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Pathopharmacology I > Wk 1 TB > Flashcards

Wk 1 TB Flashcards

1
Q

TB is any infection caused by the bacteria

A

mycobacterium

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2
Q

The most common mycobacterium is

A

Mycobacterium tuberculosis

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3
Q

What is the etiology of leprosy?

A

Mycobacterium leprae

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4
Q

Mycobacterium tuberculosis is __-shaped

A

rod

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5
Q

Mycobacterium tuberculosis is also __

A

aerobic

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6
Q

Why does mycobacterium tuberculosis most commonly affect the lungs?

A

It needs tons of oxygen to grow and proliferate

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7
Q

Where else in the body can mycobacterium tuberculosis grow?

A

end of the bone and the brain

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8
Q

What is tuberculosis characterized by?

A

Granulomas in the lungs

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9
Q

What are granulomas?

A

nodular accumulations of inflammatory cells

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10
Q

What types of inflammatory cells are in granulomas?

A

macrophages and lymphocytes

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11
Q

What is the consistency of a granuloma in the lung?

A

They are hard on the outside and the inside is cheesy or lacerated

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12
Q

What is a granuloma in the lung filled with?

A

Caseous necrosis

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13
Q

What is caseous necrosis?

A

Broken down tissue from the macrophages in the granuloma

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14
Q

What are granulomas also called?

A

tubercles

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15
Q

Tuberculosis can be transmitted by which type of animals?

A

birds and cattle, also humans

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16
Q

What are the infectious particles of tuberculosis called?

A

Tubercle bacilli

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17
Q

How is tuberculosis transmitted from person to person?

A

Via airborne droplets

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18
Q

Mycobacterium tuberculosis is a very __ growing organism

A

slow

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19
Q

Because mycobacterium tuberculosis grows slow, this makes it difficult to treat. Why?

A

We typically treat infections by inhibiting cell growth and proliferation

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20
Q

In latent TB, where is the bacteria located?

A

They remain in the tubercles/granulomas and remain dormant for life

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21
Q

A person with latent TB is __

A

asymptomatic

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22
Q

What are common reactivators of TB?

A

HIV, immunosuppressive drugs, poor nutrition status, renal failure

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23
Q

Symptoms of active TB develop very __

A

gradually

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24
Q

When in the disease process do symptoms of TB typically occur?

A

Very late in the disease

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25
Q

5 symptoms of active TB

A 
Fatigue/Lethargy
Low grade-fever/Night sweats
Weight loss/anorexia
Productive cough
Anxiety
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26
Q

What happens as the disease progresses and is not treated?

A

Dyspnea
Chest pain
Hemoptysis

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27
Q

What is it called if the TB spread to other parts of the body?

A

Extrapulmonary TB

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28
Q

What are symptoms of extrapulmonary TB? (4)

A

Neurologic deficits, meningitis symptoms, bone pain, urinary problems

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29
Q

How are high risk populations tested for TB?

A

interferon-gamma release assay (blood draw)

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30
Q

How are non-high risk population tested for TB?

A

skin test

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31
Q

How is TB infection confirmed?

A

Sputum culture and granulomas on chest x-ray

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32
Q

Second line antitubercular drugs are reserved for

A

complicated cases of TB resistant to primary antitubercular drugs

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33
Q

When treating a patient with suspected TB, it’s important to consider what?

A

That the patient may have contracted a TB strain that is resistant to antibiotics

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34
Q

The CDC always recommends using more than one drug-susceptibility test because of?

A

The increasing presence of resistance

35
Q

What is the most widely used TB medication?

A

Isoniazid

36
Q

What is the MOA of Isoniazid?

A

Disrupts cell wall synthesis essential functions

37
Q

What routes is isoniazid given?

A

PO

38
Q

What are side effects of isoniazid?

A

Peripheral neuropathy
hepatotoxicity
optic neuritis /visual disturbances
hyperglycemia

39
Q

What is optic neuritis?

A

Inflammation of the optic nerve

40
Q

What is peripheral neuropathy?

A

Peripheral neuropathy, a result of damage to the nerves located outside of the brain and spinal cord (peripheral nerves), often causes weakness, numbness and pain, usually in the hands and feet.

