Week 2 - Chemotherapy Infectious Diseases III

Question 1

What causes tuberculosis?

Answer 1

Mycobacterium tuberculosis

Question 2

How is tuberculosis primarily transmitted?

Answer 2

Airborne via inhaling infected sputum aerosolized by cough or sneeze

Question 3

What is a common characteristic of tuberculosis infections?

Answer 3

In most cases, the infected individual has no symptoms

Question 4

What diagnostic methods are used for tuberculosis?

Answer 4

• Microscopic examination of sputum smears
• Culturing of sputum samples

Question 5

What is the definition of multidrug-resistant tuberculosis (MDR-TB)?

Answer 5

TB resistant to isoniazid and rifampin

Question 6

What is extensively drug-resistant tuberculosis (XDR-TB)?

Answer 6

Resistant to isoniazid, rifampin, all fluoroquinolones, and at least one injectable second-line anti-TB drug

Question 7

What is the standard treatment approach for tuberculosis?

Answer 7

Always contains two or more drugs to which the infecting organism is sensitive

Question 8

What is the preferred minimum initial treatment for active TB?

Answer 8

Isoniazid, rifampin, pyrazinamide, and ethambutol for 8 weeks, then isoniazid and rifampin for 18 weeks

Question 9

What is directly observed therapy (DOT)?

Answer 9

Oral administration of medications observed by a healthcare employee

Question 10

How is the evaluation of tuberculosis treatment conducted?

Answer 10

• Clinical symptoms at each clinic visit
• Sputum tests evaluated every 2-4 weeks initially, then monthly after cultures become negative

Question 11

What is latent TB and how is it treated?

Answer 11

Latent TB is treated with isoniazid or isoniazid and rifapentine after ruling out active TB

Question 12

What is the action of isoniazid?

Answer 12

Kills tubercle bacilli at concentrations 10,000 times lower than those needed to affect gram + and gram - bacteria

Question 13

What are common adverse effects of isoniazid?

Answer 13

• Hepatotoxicity
• Peripheral neuropathy

Question 14

What is the primary action of rifampin?

Answer 14

Inhibits bacterial DNA-dependent RNA polymerase, suppressing RNA synthesis

Question 15

What is a common side effect of rifampin?

Answer 15

Discoloration of body fluids (red-orange urine, sweat, saliva, and tears)

Question 16

What are the most hepatotoxic first-line TB drugs?

Answer 16

Pyrazinamide

Question 17

What are the common side effects of ethambutol?

Answer 17

• Optic neuritis
• Allergic responses
• GI upset

Question 18

What is a common treatment regimen for Mycobacterium Avium Complex (MAC) infection?

Answer 18

• Azithromycin or clarithromycin
• Ethambutol
• Rifampin or rifabutin

Question 19

What is the drug class of ciprofloxacin?

Answer 19

Fluoroquinolones

Question 20

What are the primary adverse effects of ciprofloxacin?

Answer 20

• GI disturbances
• Tendon rupture
• Photo toxicity

Question 21

What is the action of metronidazole?

Answer 21

Lethal to anaerobic organisms and used for protozoal infections

Question 22

What is the primary use of amphotericin B?

Answer 22

Treatment of systemic fungal infections

some protozoal infections

Tx is 6-8 weeks and up to 3-4 onths

Question 23

What are common adverse effects of amphotericin B?

Answer 23

• Infusion reactions
• Nephrotoxicity
• Hypokalemia

Question 24

What are azoles used for?

Answer 24

Treatment of systemic mycoses with less toxicity than amphotericin B

Question 25

What is the action of acyclovir?

Answer 25

Inhibits viral replication by suppressing synthesis of viral DNA

Question 26

What is the best time to vaccinate for influenza?

Answer 26

October or November

Question 27

What is the recommended treatment for influenza if symptoms begin?

Answer 27

Oseltamivir (Tamiflu) must begin no later than 2 days after symptom onset

Question 28

What is the most common place TB infects?

Answer 28

Lungs can infect other body organs and systems

Question 29

How long does it take to get lab results (culture) from a sputum sample for possible TB?

Answer 29

culturing takes 2-6 weeks for results

Question 30

Is TB difficult to treat?

