Antitubercular agents (part 4)

Question 1

TB incubation period

Answer 1

2-10 weeks

Question 2

Risk of progressive TB disease greatest in first ___ years?

Answer 2

2

Question 3

what kind of immune response is caused by TB??

Answer 3

cell mediated

Question 4

how long do TB cultures take?

Answer 4

6 weeks

Question 5

what does TB diagnosis rely on?

Answer 5

AFB smear

Question 6

TB sites

Answer 6

lungs, urinary tract, bone

Question 7

primary TB

Answer 7

initial infection with the disease

Question 8

reactivation of TB

Answer 8

patient infected in past has reactivation of disease

Question 9

assume TB is contagious is they show which symptoms?

Answer 9

cough, undergoing cough inducing procedures, sputum smear is positive until 3 neg, pt needs to be on treatment at least 1 week, not responding to treatment

Question 10

0.1cc of PPD with 5TU is injected to test what

Answer 10

to test for exposure

Question 11

what will PPD show if positive

Answer 11

> 5mm induration

Question 12

How much prophylaxis supply of INH medication do you give? dose?

Answer 12

1 month supply

dose: 300mg PO QD

Question 13

Length of TB treatment

Answer 13

6-12 months

Question 14

INH, RIF, PZA are commonly used in which patients?

Answer 14

pediatrics

Question 15

EMB is not recommenced for which age group?

Answer 15

<13

Question 16

Streptomycin is not recommended for use in which age group?

Answer 16

children

Question 17

<5 yr old, what testing do they need?

Answer 17

color vision testing

Question 18

do TB meds appear in breast milk?

Answer 18

yes, but do not discourage breakfeeding

Question 19

pregnancy category for TB meds?

Answer 19

C, give because benefits outweigh risk, not shown to be toxic

Question 20

We see prophylaxis TB patients every month, what do we monitor?

Answer 20

liver damage, fatigue, weakness, paresthesias of hands/feet, dark urine

Question 21

who is at greatest risk for developing INH hepatitis?

Answer 21

> 35, drinkers, hs liver disease, taking meds that are toxic to the liver

Question 22

if you see s/s of toxicity what do you do?

Answer 22

DC INH immediately

Question 23

What do we monitor in patients for active tb?

Answer 23

chest xray at bassine then q6 months, sputum smear and culture at baseline then monthly until negative

Question 24

which specific monitoring do we do with INH?

Answer 24

periodic ophthalmologic exams

Question 25

which specific monitoring do we do with PZA?

Answer 25

blood glucose levels

Question 26

which specific monitoring do we do with EMB?

Answer 26

color vision for red/green at baseline and q2-3 months

Question 27

which specific monitoring do we do with SM?

Answer 27

audiogram prior to Tx then q2-3 month

Question 28

Is INH bacteriostatic or cidil?

Answer 28

both

Question 29

how does INH affect TB?

Answer 29

interferes with lipid and nucleic acid biosynthesis

Question 30

INH adverse effects?

Answer 30

urine orange-red, fever, rash, abnormal LFTs

Question 31

N/V, dizziness, slurring speech, blueing of vision, visual hallucination are all s/s of early or late INH overdose?

Answer 31

early

Question 32

respiratory distress, CNS depression are all s/s of early or late INH overdose ?

Answer 32

late

Question 33

do you take INH on an empty stomach?

Answer 33

yes, minimize alcohol consumption

Question 34

which foods should you avoid when taking INH?

Answer 34

wine, hard cheese, liver, tuna, sauerkraut

Question 35

Is Rifampin bacteriostatic or cidil?

Answer 35

both

Question 36

which drug suppresses RNA synthesis?

Answer 36

Rifampin

Question 37

if we give Rifampin at higher doses what s/s do we see

Answer 37

flu like symptoms, hematopoietic reactions

Question 38

Do you take Rifampin on an empty stomach?

Answer 38

yes

Question 39

Is Pyrazinamide bacteriostatic or cidil?

Answer 39

depends on dose

Question 40

how are diabetic patients affected with PZA?

Answer 40

BS control is harder to control

Question 41

most common adverse affects of PZA?

Answer 41

gout and hepatic toxicity

Question 42

does PZA have a P450 interaction?

Answer 42

no

Question 43

Is Ethambutol HCL (EMB) bacteriostatic or cidil?

Answer 43

cidial but only active against mycobacterium

Question 44

optic neuritis, loss of acuity, loss of red-green discrimination are sever adverse effects of which drug?

Answer 44

Ethambutol HCL (EMB)

Question 45

which may delay/reduce absorption of EMB?

Answer 45

aluminum salts

Question 46

Do you takeEthambutol HCL (EMB) with or without food?

Answer 46

take with food

Question 47

Is Cycloserine bacterial static or cidil?

Answer 47

both

Question 48

when do you give Ethionamide?

Answer 48

when first line drugs fail

Question 49

Should you take Ethionamide with or without food?

Answer 49

take with food

Question 50

tremor, psychosis, somnolence, depression, confusion, vertigo, convulsions are adverse effects of which drug?

Answer 50

Cycloserine