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PHARMACOLOGY TERM 2 > Tuberculosis: Treatment and prevention > Flashcards

Tuberculosis: Treatment and prevention Flashcards

1
Q

List the Goals for TB treatment

A

Cure the patient of TB
Prevent transmission of TB to others
Prevent the development of acquired resistance
Prevent relapse
Prevent death from TB or its complication

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2
Q

Explain about combination of therapy under principles of TB treatment

A

Usually combination tablet
Intensive and continuation hase

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3
Q

Explain about time period under principles of TB treatment

A

Time period varies until TB bacteria are eradicated in different places

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4
Q

Explain the adherence under principles TB treatment

A

Counselling sessions

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5
Q

what happen in the intensive phase

A

Bacilli rapidly eradicated from the sutum (after about 2 weeks of treatment) and clinical improvement from illness

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6
Q

What is happening in continuation phase

A

Sterilising effect of treatment, eliminates the remaining viable bacilli and prevent subsequent relapse

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7
Q

List drugs that are first line TB treatment

A

Isoniazid
Ethambutol
Pyrazinamide
Rifampicin

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8
Q

explain the mechanism of action of Isoniazid

A

Inhibits synthesis of the mycolic acid layer of the mycobacterial cell wall

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9
Q

explain the mechanism of action of ethambutol

A

Inhibit synthesis of the arabinogalactan layer of the mycobacterial cell wall

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10
Q

explain the mechanism of action of Pyrazinamide

A

Converted to an acid in the cytoplasm of the mycobacterium, acidify the intracellular environment and compromise the intergity of the cell membrane (only effective in dormant mycobacteria)

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11
Q

Explain the mechanism of action of Rifampicin

A

Inhibits mycobacterial RNA synthesis by binding to and inhibiting the enzyme RNA polymerase

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12
Q

Which TB drug is bactericidal for intra and extracellular bacteria . sterillising activity

A

Rifampicin

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13
Q

Which Tb drug is excellent early bactericidal activity

A

Isoniazid

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14
Q

Which TB drug is bacteriostatic (bactericidal at hight doses)

A

Ethambutol

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15
Q

Which TB drug is mycobactericidal for intracellular mycobacteria in an acidic medium. most useful during intensive phase

A

Pyrazinamide

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16
Q

Nmae drugs under intensive phase for extra pulmonary TB adults

A

Rifampicin
Isoniazid
Pyrazinamide
Ethambutol

17
Q

Period of treatment for intensive phase under extra pulmonary TB

18
Q

List drugs in continuation phase under extra pulmonary TB

A

Rifampicin
Isoniazid

19
Q

Explain the period of treatment for continuation phase under extra pulmonary TB

20
Q

List drugs that are used to treat severe/complicated TB under intensive phase

A

Rifampicin
Isoniazid
Pyrazinamide
Ethambutol

21
Q

What is the period of drug treatment for severe/ complicated TB under intensive phase

22
Q

List the drugs used for Severe/ complicated Tb under continuation phase and the period of treatment

A

Rifampicin
Isoniazid
7 months

23
Q

In TB Treatment children <8 years and 30 kg
List drusg for (extra) pulmonary TB intensive phase?

A

Rifampicin
Isoniazid
Pyrazinamide

24
Q

At every visits assess what ? if the patients is under TB treatment

A

TB symptoms (refer to DR is symptoms become worse)
Weight (adjust dosing accordingly. if patient is loosing weight refer to doctor)
Trace contacts and screen for TB disease. Also assess eligibilty for isoniazid preventive therapy in children <5 years and HIV infected individuals
Discuss family planning methods
Assess adherence by conducting pill counts, and review patient treatment cards
Assess side effects
Test for HIV status if unknown
Manage co-morbidities including HIV
Fllow-up test results (smear microscoy, culture, line probe essay (LPA) or drug susceptibility testing (DST), if done)

25
Q

Under monitoring safety which TB drugs are associated with Hepatotoxity ?

A

Rifampicin, isoniazid. pyrazinamide

26
Q

List TB treatment: monitoring safety

A
  • Hepatotoxicity monitoring (rifampicin, isoniazid, pyrazinamide)
  • Monitor liver function: DILI (drug-induced liver injury)
  • High risk patients: chronic infectious hepatitis, pre-existing liver disease, MDR
    TB patients, high levels of alcohol consumption, other hepatotoxic drugs,
    HIV+, females and elderly
  • Screening for hepatotoxicity: new onset abdominal pain, nausea & vomiting,
    jaundice / dark urine
  • Check bilirubin and transaminases (5x upper limit/ 3x uper limit with jaundice)
27
Q

List the side effects of Rifampicin and the comments

A

Nausea, GI disturbances
Discolouration of body fluids
(tears, saliva, urine, faeces) orange
/ red
Enzyme induction

Take with food
CI: oral contraceptives

28
Q

List side effects of Isoniazid and comments

A

Peripheral neuropathy (burning /
pins & needles in feet & legs)

Supplement with pyridoxine

29
Q

List side effects of ethambutol and comments

A

Optic neuritis
vision check-ups

30
Q

List the side effects of Pyrazinamide

A

Joint pain (gout), hepatotoxic

PHARMACOLOGY TERM 2 (45 decks)

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