Answer 30

Yes Takes a long time - months 2 or more meds

Question 31

Before you get results back from your culture (which can take up to 6 weeks) - How does the initial treatment begin?

Answer 31

Based on evidence of patterns of drug resistance in the community and immunocompetence of the patient

Question 32

How many drugs are needed to treat ACTIVE TB?

Answer 32

4 drug therapy can include as many as 7

Question 33

What two drugs do you ALWAYS start with when treating TB?

Answer 33

Isoniazid & Rifampin

Question 34

What is the standard of care by health care employee for adherence and oral administration for TB?

Answer 34

Directly Observed Therapy (DOT)

Question 35

How many meds for Latent TB?

Answer 35

2+ meds

Question 36

What organ do TB drugs affect?

Answer 36

Liver

Question 37

What is the Drug Interactions for Isoniazid?

Answer 37

Phenytoin dose should be reduced because it can increase phenytoin levels. So - MONITOR LEVELS

Question 38

What is an adverse effect of rifampin?

Answer 38

Hepatotoxic

Question 39

What happens to oral contraceptives when on rifampin?

Answer 39

renders oral contraceptives ineffective use alternate method

Question 40

What other use for Rifampin?

Answer 40

Leprosy (Hansen Disease)

Question 41

What are ADVERSE effects of Fluoroquinolone?

Answer 41

TENDON RUPTURE of Achilles tendon - usually over 60 years - taking glucocorticoids pregnancy seizures, prolong QT Dizziness, confusion Photosensitivity

Question 42

What history of disease in a patient would you NOT give Ciprofoxacin?

Answer 42

Myasthenia Gravis Genetic disorder voluntary muscles Face swallowing weakness

Question 43

When to discontinue Ciprofloxacin - what signs/symptoms?

Answer 43

First sign of tendon pain, Swelling Inflammation in ankle/foot (sore ankle)

Question 44

Daptomycin - class "Cyclic Lipopeptides" what does it kill?

Answer 44

gram + bacteria MRSA

Question 45

What is the route for Amphotericin B?

Answer 45

Usually IV go SLOW

Question 46

What do you use to treat and infuse reaction from Amphotericin B? (3 drugs)

Answer 46

Tx - Tylenol, Aspirin, diphenhydramine

Question 47

Nephrotoxicity happens in ALL patients on Amphotericin B. What would you do on days that the drug is infused to minimize this?

Answer 47

Infusing 1 liter of fluids on days drug is given. If plasma creatinine rises above 3.5 take action

Question 48

When taking amphotericin B -- drug interactions you would avoid using with ...?

Answer 48

nephrotoxic agents

Question 49

What are the adverse effects of Itraconazole?

Answer 49

Cardio suppression Liver injury

Question 50

What would you educate your patient on when taking Itraconazole - when to call DR?

Answer 50

Persistent N/V Fatigue Jaundice Dark Urine Pale stools Think - Liver

Question 51

Superficial Mycosis are treated locally Tinea Capitis =

Answer 51

Ringworm of the scalp

Question 52

Superficial Mycosis are treated locally Tinea Pedis =

Answer 52

athletes foot

Question 53

Superficial Mycosis are treated locally Tinea Corporis =

Answer 53

Ringworm of the body

Question 54

Superficial Mycosis are treated locally Tinea Cruris =

Answer 54

Jock Itch

Question 55

Superficial Mycosis are treated locally Candidiasis =

Answer 55

vulovaginal Oral = thrish

Question 56

Superficial Mycosis are treated locally Onychomycosis

Answer 56

nail fungus

Question 57

Class = -cyclovir

Answer 57

Antiviral

Question 58

Acyclovir uses:

Answer 58

Herpes virus family: Herpes simplex Varicella Zoster Shingles Chicken pox

Question 59

What are the side effects of Acyclovir?

Answer 59

reversible nephrotoxicity (greater risk when dehydrated) give slow over 1 hour and increase hydration during infusion and 2 hours after

Question 60

When should you defer a flu vaccine?

Answer 60

Acute febrile illness

Question 61

Contraindications of Flu shot?

Answer 61

allergy to eggs

Question 62

Best time to vaccinate for the flu?

Answer 62

October or November