Tuberculosis Medications and Contraindications Quiz
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Questions and Answers

What is the primary function of antiplatelets?

  • Alter platelet function without preventing platelets from working
  • Break down existing clots
  • Prevent platelet plugs (correct)
  • Lyses existing platelets

    • Which of the following drugs is classified as an antiplatelet?

  • Heparin
  • Clopidogrel (correct)
  • Ibuprofen
  • Warfarin

    • What is the primary purpose of thrombolytic drugs?

  • Prevent platelet plugs
  • Break down existing clots (correct)
  • Alter platelet function without preventing platelets from working
  • Promote platelet aggregation

    • Which type of Heparin requires frequent lab monitoring with aPTT tests?

    <p>Unfractionated heparin</p> Signup and view all the answers

    What is the primary patient education point for a patient taking Warfarin?

    <p>Maintain consistent intake of Vitamin K-rich foods</p> Signup and view all the answers

    What is the antidote for Heparin?

    <p>Idarucizumab</p> Signup and view all the answers

    What does an increase in Vitamin K do to the body when taking Warfarin?

    <p>Causes a decrease in Warfarin effectiveness</p> Signup and view all the answers

    Which of the following is a toxic effect of Warfarin?

    <p>Risk of clotting</p> Signup and view all the answers

    Why would a patient be prescribed both Warfarin and Heparin?

    <p>To allow time for Warfarin to reach therapeutic levels</p> Signup and view all the answers

    What is the most commonly used short-acting beta-2 specific bronchodilator for acute respiratory distress?

    <p>Albuterol</p> Signup and view all the answers

    Which medication is used for dilation of airways in mild or moderate cases of acute asthma, but NOT for the management of acute asthma attacks?

    <p>Theophylline</p> Signup and view all the answers

    What is the main adverse effect associated with nonselective beta-1 (cardiac) and beta-2 (respiratory) adrenergic agonists like epinephrine?

    <p>Vascular headache</p> Signup and view all the answers

    What is the primary function of anticholinergics in the treatment of respiratory conditions?

    <p>Prevent bronchoconstriction</p> Signup and view all the answers

    Which of the following is true about xanthine derivatives like theophylline?

    <p>Requires avoiding caffeine consumption</p> Signup and view all the answers

    What is the main purpose of corticosteroids in the treatment of pulmonary diseases?

    <p>Utilize anti-inflammatory effects</p> Signup and view all the answers

    Which of the following is a common adverse effect of corticosteroids used to treat chronic asthma?

    <p>Peripheral neuritis</p> Signup and view all the answers

    What is the primary purpose of inhaled corticosteroids in the treatment of bronchospastic disorders?

    <p>Control inflammation</p> Signup and view all the answers

    Which antibiotic group is structurally and pharmacologically related to penicillin?

    <p>Cephalosporins</p> Signup and view all the answers

    What distinguishes the fourth generation cephalosporins in terms of their medical application?

    <p>Treatment of uncomplicated and complicated UTIs</p> Signup and view all the answers

    What patient education should be provided for individuals allergic to penicillin regarding cephalosporin use?

    <p>Seek immediate medical attention if hives develop</p> Signup and view all the answers

    Which class of antibiotics is typically reserved for complicated body cavity and connective tissue infections in acutely ill hospitalized patients?

    <p>Carbapenems</p> Signup and view all the answers

    Which antibiotic has a strong affinity for calcium, leading to tooth discoloration in the fetus and throughout adulthood?

    <p>Tigecycline</p> Signup and view all the answers

    Which antibiotic class is known for its ototoxicity adverse effect, which could manifest as auditory impairment and vestibular impairment?

    <p>Quinolones</p> Signup and view all the answers

    Which antibiotic is indicated specifically for the treatment of C. difficile infection associated with diarrhea?

    <p>Fidaxomicin</p> Signup and view all the answers

    Which antibiotic should not be used in children younger than 8 years or pregnant/lactating women due to the risk of tooth discoloration?

    <p>Doxycycline</p> Signup and view all the answers

    What is the major adverse effect associated with Rifabutin?

    <p>Optic neuritis</p> Signup and view all the answers

    Which drug is specifically used for pulmonary multidrug-resistant tuberculosis?

    <p>Pretomanid</p> Signup and view all the answers

    What is the primary purpose of Bedaquiline in tuberculosis treatment?

