Test 3 - TB Medications (Josh) Flashcards Preview

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Flashcards in Test 3 - TB Medications (Josh) Deck (33)
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1
Q

Tuberculosis is a specials of which bacteria?

A

Mycobacterium tuberculosis

2
Q

What is unique about TB?

A
  • slow growing
  • lives and replicates inside a phagocyte
  • long time to cure (6mo to 2yrs w/ meds)
3
Q

TB primarily effects which organ?

A

Lungs

Spreads through coughing/sneezing

4
Q

What percentage of TB infected clients are latent?

A

90%

An individual can harbor the bacteria they’re whole life if not given medication to kill it

5
Q

Challenges facing the treatment of TB?

A
  • ADHERENCE (have to take the drugs for a LONG TIME)
  • RESISTENCE (bacteria can develop resistance to drug; so usually given two diff drugs at same time)
  • TOXICITY (esp. hepatotoxicity b/c you have to take drug for so long
  • COST (non-resistant TB = $12,000, resistant TB + $180,000)
6
Q

Positive reaction to TB skin test is determined by region the client lives in?

A

High Risk - treatment recommended if induration is 5mm
Moderate Risk - treatment recommended if induration is 10mm
Low Risk - treatment recommended if induration is 15mm

7
Q

What is DOT in relation to TB treatment?

A

Directly Observed Therapy

It is the standard of care for TB b/c patient adherence is most common cause of treatment failure administration of each dose is observed in clinic by rep from Health Depth.

8
Q

Why must TB treatment be monitored?

A
  • Promote Adherence

- Provide opportunity for ongoing evaluation of effectiveness of treatment regimen

9
Q

When taking rifampin (TB drug) what happens to urine?

A

Urine (and other secretions) will turn red-orange color

Harmless, but don’t wear contacts or they will be permanently stained

10
Q

Why give pyridoxine (Vitamin B6) to client taking isoniazid (TB drug)?

A

Vitamin B6 deficiency causes peripheral neuropathy

Also give Vitamin B6 to clients at Rick for this adverse effect (alcoholics, diabetics)

11
Q

What will need to happen if someone taking phenytoin needs to take isoniazid?

A

Monitor the phenytoin levels b/c isoniazid is a CYP inhibitor

12
Q

If client is taking oral contraceptives, what should they do if they are prescribed rifampin (TB Drug)?

A

Rifampin is a potent CYP inducer

  • use another method
13
Q

What types of meds does rifampin (TB drug) affect?

A

Rifampin is a CYP inducer

  • Anti-seizure meds
  • Anti-rejection meds
  • Oral contraceptives
  • HIV meds
  • Warfarin
14
Q

Why is TB being a slow-growing bacteria a problem?

A

It’s hard to kill bacteria that aren’t very metabolically active. We want them to be active, absorbing our antibiotics but if they aren’t very active, it’s hard to attack them

15
Q

What percentage of TB cases are in developing nations?

A

95%

  • second only to HIV/AIDS
  • 1/3 of humans have TB
16
Q

Which mask would you wear to treat a TB patient?

A

N95

17
Q

Latent Infection

A

Most people (90%) who have TB don’t know it b/c they have a healthy immune system that can keep the microbes in check. They can still spread it

18
Q

Clinical Manifestations of TB infection

A
  • low grade fever
  • dry cough that could progress to mucopurulent cough w/ hemoptysis
  • night sweats
  • fatigue
  • weight loss
19
Q

Two major TB drugs

A
  • isoniazid

- rifampin

20
Q

The primary TB drug is —–

A

Isoniazid

only for TB, no other uses for it

21
Q

A client could possibly only have to take one drug if they have which type of TB? Which drug?

A

If latent infection, they could take isoniazid by itself

22
Q

The most common adverse effect of isoniazid is —-

A

Peripheral neuropathy

  • symmetric (both sides) numbness/tingling
  • issues w/ balance/clumsiness
23
Q

What causes the issue of peripheral neuropathy w/ isoniazid?

A

Deficiency of vitamin B6

  • give vita. B6 prophylactically to clients at risk like alcoholics and diabetics
24
Q

Second most common adverse effect of isoniazid is —

A

Hepatotoxicity

  • watch AST level
  • watch JAUNDICE s/s
  • usually only affects older clients
25
Q

When should you hold off giving isoniazid?

A

AST level 3-5x’s original value

26
Q

—- is a broad-spectrum antibiotic used to treat TB.

A

Rifampin (Protein Synthesis Inhibitor)

  • take it on an empty stomach
27
Q

Of the TB drugs, —– has many uses while —- is only used for TB.

A

Rifampin

isoniazid

28
Q

—- can be taken with or without food.

—- can be taken only without food.

A

Isoniazid

Rifampin (food decreases absorption)

29
Q

Common side effect of rifampin is —-

A

Hepatitis (only problematic for ~ 1%)

  • JAUNDICE s/s
30
Q

—– can cause your secretions to turn red-orange.

A

rifampin

31
Q

Why would you need to check a client’s current meds if starting them on isoniazid or rifampin?

A

Both have lots of CYP interactions

32
Q

—— is a CYP inhibitor which leads to — —

—– is a CYP inducer which leads to —- —-

A

Isoniazid –> drug toxity

Rifampin –> sub-therapeutic drug levels

33
Q

Biggest drug to be concerned about w/ isoniazid?

A

Phenytoin

Has a narrow therapeutic range and isoniazid is a CYP inhibitor which leads to increased levels of the drug