41-Antimycobacterial Agents Flashcards
(33 cards)
Which dz is known to claim lives every 10 seconds?
TB
What are the risk factors for TB?
Foreign born, Immunosuppressed, poverty and malnutrition, IDU, age and gender (male>female), prisons, contact with infected pt
What plays a major role in treatment failure for TB?
drug resistance
The best treatment for TB is _________ and ________?
Dx and prevention
How much dose do you use for a PPD skin test?
0.1cc , circle the spot and will be read 2 days later
What is 1/3 of the world infected with?
Latent TB
What is the main goal in treatment of TB?
Kill the tubercle bacilli rapidly, prevent resistance, prevent relapse and prevent transmission
Would you place a patient with active TB in the general ward?
No, isolation in negative pressure ventilated room is essential.
What can immunocompetant patients with emphysema get?
MAC
Who else commonly gets MAC?
AIDS patients get MAC and also PNA, bacteremia and lymphadentitis
What is leprosy? a.k.a Hansen’s dz
It is a slow progressive chronic dz over decades caused by mycobacterium leprae.
Do you have to wait for cx to come back before you start treatment?
No, it takes long for cx to come back. Tx with daily dapsone, clofazamine and monthly Rifampin for 6months
What are some ADRs of Dapsone?
Gi disturbances, peripheral neuropathy, optic neuritis, blurred vision, lupus like symptoms and nephrotic syndrome
If a leper has G6PD and on dapsone what is this patient at risk to have?
hemolytic anemia
What are the first line of drugs you would use for TB?
INH, Ethambutol, Pyrazinamide, Rifampin
Second line drugs for TB?
Rifabutin, Rifapentine, Fluoroquinolones, cycloserine
Properties of INH?
Taken PO qd, extensively metabolized
ADRs of INH?
liver damage, fatal hepatitis (avoid ETOH), peripheral neuropathy (treat with Vit B6)
Properties of Enthambutol
Given PO, well distributed and renal adjusted
ADRs of Enthambutol?
Optic neuritis, impaired red-green color discrimination, hyperuricemia, gout, hepatitis
Properties of Pyrazinamide)
Given PO, Rapid cidal effects, can reduce treatment length to 6months as opposed to 9months
ADRs of Pyrazinamide?
Hyperuricemia, gout, Hepatitis, fever, hematologic toxicity
Properties of Rifampin?
Given PO, hepatic ally metabolized, undergoes enterhepatic cycling (30% unchanged in urine).
Rifampin can be given prophylactically to prevent___?
TB, meningococcal dz, H. flu