    <p>Reduce cough</p> Signup and view all the answers

    Which NSAID should not be used in patients with sulfa allergy?

    <p>Celecoxib</p> Signup and view all the answers

    What is a characteristic of Reyes Syndrome?

    <p>Swelling of the brain and liver</p> Signup and view all the answers

    Which adverse effect is considered the most serious when administering opioid drugs?

    <p>CNS depression</p> Signup and view all the answers

    In the management of opioid overdose, which drug is commonly used for suspected acute opioid overdose?

    <p>Naloxone (Narcan)</p> Signup and view all the answers

    What is the primary indication for the use of Methadone in the treatment of detoxification for opioid addicts?

    <p>Opioid addiction</p> Signup and view all the answers

    Which drug is known for its analgesic and antipyretic effects but has little to no anti-inflammatory properties?

    <p>Acetaminophen (Tylenol)</p> Signup and view all the answers

    What is the primary route of administration for Morphine Sulfate in a hospital setting?

    <p>Oral</p> Signup and view all the answers

    Which patient population should use extreme caution with opioid drugs due to the risk of respiratory insufficiency?

    <p>Patients with morbid obesity</p> Signup and view all the answers

    What is the recommended management for an Acetaminophen overdose due to potential hepatoxicity?

    <p>Acetylcysteine regimen</p> Signup and view all the answers

    Which drug is commonly used in the treatment of alcohol and opioid addiction and can be purchased over the counter?

    <p>Naltrexone</p> Signup and view all the answers

    What is the primary role of Lesinurad in patient management?

    <p>Ensuring good renal function</p> Signup and view all the answers

    Which drug should be administered in case of suspected acute opioid overdose where respiratory depression is observed?

    <p>Naloxone (Narcan)</p> Signup and view all the answers

    Lesinurad is used to alleviate moderate to severe pain.

    <p>False</p> Signup and view all the answers

    Sulfinpyrazone is indicated for the treatment of severe asthma.

    <p>False</p> Signup and view all the answers

    Opioid drugs are primarily used for cough suppression and diarrhea treatment.

    <p>True</p> Signup and view all the answers

    Acetaminophen overdose can lead to hepatic necrosis.

    <p>True</p> Signup and view all the answers

    Naltrexone is commonly used as an opioid antagonist in case of overdose.

    <p>True</p> Signup and view all the answers

    Methadone is the opioid of choice in treating acute pain.

    <p>False</p> Signup and view all the answers

    Morphine Sulfate is primarily given in oral form.

    <p>True</p> Signup and view all the answers

    Acetaminophen has significant anti-inflammatory effects.

    <p>False</p> Signup and view all the answers

    The management of tuberculosis includes a chest X-ray if the Mantoux test is negative.

    <p>False</p> Signup and view all the answers

    Warfarin should be avoided with alcohol due to potential liver toxicity.

    <p>True</p> Signup and view all the answers

    Lesinurad should be taken with at least 2 liters of fluid a day.

    <p>False</p> Signup and view all the answers

    Sulfinpyrazone is indicated for the short-term use in the treatment of gout.

    <p>False</p> Signup and view all the answers

    Opioid drugs are primarily used for cough suppression, diarrhea treatment, and balanced anesthesia.

    <p>True</p> Signup and view all the answers

    Morphine Sulfate is primarily administered rectally in a hospital setting.

    <p>False</p> Signup and view all the answers

    Acetaminophen has significant anti-inflammatory effects.

    <p>False</p> Signup and view all the answers

    Naloxone is commonly used as an antidote for suspected acute opioid overdose.

    <p>True</p> Signup and view all the answers

    Warfarin should be avoided with alcohol due to potential hepatoxicity.

    <p>True</p> Signup and view all the answers

    Patients allergic to penicillin should use cephalosporins with caution.

    <p>True</p> Signup and view all the answers

    Acetaminophen overdose can lead to nephropathy.

    <p>False</p> Signup and view all the answers

    Methadone is the opioid of choice in treating acute pain.

