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Anti-TB Drugs
| Question | Answer |
|---|---|
| Four drugs ? | *RIPE....* Rifampin -Isoniazid -Pyrazinamide -Ethambutol |
| Give for initial tmt ? | * All 4 and can discontinue Ethambutol after 2mths if no resistance is found |
| For continued tmt ? | * R and I for 4 more months |
| If INH resistant ? | * RIF + PZA + ETB (6 months) |
| If RIF resistant ? | * INH + ETB + FQ + PZA (2 months) ..... *INH + ETB + FQ (10-16 months) |
| Drug resistance ? | * even if there is 1 resistant bacteria cell and you kill off all the others , that one can reactivate an entire TB infection... reason why drug combos are used |
| Rifampin use ? | * can be used alone in latent/asymptomatic patients ..... * Not to be used alone in active TB infections |
| Rifampin Spectrum ? | * broad spectrum ABx that targets RNA Polymerase.... *can be used for Neisseria and in both G+/G- |
| Rifampins 3R side effects ? | * Revs up CYP450s, so excretes other drugs faster.... * RED/Orange urine... *RNA Polymerase inhibitor |
| Same MOA as Rifampin and you give to HIV patients ? | * Rifabutin... lower CYP450 increase, but super $$$ |
| Isoniazid use ? | * DOC for Asymptomatic/Latent TB... if can't use, then use Rifampin.... * Always combo with active TB |
| Isoniazid MOA ? | * Inhibits synthesis of mycolic acids used to make the cell wall....Bactericidal |
| Isoniazid pharmokinetics ? | * Removed by the liver (acetylation), so fast acetylators can remove it faster or slow can have higher side effects bc of slower removal |
| Isoniazid Side Effects ? | * Peripheral neuropathy and CNS toxicity in pts that are alcoholics, diabetics, pregnant women, so supplement with B6..... * most common/most fatal is drug induced hepatitis as age increases bc drug lvls rise in declining liver fct |
| Pyrazinamide MOA ? | * Bactericidal, moa really unknown |
| Pyrazinamide Side Effects ? | * hepatotoxicity and hyperuricemia (watch out in gout ppl) |
| RIP to the Liver ? | * R I and P all cause liver hepatotoxicty |
| Ethambutol use ? | * The only bacteriostatic drug..... * helps if resistance and discontinued if no resistance |
| Ethambutol side effects ? | * Optic Neuritis (E for eye)lose some vision and red/green colors.... * Hyperuricemia (in P and E) |
| Streptomycin use ? | * used in only severe TB cases ..... * is an aminoglycoside that is a protein synthesis inhibitor (Bactericidal) |
| Streptomycin Side Effects ? | * vertigo & hearing loss (can be permanent is left).... * Nephrotoxicity |
Created by:
thamrick800
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