Term
| Why does treatment of mycobacteria take so long? |
|
Definition
| Because they are slow growing |
|
|
Term
| What are some of the problems presented by the long treatment times needed to treat mycobacterial infections? |
|
Definition
1. Drug toxicity
2. poor patient adherence
3. drug resistance by the target bacteria |
|
|
Term
| Why are some mycobacteria referred to as acid-fast bacteria? |
|
Definition
| Because they resist decolorizing by the dilute acid used in some staining protocols |
|
|
Term
| What is the principal cause underlying the emergence of resistance to tuberculosis drug therapy? |
|
Definition
|
|
Term
| What is the Prime Directive in tuberculosis treatment? |
|
Definition
| Always treat TB with two drugs or more to reduce the likelihood of the vacteria becoming drug resistant. |
|
|
Term
| In the standard four-drug tuberculosis regimen, which two drugs are almost always included? |
|
Definition
|
|
Term
| What are the two phases of TB treatment? |
|
Definition
Initial (induction) phase
Continuation phase |
|
|
Term
| What is the goal of the Initial phase of TB treatment? |
|
Definition
| Eliminiation of actively dividing extracellular tubercle bacilli and noninfectious sputum |
|
|
Term
| What is the goal of the Continuation phase of TB treatment? |
|
Definition
| Elimination of intracellular 'persisters' |
|
|
Term
| Do all people infected with M. tuberculosis exhibit symptoms of the disease? |
|
Definition
| No. Most people remain asymptomatic, though they will harbor dormant bacteria for life in the absence of drug therapy. |
|
|
Term
| What two ways can a person develop active TB? |
|
Definition
1. reactivation of an old infection
2. recent person-to-person transmission of a new infection |
|
|
Term
| How long does treatment for TB last? |
|
Definition
|
|
Term
| What can be done to greatly increase patient adherence to TB therapy? |
|
Definition
| by using directly observed therapy combined with intermittent dosing rather than daily dosing |
|
|
Term
| What are the three methods employed to evaluate TB therapy? |
|
Definition
1. bacteriologic evaluation of sputum
2. clinical evaluation
3. chest radiographs |
|
|
Term
| What are the four first line drugs used for TB? |
|
Definition
| Isoniazid, rifampin, pyrazinamide and ethambutol |
|
|
Term
| How many drugs may be needed for initial treatment of MDR-TB and XDR-TB? |
|
Definition
|
|
Term
| What is the greatest risk factor for liver damage in patients taking Isoniazid? |
|
Definition
|
|
Term
| What can be given to a patient taking Isoniazid to prevent drug induced peripheral neuropathy? |
|
Definition
|
|
Term
| Which medications can be metabolized more quickly by Rifampin? |
|
Definition
| oral contraceptives, warfarin, certain protease inhibitors and NNRTIs used for HIV infection |
|
|
Term
| What is the greatest risk for patients taking combination Rifampin, Isoniazid and Pyrazinamide? |
|
Definition
| Liver injury due to the severe hepatotoxicity of medications that are already liver toxic separately. |
|
|
Term
| How is Ethambutol different from Rifampin, Isoniazid and Pyrazinamide? |
|
Definition
| It is bacteriostatic, not bactericidal |
|
|
Term
| What is the principle adverse effect of Ethambutol? |
|
Definition
|
|
Term
| What is given under the skin during the TB skin test? How long does it take to react in an infected person? |
|
Definition
Purified protein dirivative (PPD)
48-72 hours |
|
|
Term
| What new regimen is just as effective as Isoniazid for the treatment of latent TB and may replace it soon as the standard treatment? |
|
Definition
| Isoniazid plus rifapentine taken once a week for three months, which is half as long as the standard 9 month treatment with Isonizid alone. |
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