    <p>False</p> Signup and view all the answers

    Match the following medications with their primary usage:

    <p>Lesinurad = Alleviate moderate to severe pain Sulfinpyrazone = Short-term use for gout Morphine Sulfate = Treat severe pain Acetaminophen (Tylenol) = Analgesic and antipyretic effects</p> Signup and view all the answers

    Match the following adverse effects with the correct medication:

    <p>Nausea and vomiting = Opioid drugs Urinary retention = Opioid drugs Diaphoresis and flushing = Opioid drugs Constipation (in severe opioid use) = Opioid drugs</p> Signup and view all the answers

    Match the following overdose management options with the correct medication:

    <p>Naloxone (Narcan) = Opioid drugs Acetylcysteine regimen = Acetaminophen (Tylenol) Naltrexone = Alcohol and opioid addiction ACETYLCYSTEINE REGIMEN = Acetaminophen (Tylenol)</p> Signup and view all the answers

    Match the following indications with the correct medication:

    <p>Used for severe pain = Morphine Sulfate Analgesic and antipyretic effects = Acetaminophen (Tylenol) Treat moderate to severe pain = Lesinurad Short-term use for gout = Sulfinpyrazone</p> Signup and view all the answers

    Match the following contraindications with the correct medication:

    <p>Known drug allergy = Opioid drugs Severe asthma = Opioid drugs Liver dysfunction = Acetaminophen (Tylenol) Possible liver failure = Acetaminophen (Tylenol)</p> Signup and view all the answers

    Match the following patient education points with the correct medication:

    <p>Drink at least 2 liters of fluid a day = Lesinurad Avoid alcohol or other hepatotoxic drugs = Acetaminophen (Tylenol) Contact physician if vital signs change or pain continues = Acetaminophen (Tylenol) Inform patients of slower movements to avoid orthostatic hypotension = Morphine Sulfate</p> Signup and view all the answers

    Match the following purposes with the corresponding overdose management option:

    <p>Suspected acute opioid overdose with respiratory depression = Naloxone (Narcan) Overdose management for hepatic necrosis due to chronic use = ACETYLCYSTEINE REGIMEN Alcohol and opioid addiction treatment option = Naltrexone Recommended antidote for acetaminophen overdose to prevent hepatoxicity = ACETYLCYSTEINE REGIMEN</p> Signup and view all the answers

    Match the following diagnostic steps with their corresponding purpose:

    <p>Tuberculin skin test (Mantoux test) = Diagnosis of tuberculosis Chest X-ray after positive skin test results = Diagnosis of tuberculosis Culture of sputum or stomach secretions after signs on X-ray = Diagnosis of tuberculosis Acid-fast bacillus smear test on sputum for quick determination = Diagnosis of tuberculosis</p> Signup and view all the answers

    Match the following consequences of withdrawal symptoms with their corresponding treatment option:

    <p>Anxiety, irritability, chills, hot flashes, joint pain, lacrimation, rhinorrhea, diaphoresis, nausea, vomiting, abdominal cramps, diarrhea, confusion = Withdrawal symptoms or opioid abstinence syndrome Cardiac dysrhythmias and nephropathy in long-term ingestion of large doses = Methadone as opioid treatment</p> Signup and view all the answers

    Match the following management steps with their corresponding patient condition:

    <p>Continuously monitor respiratory rate and O2 levels, check vital signs baseline when administering IV opioids fastest absorption route. = Severe respiratory depression patient condition Dyspnea, diminished breath sounds or shallow breathing indicate respiratory depression. = Respiratory depression manifestations Avoid alcohol or other hepatotoxic drugs. = Patient with liver dysfunction condition patient education point. Inform patients to make slower motions and dangle feet when getting up to avoid orthostatic hypotension. = Patient education when taking medications.</p> Signup and view all the answers

    Lesinurad is primarily used for alleviating moderate to severe pain.

    <p>False</p> Signup and view all the answers

    Sulfinpyrazone is indicated for long-term use in the treatment of gout.

    <p>False</p> Signup and view all the answers

    Opioids are primarily used for cough suppression, diarrhea treatment, and balanced anesthesia.

    <p>True</p> Signup and view all the answers

    Methadone is not the opioid of choice in the treatment of detoxification for opioid addicts.

    <p>False</p> Signup and view all the answers

    Acetaminophen overdose management involves administering ibuprofen.

    <p>False</p> Signup and view all the answers

    The diagnosis of tuberculosis involves a chest X-ray if the Mantoux test results are negative.

    <p>False</p> Signup and view all the answers

    Acetaminophen has little to no anti-inflammatory effects.

