Clinical pharmacology and therapeutics of Tuberculosis Flashcards
(14 cards)
TB prevention in hospital
Negative pressure isolation room with direct outdoor exhaust
TB infection RF
-Close indoor contact with individual with active disease
-From a TB endemic country
RF for developing active TB
-HIV
-Immunosuppression
-Diabetes
-Children
- <1 year since infection
Forms of active TB
- Drug susceptible TB
- Monoresistant TB
- Polyresistant TB
- MDR TB
- Extensively drug-resistant TB (XDR-TB)
What is drug susceptible TB?
TB strains that are sensitive to the standard first-line agents
What is monoresistant TB?
TB strains that are sensitive to just one anti-TB drug
What is polyresistant TB?
TB strains that are resistant to more than 1 anti-TB drug but not INH and RIF (isoniazid and rifampin)
What is multi-drug resistant TB?
TB strains that are resistant to RIF and INH
What is XDR-TB?
TB strains that are resistant to RIF and INH + at least one injectable agent (amikacin, kanamycin, or capreomycin) + any of the FQ
How is resistance in TB slightly different than other bacteria?
Spontaneous mutations develop as bacilli proliferate
**Once there is a large bacterial load, it is a good predictor that pt will be resistant to rifampin
**Can also develop resistance if you take 2 tablets and miss 1
**Use combo of drugs so that resistant organisms cannot continue to spread
Tx of drug-susceptible TB
**Standard intensive phase (6 month)
Rifampin + Isoniazid + Ethambutol + Pyrazinamide
Tx of drug-susceptible TB
**Rifapentine-based 4-month tx of intensive phase
Rifapentine + Isoniazid + Moxifloxacin + Pyrazinamide
Tx of drug-susceptible TB
**Standard 6 month regimen; continuation phase
Rifampin + Isoniazid
Tx of drug-susceptible TB
**Rifapentine-based 4-month tx of continuation phase
Rifapentine + Isoniazid + Moxifloxacin
