Tuberculosis Flashcards
When do you read at TB test?
48-72 hours after
What are the three levels of a positive TB test?
> 5mm if HIV, steroid use, or close contact with personof active TB
> 10mm if DM, CKD< or health care worker
> 15mm is positive for all
What is BCG/
A TB vaccine
Four treatment options for latent TB
- Rifampin 10mg/kg QD x 4 months
- Isoniazid and rifampin QD x 3 months
- Isoniazid and rifapentin weekly for 3 months
If rifamycin issue- give isoniazid 300mg QD x 6-9 months
Rifamate and rifater components
Counseling
Rifamate - isoniazid and rifampin
Rifater - Isoniazid + rifampin + pyrazinamide
Both are once a day on an empty stomach
Isoniazid
ADE
Dose
What must always be added
Hepatotoxicity, peripheral neuroapthy
up to 300mg PO QD
Always add B6
Rifampin
Brand
ADE
PgX
DOse
Rifadin
Hepatotox, fever, rash, thrombocytopenia , red-orange body discoloration
INDUCER of 1A2, 3A4, 2C9
10mg/kg up to 600mg/day on empty stomach
Rifapentin
Duration of action
Brand
ADE
Long-acting
Priftin
Hepatotox, thrombocytopenia, hyperuricemia, orange-brown discoloration
Pyrazinamide
ADE
Renal adjustment
hepatotox, hyperuricemia
Avoid in renal dysfunction
Ethambutol
Brand
ADE
Myambutol
Optic neuritis , renal impairment, increase uric acid
Streptomycin
ADE
ROA
Nephrotox, ototox
IM/IV
Bedaquiline
Brand
Indication
Sirturo
Combo therapy if failed other agents - DOT only and must be in combo with 3 other drugs
Preferred regimen for active TB
isoniazid, rifampin, pyrazinamide, and ethambutol for 8 months
then
isoniazid and rifampin for 18 weeks
Pretomanid
Indication
Dose
Combo regimen with bedaquiline and linezolid for pulmonary extensive drug resistant TB
200mg PO QD x 26 weeks