    <p>True</p> Signup and view all the answers

    Nonopioid Analgesics like Acetaminophen should not be taken with alcohol.

    <p>True</p> Signup and view all the answers

    Naloxone is commonly used for alcohol addiction and comes in oral form.

    <p>False</p> Signup and view all the answers

    Morphine Sulfate is primarily given in oral form.

    <p>False</p> Signup and view all the answers

    What is the primary purpose of using opioid drugs?

    <p>Alleviating moderate to severe pain</p> Signup and view all the answers

    What should be done if a patient experiences respiratory depression while on opioids?

    <p>Administer an opioid antagonist</p> Signup and view all the answers

    Which medication is recommended for the management of acetaminophen overdose?

    <p>Acetylcysteine</p> Signup and view all the answers

    In which condition should extreme caution be taken when administering opioid drugs?

    <p>Respiratory insufficiency</p> Signup and view all the answers

    What is the most common side effect associated with morphine sulfate use?

    <p>Nausea and vomiting</p> Signup and view all the answers

    Which of the following is a contraindication for using nonopioid analgesics like acetaminophen?

    <p>Liver dysfunction</p> Signup and view all the answers

    What is the common adverse effect associated with nonselective beta-1 (cardiac) and beta-2 (respiratory) adrenergic agonists like epinephrine?

    <p>Auditory impairment</p> Signup and view all the answers

    Which medication is commonly used as an opioid antagonist in case of overdose?

    <p>Naloxone</p> Signup and view all the answers

    What is the primary route of administration for Morphine Sulfate in a hospital setting?

    <p>Intravenous</p> Signup and view all the answers

    What is the antidote for Heparin?

    <p>IV protamine sulfate</p> Signup and view all the answers

    What should you do if a patient has a low INR while on Warfarin?

    <p>Risk of clotting increases</p> Signup and view all the answers

    What are the side effects of Warfarin toxicity?

    <p>Risk of clotting</p> Signup and view all the answers

    Which antidote is used for Warfarin overdose?

    <p>Vitamin K</p> Signup and view all the answers

    What is the primary function of antiplatelet drug Aspirin?

    <p>Prevents platelet adhesion</p> Signup and view all the answers

    What is the primary function of antiplatelets?

    <p>Prevent blood clots from forming by keeping platelets from sticking together</p> Signup and view all the answers

    What is the main function of thrombolytic drugs?

    <p>Break down (lyse) existing clots</p> Signup and view all the answers

    Which drug alters platelet function without preventing them from working?

    <p>Heparin</p> Signup and view all the answers

    What is the primary route of administration for Low Molecular Weight Heparin (LMWH)?

    <p>Subcutaneous</p> Signup and view all the answers

    Which of the following is a type of LMWH heparin?

    <p>Enoxaparin (Lovenox)</p> Signup and view all the answers

    What is the primary purpose of anticholinergics in the treatment of respiratory conditions?

    <p>Reduce secretions in COPD patients</p> Signup and view all the answers

    Which medication is used for dilation of airways in mild or moderate cases of acute asthma, but NOT for the management of acute asthma attacks?

    <p>Theophylline</p> Signup and view all the answers

    What distinguishes xanthine derivatives like theophylline in terms of their medical application?

    <p>Increase cAMP levels</p> Signup and view all the answers

    Which adverse effects are associated with nonselective adrenergic agonists like epinephrine?

    <p>Vascular headache and hyperglycemia</p> Signup and view all the answers

    What is the main drug interaction concern for patients taking theophylline?

    <p>Changes in enzyme levels in the pancreas for diabetics</p> Signup and view all the answers

    What adverse effect is commonly associated with Ethambutol use in pediatric patients?

    <p>Optic neuritis</p> Signup and view all the answers

    Which drug used for multidrug-resistant TB can lead to serious adverse effects like chest pain and cardiac arrest?

    <p>Bedaquiline</p> Signup and view all the answers

    What is the primary purpose of Levofloxacin in tuberculosis treatment?

    <p>Address chronic cough</p> Signup and view all the answers

    What is the significant effect of Rifampin on bodily fluids as mentioned in the text?

    <p>Turn them redish-orange</p> Signup and view all the answers

    Which class of antibiotics should not be administered to children younger than 8 years due to the risk of tooth discoloration?

