Tuberculosis Pharmacotherapy

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Author:
giddyupp
ID:
64058
Filename:
Tuberculosis Pharmacotherapy
Updated:
2011-02-04 11:49:58
Tags:
Tuberculosis Pharmacotherapy PHPR523 Test2
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Description:
Tuberculosis Pharmacotherapy
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  1. What are the 1st line agents used to treat TB and their most common SE?
    • INH:
    • The most effective!
    • Neurotoxicity (give with 25-50 mg vit B6)
    • hepatotox
    • Rifampin/Rifabutin/Rifapentine:
    • use rifampin, unless HIV+ (then use rifabutin to decrease DI)
    • 3A4 inducer
    • Hepatotoxic
    • Discolors body fluids
    • Pyrazinamide:
    • Most hepatotoxic
    • ↑ uric acid (gout attacks)
    • Ethambutol:
    • Hepatotoxic
    • Optic neuritis
  2. What is the initial treatment for TB?
    • INH + Rif + EMB + PZA x 2mo, then:
    • INH + Rif x 4mo
    • If cavitation evident, INH + Rif x 3 add'l mo
  3. What are the 2nd line agents used in TB?
    • Cycloserine:
    • Lots of AE (including liver failure)
    • Ethionamide:
    • Neurotoxic (supplement with B6)
    • AG:
    • Streptomycin best (amikacin and capreomycin other options)
    • No hepatotoxicity
    • Ototoxic
    • nephrotoxic
    • p-Aminosalicylic acid (PAS)
    • FQ:
    • Moxi used most often
    • NOT Cipro
    • Linezolid
  4. What is the treatment for Latent TB?
    • INH for 6 mo (use for 9 months if HIV+, children, granulomas on x-ray)
    • Rifampin for 4 months (Rifabutin if HIV+)
  5. How should the regimen change for a patient experiencing toxicity?
    • Hepatotoxicity:
    • INH + RIF + streptomycin + FQ
    • (Take out PZA and EMB first)
    • (Try to keep pt on INH)

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