TB First-line drugs

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Author:
aiwanski
ID:
172560
Filename:
TB First-line drugs
Updated:
2012-09-22 16:40:27
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TB First line drugs
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TB First-line drugs
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  1. ______?  Kills actively growing myobacteria outside the cell and inhibits the growth of dormant bacteria inside macrophages and caseating granulomas?
    Isoniazid (INH)
  2. Isoniazid kills actively growing myobacteria outside the cell and inhibits the growth of dormant bacteria inside macrophages and caseating granulomas.  There are 4 dx listed, name at least 2 and their rationales?
    Teach the patient to take the drug on an empty stomach 1 hour before or 2 hours after meals) and to avoid antacids.  Rationale: Food and antacids slow or prevent absorption of the drug from the GI tract.

    Teach the patient to take a daily multiple vitamin that contains B complex vitamis while on this drug.  Rationale: Drug can depleate body of B complex.

    Remind patient to avoid drinking alcoholic beverages while on this drug.  Rationale: The drug can cause liver damage and can be potentiated by alcohol. 

    Teach the patient to report darkening of the urine, a yellow appearance on the skin or whites of the eyes, and an increased tendency to bruise or bleed.  Rationale: These indications may indicate toxicity or failure.

    **May cause hyperglycemia**
  3. ______?  Kills slower-growing organisms even those that reside in macrophages and caseating granulomas? 
    Rifampin (RIF)
  4. Rifampin (RIF) kills slower-growing organisms, even those that reside in macrophages and caseating granulomas.  There are 5 interventions listed, name at least 2 and their rationales. 
    Teach the patient to expect the drug to stain the skin and urine and expect all other secretions to have a reddish-orange tinge; also, soft contact lenses will become permanently stained.  Rationale: This is an expected and harmless side effect of the drug and will clear some time after the patient stops taking the drug.

    Teach women using oral contraceptives to use an additional method of contraception while taking this drug and for 1 month after stopping the drug.  Rationale: This drug reduces the effectiveness of oral contraceptives. 

    Remind the patient to avoid driking alcoholic beverages while on this drug.  Rationale: Drug causes liver damage and is potentiated by alcohol. 

    Teach the patient to report darkening of the urine, a yellow appearance to the skin or whites of the eyes, and an increased tendency to bruise or bleed.  Rationale: These manifestations may indicate liver toxicity or failure.

    Ask the patient about all other drugs in use.  Rationale: This drug interacts with many drugs. 
  5. _______? is not inactivated by the acidic environment of macrophages and can effectively kill organisms residing within them?
    Pyrazinamide (PZA)
  6. Pyrazinamide is not inactivated by the acidic environment of macrophages and can effectively kill organisms residing within them.  There are 5 interventions and rationales.  Name at least 2 of them?
    Ask whether the patient has ever had gout.  Rationale: This drug increases uric acid formation and will make gout worse.

    Teach the patient to drink at least 8 oz of water when taking this tablet and to increase fluid intake.  Rationale: More fluids help prevent uric acid from precipitating and causing gout or kidney problems. 

    Teach the patient to wear protective clothing a hat, and sunscreen when going outdoors in the sunlight.  Rationale: The drug causes photosensitivity and greatly increases the risk of sunburn.

    Remind the patient to avoid drinking alcoholic beverages while on this drug.  Rationale: The drug can cause liver damage.  This effect is potentiated by alcohol.

    Teach the patient to report darkening of the urine, a yellow appearance to the skin or whites of the eyes, and an increased tendency to bruise or bleed.  Rationale: These manifestations may indicate liver toxicity or failure. 
  7. ________?  Inhibits bacterial RNA synthesis, thus supressing bacterial growth.  It is slow acting and is bacteriostatic rather than bacteriocidal.  Thus it must be used in combination with other anti-TB drugs. 
    Ethambutol (EMB)
  8. Ethambutol inhibits bacterial RNA synthesis, thus supressing bacterial growth.  It
    is slow acting and is bacteriostatic rather than bacteriocidal.  Thus it
    must be used in combination with other anti-TB drugs. There are 4 interventions and rationales.  Name at least 2?
    Remind the patient to avoid drinking alcoholic beverages while on this drug.  Rationale: The drug induces severe nausea and vomiting when alcohol is ingested. 

    Teach the patient to report any changes in vision, such as reduced color vision, blurred vision, or reduced visual fields, immediately to his or her healthcare provider.  Rationale: The drug can cause optic neuritis and can lead to blindness.  When the probelm is discovered early the eye problems are usually reversed when the drug is stopped. 

    Ask whether the patient has ever had gout.  Rationale: This drug increases uric acid formation and will make gout worse. 

    Teach the patient to drink at least 8 oz of water when taking this tablet to increase fluid intake. Rationale: More fluids help prevent uric acid from precipitating and causing gout or kidney problems. 
  9. Name 4 first line treatment drugs for TB?
    • Isoniazid (INH)
    • Rifampin (RIF)
    • Pyrazinamide (PZA)
    • Ethambutol (EMB)

    **Not in book but in class streptomycin**
  10. _______ TB?  Has no symptoms.  Does not feel sick.  Cannot spread TB to others.  Usually has a skin test or blood test result indicating ____pos/neg?____ infection.  Has a normal chest xray and a __pos/neg?__ sputum smear.
    • Latent
    • Positive
    • negative
  11. _____TB has symptoms that may include: a bad cough that lasts ___ weeks or longer, pain in the chest, coughing up blood or sputum, weakness/fatigue, weigh loss, no appetite, chills, fever, sweating at night.  Usually feels sick.  May spread TB to others.  Usually has a skin test positive.  May have an abnormal chest xray or positive sputum smear or culture. 
    • Active TB
    • 3 weeks
  12. If exposure to TB is brief than you have ______infection.  Otherwise you have infection and it is either ________ or __________?
    • No
    • Active
    • Latent

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