    <p>Tetracyclines</p> Signup and view all the answers

    Which antibiotic class is typically reserved for complicated body cavity and connective tissue infections in acutely ill hospitalized patients?

    <p>Carbapenems</p> Signup and view all the answers

    Which antibiotic class is known for its ototoxicity adverse effect, which could manifest as auditory impairment and vestibular impairment?

    <p>Aminoglycosides</p> Signup and view all the answers

    What distinguishes Fidaxomicin (Dificid) from other antibiotics mentioned in the text?

    <p>Specifically treats C. difficile infection</p> Signup and view all the answers

    Which antibiotic should not be used in children younger than 8 years or pregnant/lactating women due to the risk of tooth discoloration?

    <p>Tetracyclines</p> Signup and view all the answers

    What is the primary indication for the use of Plazomicin (Zemdi) as mentioned in the text?

    <p>Deep wounds</p> Signup and view all the answers

    What is the primary indication for using inhaled corticosteroids in the treatment of bronchospastic disorders?

    <p>To control the inflammatory response believed to cause the disorders</p> Signup and view all the answers

    Which of the following is a common adverse effect associated with sulfonamides antibiotics like sulfamethoxazole?

    <p>Photosensitivity and exfoliative dermatitis</p> Signup and view all the answers

    Which is true regarding the use of cephalosporin antibiotics in patients who are allergic to penicillin?

    <p>Might trigger an allergic reaction due to shared antigenic determinants with penicillin</p> Signup and view all the answers

    Which drug class is primarily administered for surgical prophylaxis and susceptible staphylococcal infections?

    <p>Beta-lactam antibiotics like penicillins</p> Signup and view all the answers

    What is the primary mode of action (MOA) of corticosteroids in the treatment of bronchospastic disorders?

    <p>Stabilizing membranes of cells that release harmful bronchoconstricting substances</p> Signup and view all the answers

    What is the main purpose of methadone in the treatment of opioid addicts?

    <p>To alleviate moderate to severe pain</p> Signup and view all the answers

    Which patient condition warrants extreme caution when administering opioid drugs?

    <p>Elevated intracranial pressure</p> Signup and view all the answers

    What is the primary function of naloxone (Narcan) in opioid overdose management?

    <p>Reverse opioid-induced respiratory depression</p> Signup and view all the answers

    Which adverse effect requires continuous monitoring when administering opioids?

    <p>Constipation</p> Signup and view all the answers

    What is the primary indication for using Acetaminophen (Tylenol)?

    <p>Treatment of fever</p> Signup and view all the answers

    In what patient population should Acetaminophen be used cautiously due to potential liver toxicity?

    <p>Elderly patients</p> Signup and view all the answers

    What is the primary role of Lesinurad in patient management?

    <p>Alleviating moderate to severe pain</p> Signup and view all the answers

    Which drug is commonly used in the treatment of alcohol and opioid addiction and can be purchased over the counter?

    <p>Naltrexone</p> Signup and view all the answers

    Study Notes

    Tuberculosis (TB)

    • Rifapentine: contraindicated in patients with liver disease
    • Ethambutol: first bacteriostatic drug used to treat TB, causes optic neuritis in pediatric patients (younger than 13)
    • Other first-line drugs: Rifabutin, Pyrazinamide, Rifampin, Streptomycin
    • Second-line drugs: Bedaquiline (used for multidrug-resistant TB), Pretomanid (used for only pulmonary multidrug-resistant TB), Capreomycin, Cycloserine, Levofloxacin, Ethionamide, Oflaxacin, Kanamycin, Para-aminosalicylic acid (PAS)

    TB Infection and Diagnosis

    • Primary TB infection: first infectious episode
    • Reinfection: chronic form of the disease
    • Dormancy: may test positive for exposure but not necessarily infectious
    • Multi-drug resistant TB (MDR-TB): TB bacteria resistant to almost all drugs, including isoniazid (INH) and rifampin
    • Purified protein derivatives (PPD) or Mantoux test: an injection given intradermally to detect exposure to TB organism
    • A positive result is indicated by induration (not erythema) at the site of injection

    Drug Therapy Considerations

    • Monitor patient closely during therapy
    • Major effects of drug therapy: reduction of cough, and therefore reduction of infectiousness
    • Normally occurs within 2 weeks
    • Treatment can take up to 2 years due to non-compliance and environmental factors
    • Patient education: therapy may last from 12 months to 2 years, take medications as ordered, and inform patient of importance of taking medications as prescribed