41
Q

Where is isoniazid metabolized?

A

the liver

42
Q

What should be monitored on a patient taking isoniazid?

A

liver enzymes

43
Q

Why should you teach patients taking isoniazid to avoid antacids?

A

It reduces the absorption of INH

44
Q

When isoniazid is given in conjunction with rifampin, what can happen?

A

Increase CNS side effects and hepatotoxicity

45
Q

If isoniazid is given in conjunction with phenytoin, what can happen?

A

It will increase the effects of phenytoin

46
Q

What is phenytoin used for?

A

Seizures

47
Q

Isoniazid has a __ __ __

A

black box warning

48
Q

Why does Isoniazid have a black box warning?

A

Increased risk of hepatitis

49
Q

What is isoniazid often given with because of the increased risk of hepatitis?

A

Vitamin b6

50
Q

What is the scientific name of vitamin b6?

A

pyridoxine

51
Q

Rifampin is used __-line for treatment of TB

A

first

52
Q

What is the MOA of rifampin?

A

Inhibits protein synthesis via attacking the hydrocarbon ring structure

53
Q

Where is rifampin metabolized?

A

the liver

54
Q

If giving rifampin and INH together, if can cause

A

hepatitis

55
Q

What is a unique, notable side effect of rifampin?

A

red-brown discoloration of the urine and other bodily fluids

56
Q

Rifampin has a ton of drug interaction because it is a

A

CYP inducer

57
Q

Rifampin decreases the side effects of which drugs?

A 
beta blockers
benzos
anticoags
diabetic medications
phenytoin 
cyclosporins
theophylline
58
Q

If a patient is taking rifampin, they need to tell their HCP because…

A

they may need much higher doses of other medications

59
Q

What routes is rifampin given?

A

PO or IV

60
Q

What is the MOA of ethambutol?

A

Diffuses into the mycobacteria and suppresses RNA synthesis, which inhibits protein synthesis

61
Q

Ethambutol is a first-line __

A

bacteriostatic

62
Q

What are two notable side effects of ethambutol?

A

retrobulbar neuritis

blindness

63
Q

A patient taking ethambutol may need to be seen frequently by a __

A

ophthalmologist

64
Q

What route is ethambutol given?

A

PO

65
Q

Ethambutol is used in combination with __ and __

A

INH and rifampin (there is a pill that contains all 3)

66
Q

You can’t give ethambutol to children less than…

A

13 years old

67
Q

Pyrazinamide is __ or __ depending on the concentration

A

bacteriostatic or bacteriocidal

68
Q

Pyrazinamide is __ used in combination with other medications

A

always

69
Q

What is the MOA of pyrazinamide?

A

Unknown but thought to inhibit lipid and nucleic acid synthesis

70
Q

What are two notable side effects of pyrazinamide?

A

hepatotoxicity and hyperuricemia

71
Q

What is hyperuricemia?

A

elevated uric acid level in the blood

72
Q

Which two conditions is pyrazinamide contraindicated for?

A

Severe hepatic disease and acute gout

73
Q

What routes if pyrazinamide given?

A

PO

74
Q

Pyrazinamide is not for __ people in the US, but may see it used in other countries

A

pregnant

75
Q

What was the first drug ever available to treat TB?

A

Steptomycin

76
Q

What is the MOA of streptomycin?

A

Aminoglycoside – interfering with normal protein synthesis causing production of faulty proteins within the bacteria

77
Q

3 notable side effects of steptomycin

A

ototoxicity, nephrotoxicity, blood dyscrasias

78
Q

What is ototoxicity?

A

Ototoxicity is when a person develops hearing or balance problems due to a medicine.

79
Q

What are blood dyscrasias?

A

Dyscrasia is a nonspecific term that refers to a disease or disorder, especially of the blood

80
Q

What routes is streptomycin given?

A

IM injection

81
Q

How frequently is streptomycin given?

A

Daily

82
Q

Be careful giving streptomycin to people on __ because?

A

Anticoagulants; because streptomycin can increase bleeding

83
Q

What special groups are at highest risk to have TB?

A

Asian and hispanic immigrants

Pathopharmacology I (33 decks)

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