What is the general duration for TB tx? (short or long)
Why is this?
- long tx
- they. are a slow growing bacteria
Does a positive acid fast smear = positive for TB
no this only indicated the presence of mycobacterium
What is the difference in the diagnostic criteria for active vs latent TB?
I really don’t know what mare bare is looking for here considering the self study quiz answer….
What are the 3 different tx options for latent TB according to the CDC?
- NIH alone daily for 6-9 mo (9 mo preferred, 6 mo not for kids)
- NIH + rifapentine taken weekly for 12 wks
- rifampin daily for 4 mo –> NIH resistant TB, or cannot take NIH
Why should we tx TB with at least 2 drugs?
decreases the change of the bacteria developing resistance –> it would have to undergo 2 subsequent mutations specific to the treatment which is unlikely
Which 4 drugs are typically given as induction therapy for active TB?
- NIH
- rifampin
- pyrazinamide
- ethambutol
What is the minimal treatment time for active TB
What about MDR TB
- minimal : 6 mo
- MRD-TB : up to 24 mo or until sputum cultures become negative
When is second line drug theory used?
- resistance occurs to first line agents
- severe pulmonary and disseminated TB infections
MDR-TB is resistant to what 2 medications?
- NIH
- rifampin
XDR-TB is resistance to which drugs (2 specific, 2 categories)
- NIH
- rifampin
- all fluoroquinolone
- at least 1 of the injectable 2nd line anti TB drugs
What is directly observed therapy? How does it and intermittent dosing impact TB tx?
- DOT : pt is observed while taking their meds
- intermittent dose : dosing is 2-3 times / wk
- this is very important in promoting adherence
How are the drugs used to treat TB selected for the pt?
- ideally : from culture and sensitivity tests –> take a LONG time
- until then –> empirically based on : patterns of drug resistance in the community, and the immunocompetence of the pt
In which phase of TB tx are we working to actively eliminate dividing extracellular TB?
This phase is over when we achieve what?
- induction phase
- non-infectious sputum sample
In which phase of TB tx does elimination of intracellular bacteria occur?
- continuation
Which drug can cause a deficiency in Vit B6?
How would a pt with this deficiency present?
- NIH
- peripheral neuropathy
Which drug would be most appropriate for a pt with severe liver cirrhosis?
- ethambutol
NIH is a CYP inhibitor, what 3 drugs are of concern for a drug drug interaction?
- phenytoin
- diazepam
- carbamazepine
Which drug should be given on an empty stomach?
rifampin
Which drug can potentially interaction with OCP, warfarin, protease inhibitors, and NNRTIs?
rifampin
What is the most common SE associated with NIH?
rifampin?
pyrazinamide?
- NIH : peripheral neuropathy
- Rif : red/orange discoloration of body fluids
- pry : pain in multiple joints
What drug can cause optic neuritis? What problem can this cause?
- ethambutol
- blurred vision, constricted field of vision, color discrimination problems