    Anti-Inflammatory Drugs

    • NSAIDs (nonsteroidal anti-inflammatory drugs):
      • Pain relief for mild or moderate headaches, myalgia, neuralgia, and arthralgia
      • Treatment of gout and hyperuricemia
      • Examples: Diclofenac sodium (Voltaren), Indomethacin, Sulindac, Tolmetin, Etodolac, Ketorolac, Celecoxib (Celebrex)
    • Acetic acid derivatives: Diclofenac sodium (Voltaren)
    • Cyclooxygenase-2 (COX-2) inhibitors: Celecoxib (Celebrex)
    • Enolic acid derivatives: Nabumetone (Relafen), Meloxicam (Mobic)
    • Propionic acid derivatives: Fenoprofen (Nalfon), Flurbiprofen (Ansaid), Ibuprofen (Motrin, Advil)
    • Aspirin: good for inflammation, irreversibly inhibits COX-1 receptor within platelets, contraindications: known drug allergy, peptic ulcers, vitamin K deficiency

    Antigout and Anticoagulant Medications

    • Antigout medications:
      • Allopurinol: used to prevent uric acid production and to prevent acute tumor lysis syndrome
      • Febuxostat: used to decrease uric acid production
      • Colchicine: used for short-term management of gout
      • Probenecid: inhibits the reabsorption of uric acid in the kidneys and thus increases the excretion of uric acid
    • Anticoagulant medications:
      • Warfarin: therapeutic range is 2-3, patient education: safe administration, prevention and management of bleeding, and when to contact the doctor
      • Heparin: unfractionated and low molecular weight, lab monitoring: aPTT, antidote: IV protamine sulfate
      • Antiplatelet medications: Aspirin, Clopidogrel, and Ticagrelor

    COPD (Chronic Obstructive Pulmonary Disease)

    • Definition: recurrent and reversible shortness of breath
    • Causes: bronchospasms, inflammation of the bronchial mucosa, edema of the bronchial mucosa, and production of viscous mucus
    • Short-acting beta agonists (SABAs):
      • Albuterol (Ventolin, ProAir): most commonly used, first line of defense in acute respiratory distress
      • Levalbuterol (Xopenex)
      • Terbutaline (Brethine)
      • Metproterenol (Alupent)
    • Long-acting beta agonists (LABAs):
      • Arformoterol (Brovana)
      • Formoterol (Foradil, Perforomist)
      • Salmeterol (Serevent)
      • Vilanterol in conjunction with fluticasone (Breo Ellipta)
      • Vilanterol in conjunction with the anticholinergic, umeclidinium (Anoro Ellipta)
    • Anticholinergics:
      • Ipratropium (Atrovent)
      • Tiotropium (Spiriva)
      • Aclidinium (Tudorza)
    • Xanthine derivatives: Theophylline
    • Corticosteroids:
      • Inhaled corticosteroids: Beclomethasone (Beclovent), Budesonide (pulmicort, turbuhaler), Ciclesonide (Omnaris), Flunisolide (Aerobid), Fluticasone (Flovent, Flonase)
      • Systemic corticosteroids: used to treat acute exacerbations or severe asthma

    Antibiotics

    • Sulfonamides: one of the first groups of antibiotics, often combined with another antibiotic
    • Beta-Lactam antibiotics: Penicillins, Cephalosporins, Carbapenems, Monobactams
    • Macrolides: Erythromycin (E-mycin), Azithromycin (Zithromax), Clarithromycin (Biaxin)
    • Tetracyclines: Demeclocyline, Oxytetracycline, Tetracycline
    • Aminoglycosides: Gentamicin, Neomycin, Tobramycin, Amikacin
    • Quinolones: Ciprofloxacin (Cipro), Norfloxacin (Noroxin), Levofloxacin (Levaquin), Moxifloxacin (Avelox), Gemifloxacin (Factive), Delfloxacin (Baxda)

