Term
In LTBI (latent tb infection), what is drug of choice?
What patients SHOULD receive this therapy?
Dosing interval for DOC?
Monitoring parameters of DOC? |
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Definition
DOC in LTBI : Isoniazid
Monitor LFTs, INH can cause hepatitis.
Dosing: INH twice weekly for 9 months
Patients with LBTI with contact to TB, HIV, organ transplanted, or positive manitoux skin test. |
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Term
In LTBI, if patient resistant/unable to take INH, what is a good alternative?
Dosing interval and duration? |
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Definition
| Alternative to INH in LTBI: Rifampin daily for 4 months |
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Term
| Standard therapy for active TB? |
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Definition
Standard therapy for active TB
INH + Rifampin + EMB + Pyrazinamide for 2 months,
THEN
INH + Rifampin for 4 months |
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Term
| When should initial therapy with the 4 drugs be RESTARTED? |
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Definition
If treatment interruption for > 14 days during initial treatment (first 2 months with INH+Rifampin+Pyrazinamide+Ethambutol)
OR
>3 months during continuation phase ( 4 months of INH+Rifampin)
Initial therapy should be restarted - INH+Rifampin+Pyrazinamide+EMB for 2 months |
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Term
| In Active TB with INH resistance, what is regimen of choice? |
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Definition
In Active TB with INH resistance, what is regimen of choice?
Rifampin + Pyrazinamide + EMB + either a respiratory quinolone OR Streptomycin for 6-10 months (depending on dosing) |
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Term
| In Active TB with Rifampin resistance, what is regimen of choice? |
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Definition
In Active TB with Rifampin resistance, what is regimen of choice?
INH + Pyrazinamide + EMB + either a respiratory quinolone OR Streptomycin for 9-16 months (depending on dosing) |
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Term
Definition of Antituberculosis Drug induced Hepatotoxicity?
What should be done specific medications ? What regimen should be used against active TB and when should it be reinstituted? |
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Definition
Definition of Antituberculosis Drug induced Hepatotoxicity?
AST > 3x ULN in symptomatic (N/V/abd pain)
AST > 5x ULN in unsymptomatic patients
What should be done specific medications ? What regimen should be used against active TB?
D/C all hepatotoxic meds
For active TB use EMB + streptomycin + FQ ONLY when liver function improves |
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Term
TB and pregnancy
Regimen in LBTI ?
Regimen in active TB?
Which anti-TB drug is contraindicated?
What should always be given in addition to active TB regimen in preg/breastfeeding? |
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Definition
TB and pregnancy
Regimen in LBTI - same as normal: INH for 9 months(DOC) or Rifampin for 4 months
Regimen in active TB:
INH + Rifampin + EMB
Do NOT use streptomycin pregnancy
Preg/breastfeeding using INH should ALWAYS use pyridoxine (vitamin B6) |
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Term
TB and HIV
What drug should you be careful of as it decreases concentration of protease inhibitors and NNRTIs (drugs used in HIV)?
What is the regimen in active TB in HIV patients?
What is a good substitute for this drug? |
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Definition
What drug should you be careful of as it decreases concentration of protease inhibitors and NNRTIs (drugs used in HIV) - RIFAMPIN
What is a good substitute for this drug: RIFABUTIN
Regimen: INH+RIFABUTIN+EMB+PYRAZINAMIDE |
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