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Flashcards in TB 2 Deck (16)
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1

who should not use isoniazide

someone with an AST or ALT 6-8 times normal

2

what should always be given in combination with isoniazide? why

vitamin B6 (pyridoxine)
prevent neurotoxic side effects

3

what does rifampin compete with for uptake by hepatocytes

bilirubin

4

what are two major adverse effects of pyraxinamide

hepatotoxicity
hyperuricemia (avoid with gout)

5

which TB drug has no risk of hepatotoxicity?
what risk does it have?

ethambutol
optic neuritis

6

what is the least likely to be resistant of all first line TB agents

ethambutol

7

what are the non-pharm steps for TB

1. respiratory isolation = prevent spread
2. contact investigation
3. return pt. to state of normal weight

8

what are steps of treatment of active TB in initial phase

1. obtain smears and cultures
2. 4 drug regimen for 2 months
3. smears and cultures at end of 2 months

9

how long do TB cultures take to get results?
how long for smears?

cultures = 6-8 weeks
smears immediate results

10

what are the 4 drugs in TB regimen

1. isoniazid
2. rifampin
3. pyrazinamide
4. ethambutol

11

what are steps of treatment of active TB in continuation phase

1. check for cavities in chest xray or positive smear
2. if culture is negative continue isoniazid and rifampin for 4 more months (6 months of treatment)
3. if culture is positive continue isoniazid and rifampin for 7 more months (9 months of treatment)
(same treatment if xrays or smear are negative)

12

what are 4 things to do/ note with drug resistant TB

1. consult TB specialist
2. avoid monotherapy
3. avoid adding only a single agent at a time
4. try and use at least 3 previously unused, susceptible drugs

13

how is monitoring response to TB therapy done

1. smears and cultures monthly until 3 are negative
2. follow up at 6 months and 1 year after therapy
3. if still positive after treatment consult ID specialist

14

how is latent TB treated

isoniazid for 9 months and no alcohol for that time

15

what is the option for latent TB treatment if isoniazid is not tolerated

rifampin

16

what is the preferred treatment for latent TB in pregnant women

isoniazid