TB Meds

Question 1

What are First Line Meds?

Answer 1

RIPE 1. rifampin, rifabutin, rifapentine 2. Isoniazid 3. Pyrazinamide 4. Ethambutol

Question 2

What are a few of the second line meds?

Answer 2

streptomycin, cycloserine, p-aminosalicyclic acid, levofloxacin, moxifloxacin, gatifloxacin, capreomycin etc.

Question 3

Isoniazid (INH) MOA

Answer 3

MOA: inhibit bacterial cell wall synth.

Question 4

Isoniazid cidal or static?

Answer 4

2. Bactericidal

Question 5

Isoniazid .. why does it interact with other drugs?

Answer 5

P450 2C9 inhibitor

Question 6

Isoniazid 2 common ADRs

Answer 6

peripheral neuropathy, elevated LFT

Question 7

Isoniazid intoxication sx:

Answer 7

resp. distress, cns depression, metabolic acidosis, hyperglycemia

Question 8

Rifampin MOA

Answer 8

inhibits DNA dependent RNA polymerase

Question 9

Rifampin static or cidal?

Answer 9

bactericidal

Question 10

Rifampin for what pt ages?

Answer 10

for patients 12 yo +

Question 11

Rifampin ADRS

Answer 11

red orange body fluids , GI, flatulence, CDAD etc

Question 12

Rifampin interacts with drugs why?

Answer 12

STRONG 3A4 inducer - interacts with oral contraceptives, INH, warfarin and many others

Question 13

Rifapentine MOA and static or cidal?

Answer 13

MOA: inhibits DNA dependent RNA polymerase, cidal

Question 14

What four patient populations can you NOT use Rifapentine with?

Answer 14

Pregnant, HIV, kids under 2, or resistant M. tb

Question 15

Rifapentine induces which 2 p450 enzymes?

Answer 15

3A4, 2C9

Question 16

Rifapentine ADR

Answer 16

colored body fluids, hepatotoxicity, hyperbilirubinemia, cdad

Question 17

Pyrazinamide: indication and 2 contraindications

Answer 17

for active TB in adults and kids. Contraindicated with gout or severe liver disease

Question 18

Pyrazinamide: elimination?

Answer 18

urine excretion

Question 19

Pyrazinamide 3 ADR

Answer 19

hyperuricemia (stops renal excretion uric acid), increased LFT, rash

Question 20

Ethambutol MOA

Answer 20

inhibits metabolite synthesis, impairs cell metabolism and stops reproduction. (Only works on mycobacteria)

Question 21

Ethambutol indication

Answer 21

used in combo TB therapies never a monotherapy option

Question 22

Ethambutol ADRs

Answer 22

decreased visual acuity, optic neuritis, optic neuropathy, hyperuricemia, GI, confusion, etc

Question 23

What is the one drug interaction with ethambutol?

Answer 23

aluminum containing antacids