tuberculosis drug therapy?

A
  • rapid detection of patient with active TB disease
  • isolation of patients with active TB disease
  • collect appropiate clinical specimens for diagnosis
  • prompt initiation combination therapy
  • directly observed therapy (DOT) utilization
  • prompt reporting of TB diagnosis to appropiate public health organization
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the first line agents for tuberculosis treatment?

A
  • isoniazid
  • rifampin
  • pyrazinamide
  • ethambutol
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How is isoniazid dosed?

A

weight based dosing using total body weight

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the dosage forms of Isoniazid?

A

PO, IM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the bioavaliability of Isoniazid?

A

well absorbed, 100% bioavaliability

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How is Isoniazid distributed?

A

widely distributed into fluids and intracellular spaces

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How is Isoniazid metabolized?

A

primarily metabolized by NAT2 which is genetically polymorphic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the adverse effects of Isoniazid?

A
  • increased transaminases
  • hepatitis
  • peripheral neuropathy
  • neurotoxicity
  • anemias
  • cytopenias
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What can be given to patients at risk for peripherl neuropathy associated with Isoniazid use?

A

pyridoxine (B6)

19
Q

What are the drug interactions with Isoniazid?

A
  • antacids
  • phenytoin
  • carbamazepine
  • valproic acid
  • benzodiazepines
  • disulfiram
  • warfarin
  • acetaminophen
20
Q

What is consider the most important drug for TB?

A

rifampin

BUT cannot be used alone

21
Q

What are the adverse effects of Rifampin?

A
  • GI reactions
  • hepatotoxicity
  • flu-like symptoms
  • orange like discoloration of bodily fluids
  • blood dycrasias
22
Q

What are the drug interactions of Rifampin?

A

INDUCES CYP450 ENZYMES
- clarithromycin, erthromycin
- azole antifungals
- estrogens
- protease inhibitors (HIV drugs)
- beta blockers
- warfarin
- calcium channel blockers
- digoxin
- immunosuppressants

23
Q

What are the dosage forms of Rifampin?

A

IV, PO

24
Q

What are the dosage forms of Pyrazinamide?

A

PO

25
Q

What is unique about the MOA of Pyrazinamide?

A

prodrug that is activated by pyrazinamidase enzyme of susceptible M. tuberculosis

26
Q

What is the dosing of Pyrazinamide?

A

weight based dosing using lean body weight

27
Q

How is Pyrazinamide excreted?

A

urine via glomerular filtration

28
Q

What are the adverse effects of Pyrazinamide?

A
  • GI upset
  • arthralgia
  • hyperuricemia
  • gout
  • hepatotoxicity (issue when in combo with rifampin)
29
Q

What are the drug interactions of Pyrazinaminde?

A

rifampin, not typically used together but if they must- only for a short time due to hepatotoxicity

30
Q

What are the dosage forms of Ethambutol?

A

PO

31
Q

How is Ethambutol dosed?

A

weight based dosing using lean body weight

32
Q

What are the adverse effects of Ethambutol?

A
  • optic neuritis
  • decreased visual acuity/blurry vision or decrease color discrimination
  • hypersensitivity reactions
  • hyperuricemia and gout
  • thrombocytopenia
33
Q

What are the drug interactions of Ethambutol?

A

no significant drug interactions

34
Q

What are the second line/alternative agents for tuberculosis?

A
  • rifabutin or rifapentine
  • moxifloxacin or levofloxacin
  • bedaquiline
  • linezolid
  • cyclosporin
  • amikacin or streptomycin
  • ethionamide
35
Q

What drugs are included in the intensive phase?

A
  • rifampin
  • isoniazid
  • pyrazinamide
  • ethambutol
36
Q

How long does the intensive phase last?

A

2 months

37
Q

What is the preferred dosing for the intensive phase?

A

once daily

38
Q

How long is the continuation phase?

A

4 months or 7 months

39
Q

What drugs are used in the continuation phase?

A

isoniazid and rifampin

40
Q

When would 7 months be considered for the continuation phase?

A

PATIENTS W/ CAVITATION ON INITIAL CXR AND WHO HAVE A POSITIVE SPUTUM CULTURE AFTER 2 MONTHS ON INTENSIVE THERAPY, but may also consider for:
- cavitation OR positive cultures after intensive phase
- patients who intensive phase did not include pyrazinamide
- persons with HIV not recieving antiretroviral therapy during TB treatment
- extensive disease on CXR
- active smoker

41
Q

What is the recommended monitoring during TB treatment?

A
  • sputum smears and cultures
  • drug and susceptibility testing
  • chest xray
  • weight
  • symptom and adhearance review
  • vision assessment
  • AST, ALT, billirubin, alkaline phosphate
  • platelet count
  • creatine
  • HIV
  • hep B & C
  • diabetes status
42
Q

What is the new 4-drug, 4-month regimen?

A
  • rifapentine
  • moxifloxacin
  • isoniazid
  • pyrazinamide
43
Q

What are the preferred regimens for treatment of latent TB?

A
  • isoniazid + rifapentine once weekly for 3 months
  • rifampin daily for 4 months (not typically used alone)
  • isoniazid + rifampin daily for 3 months

Therapeutics 3 (19 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions