Pharm 7b Tuberculosis

  1. The tuberculosis is a bacterial infection caused by
    Mycobacterium tuberculosis
  2. How is tuberculosis contracted
    The microorganism is inhaled into the lungs through aerosol droplets from coughing, sneezing, or similar close contact with an infected individual
  3. –MTB is slow growing (____ to ____ weeks after exposure) with an optimum growing temperature of ___ degrees C, which is body temperature.
    • four to six weeks
    • 37°C
  4. Four to six weeks after the first contact with the infection, early symptoms may develop, including
    fever, chills, gastrointestinal upset, and “night sweats.”
  5. Symptoms that develop later (active TB) include
    weight loss (anorexia), nausea, vomiting, night headaches, and palpitations (chest pain). A productive cough producing odorless, green-yellow sputum with blood (hemoptysis) is a feature of TB
  6. Screening of tuberculosis is done using the ________ which only indicates ________ and does not differentiate between _____ and ________
    • tuberculin skin test
    • exposure to infection
    • infection and disease
  7. The tuberculin skin test is based on a skin reaction to the _____ injection of ________
    • transdermal
    • purified protein derivative (PPD) tuberculin
  8. A positive reaction which is taken _________ after injection causes ________
    • 48–72 hours 
    • local raised swelling and induration
  9. The __________ is the gold standard to detect the presence of TB
    PPD test
  10. An individual with a positive skin test (PPD+) should have a ________ taken. A definitive diagnosis of TB requires _________
    • chest X-ray
    • sputum culture
  11. Treatment of tuberculosis is a long term regimen of ________ months but noncompliance can led to ___________
    • 6-9 months
    • an increase in multidrug-resistant bacterial strains
  12. The most common medications used to treat tuberculosis include
    • Rifampin (Rifadin, Rimactane)
    • Isoniazid (INH)
    • Pyrazinamide (PZA)
    • Ethambutol (Myambutol)
  13. What is latent TB
    positive PPD but no symptoms and normal chest x-ray
  14. If Latent Tuberculosis Infection prophylaxis is started with
    isoniazid (INH)
  15. INH may be given to household contact of individuals with TB disease, though therapy may be stopped if the contact remains PPD negative after ______ months
    three months
  16. If drug-resistant tuberculosis infection is likely, the American Thoracic Society and the CDC recommend treatment of disease with ___________ to which the organism is likely to be susceptible
    at least two drugs
  17. For patients with latent Tuberculosis Infection If drug resistant tuberculosis infection is likely drugs including _________ and ________ are taken for ________ or  ________ alone for ______ months
    • rifampin (Rifadin) and pyrazinamide (PZA)
    • two months
    • rifampin
    • four
  18. With INH and rifampin resistance, the CDC recommends ____________ with __________.
    ethambutol (Myambutol) with PZA
  19. Primary risk or adverse side effect of isoniazid is _______ and characterized by _________ . Risk is increased with _______
    • hepatitis
    • abdominal pain and jaundice
    • alcohol and acetaminophen (Tylenol)
  20. What are the adverse effects of INH and what may be given with it
    • –Gastrointestinal problems, peripheral neuropathy (disease involving the nerves – muscle weakness, numbness of fingers and toes), from anemia due to Vitamin B6 deficiency
    • pyridoxine ( a form of B6) may be given together with INH, depending on the adequacy of the patient’s diet
  21. What are the two phases of treatment for patients with TB
    • Initial (bactericidal) phase
    • Continuation (subsequent sterilizing) phase
  22. Describe the Initial (bactericidal) phase
    –which consists of two months of therapy followed by the continuation phase
  23. Describe the Continuation (subsequent sterilizing) phase
    –which lasts four to seven months for patients with drug-susceptible disease in the absence of HIV infection
  24. A _________ regimen should be started in patients with active TB
  25. For Initial and Continuation Therapy after two months of therapy of these four drugs, the patient enters the continuation phase where ______ and _______ are discontinued and ________ and _______ are continued for another _______
    • pyrazinamide and ethambutol
    • isoniazid and rifampin
    • four months
  26. If the patient is considered a high risk for relapse (positive TB cultures after two months of therapy), therapy should continue for an additional
    3 months
  27. With patients with TB and HIV during the continuation phase, the patient should receive
    higher doses of INH and rifampin to prevent relapse with rifampin-resistant organisms, and the recommended time of treatment is longer
  28. Development of drug resistance is lower in children so treatment usually starts with
    INH, pyrazinamide, and rifampin
  29. ________ is not routinely given to children under 13 years of age because it can cause ____________
    • Ethambutol
    • decreased visual acuity and a temporary loss of vision
  30. Rifampin causes
    red/orange saliva
Card Set
Pharm 7b Tuberculosis
Pharm 7b Tuberculosis