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BFI: Pharmacology > Tuberculosis treatment > Flashcards

Tuberculosis treatment Flashcards

1
Q

Main drug treatments for tuberculosis

A

Rifampicin

Isoniazid

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2
Q

Why combination of treatments used

A

Prevent resistance
Eradication of bacilli in diff. environments
- small no. of drug resistant mutants emerge regularly during replication
- if treated, drug resistant mutants become predominant popu.
- Its rare for drug resistant mutants to be resistant to 2 antituberculosis drugs due to unrelated nature of resistant mechanisms

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3
Q

Why treatment is given for a prolonged period

A

TB bacteria grow slowly and dormant bacteria divide when threatened by antibiotic therapy

6 months allow all active + dormant organisms to be killed

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4
Q

Which individuals take the standard treatment of respiratory TB

A

HIV positive adults
non-HIV positive adults
Children

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5
Q

Role of other HCP in the management of patients with TB

A

TB nurse

  • anyone suspected/diagnosed with TB or latent TB is reffered
  • All patients have own case worker
  • HIV tested
  • Patients given nurses phone number and encouraged to call if an probles arise
  • Contact traced
  • See new arrivals from other countries
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6
Q

How is contact tracing conducted

A

Non-infectious case - household contacts only
Infectious case - household contacts + anyone who they had contact with for 8 hours or more in previous 6 months.

Special circumstances - need to go to schools, workplaces, prisons

Mantoux testing - injected with tuberculin protein; if a reaction occurs then patient has TB
- But also blood test + CXR (chest xray)

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7
Q

Treatment of latent TB

A 
Treated under TB specialist team
Treatment with 
- Rifampicin 600mg twice daily
- Isoniazid 300mg twice daily 
For 3 months
(6 months with Isoniazid alone)
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8
Q

MDRTB

A

Resistant to at least Isoniazid + Rifampicin

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9
Q

XDRTB

A

Resistant to

  • Isoniazid + Rifampicin
  • a Quinolone
  • second line Injectable (capreomycin, kanamycin, amikacin)
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10
Q

Treatment for MDRTB + XDRTB

A
  • longer
  • multiple drug treatments required
  • problem of many side effects
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11
Q

Latent TB

A

Not infectious and cannot spread TB infection to others

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12
Q

Why do HIV patients with latent disease start haart

A

HAART - highly active antiretroviral drugs

- leads to reducing likelihood of disease becoming active

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13
Q

Rifampicin

A
  • BACTERICIDAL
  • more active against isoniazid
  • induces drug metabolism via induction of cytochrome p450
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14
Q

Isoniazid

A

Inhibits mycolic acid synthesis

  • BACTERICIDAL against active mycobacteria
  • metabolised in liver by acetylation
  • available in tablet, syrup, IV
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15
Q

Pyrazinamide

A
  • BACTERICIDAL
  • dose is weight based
  • available as 500mg tablets
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16
Q

Ethambutol

A

Inhibits growth of mycobacteria through arabinosyl transferases involved in cell wall synthesis

  • BACTERIOSTATIC
  • dose is weight based (tablets only)
  • dose reduction in renal failure
17
Q

Pyrazinamide

A
  • BACTERICIDAL
  • dose is weight based
  • available as 500mg tablets
18
Q

Why do HIV patients with latent disease start haart

A

HAART - highly active antiretroviral drugs

- leads to reducing likelihood of disease becoming active

19
Q

Voractiv/Rimstar

A

Quadruple therapy in one tablet

- used in initial intensive treatment phase

20
Q

Voractiv/Rimstar

A

Quadruple therapy in one tablet (rifampicin 150mg, isoniazid 75mg, pyramzinamide 400mg, ethambutol 275mg)
- used in initial intensive treatment phase

21
Q

Voractiv/Rimstar

A

Quadruple therapy in one tablet (rifampicin 150mg, isoniazid 75mg, pyramzinamide 400mg, ethambutol 275mg)
- used in initial intensive treatment phase

22
Q

Which drug causes optic neuritis

A

Ethambutol

- counsel on eyesight (red-green blindness)

23
Q

Which drug can show signs of liver toxicity

A

Pyrazinamide

- counsel on nausea, vomiting, malaise, jaundice + joint bain

24
Q

Which drug can show signs of liver toxicity

A

Pyrazinamide

- counsel on nausea, vomiting, malaise, jaundice + joint bain

25
Q

Why drug can cause peripheral neuropathy + abnormalities in liver function

A 
Isoniazid
- counsel on Nausea, vomiting, malaise, jaundice 
- tingling/numbness of hands + liver 
- Take before food
give pyridoxine prophylaxis
26
Q

What drug causes hepatitis, pruritis, rashes + thrombocytopenia

A

Rifampicin

  • counsel on taking before food, interact with other meds
  • oral contraceptives, pregnancy
  • discolour bodily fluids
  • discolour contact lenses
  • cause nausea, vomiting, malaise, jaundice, rashes, bruising

BFI: Pharmacology (8 decks)

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