    Antitubercular Drugs

    • First-line drugs: Isoniazid (INH), Rifampin, Pyrazinamide, Ethambutol, Streptomycin
    • Second-line drugs: Bedaquiline, Pretomanid, Capreomycin, Cycloserine, Levofloxacin, Ethionamide, Oflaxacin, Kanamycin, Para-aminosalicylic acid (PAS)### Tuberculosis (TB)
    • Contraindicated for patients with liver disease: Rifapentine
    • First bacteriostatic drug used to treat TB: Ethambutol
    • Causes optic neuritis in pediatric patients (younger than 13): Rifabutin
    • Second-line drugs for TB include:
      • Bedaquiline (used for multidrug-resistant TB)
      • Adverse effects: headache, chest pain, nausea, and OT prolongation and cardiac arrest

    PPD (Purified Protein Derivatives, Mantoux)

    • An injection given intradermally to detect exposure to the TB organism
    • A positive result is indicated by induration (not erythema) at the site of injection

    TB Treatment

    • Major effects of drug therapy: reduction of cough, and therefore reduction of the infectiousness of the patient
    • Therapy may last from 12 months up to 2 years
    • Patient education: importance of taking medication as prescribed, and awareness of potential side effects (e.g., reddish-orange color of bodily fluids)

    NSAIDs (Nonsteroidal Anti-Inflammatory Drugs)

    • Common uses: pain relief, treatment of gout and hyperuricemia
    • Types of NSAIDs:
      • Acetic acid derivatives: Diclofenac sodium (Voltaren), Indomethacin, Sulindac, Tolmetin, Etodolac, Ketorolac
      • Cyclooxygenase-2 (COX-2) inhibitors: Celecoxib (Celebrex)
      • Enolic acid derivatives: Nabumetone (Relafen), Meloxicam (Mobic), Piroxicam (Feldene)
      • Propionic acid derivatives: Fenoprofen (Nalfon), Flurbiprofen (Ansaid), Ibuprofen (Motrin, Advil), Ketoprofen (Orudis KT), Naproxen (Naprosyn, Aleve), Oxaprozin (Daypro)

    Opioid Drugs

    • Used to alleviate moderate to severe pain
    • Indications: often used with adjuvant analgesic drug to assist primary drugs with pain relief
    • Contraindications: known drug allergy, severe asthma, respiratory insufficiency, elevated intracranial pressure, morbid obesity or sleep apnea, paralytic ileus
    • Adverse effects: CNS depression, nausea, vomiting, urinary retention, diaphoresis, and flushing

    Antiplatelet and Anticoagulant Drugs

    • Antiplatelets: prevent platelet adhesion and aggregation
    • Examples: Aspirin, Clopidogrel, and Ticagrelor
    • Heparin: prevents platelet plug formation
    • Warfarin: prevents vitamin K-dependent clotting factor synthesis
    • Antidotes:
      • Heparin: protamine sulfate
      • Warfarin: vitamin K

    COPD (Chronic Obstructive Pulmonary Disease)

    • Definition: recurrent and reversible shortness of breath
    • Causes: bronchospasms, inflammation of the bronchial mucosa, edema of the bronchial mucosa, and production of viscous mucus
    • Treatment:
      • SABAs (Short-Acting Beta Agonists): Albuterol (Ventolin, ProAir)
      • LABAs (Long-Acting Beta Agonists): Arformoterol (Brovana), Formoterol (Foradil, Perforomist), Salmeterol (Serevent)
      • Corticosteroids: inhaled or oral forms, reduce inflammation and swelling in the airways
      • Xanthine Derivatives: Theophylline, used to treat bronchospasms and COPD

    Antibiotics

    • Sulfonamides: often combined with another antibiotic, effective against both gram-positive and gram-negative bacteria

    • Beta-Lactum Antibiotics: Penicillins, Cephalosporins, Carbapenems, and Monobactams

    • Indications: prevention and treatment of infections caused by susceptible bacteria

    • Adverse effects: nausea, vomiting, diarrhea, and abdominal pain### Antibiotics

    • Carbapenems:

    • Reserved for complicated body cavity and connective tissue infections in acutely ill hospitalized patients

    • Medications include: Imipenem/Cilastatin, Meropenem, Ertapenem, Doripenem

    • Must be infused over 60 minutes due to possible drug-induced seizures

    Macrolides

    • Used to treat respiratory tract infections, skin infections, and STDs
    • Medications include: Erythromycin, Azithromycin, Clarithromycin
    • Adverse effects: palpitations, jaundice, chest pain, hearing loss, headache, tinnitus, dizziness, vertigo, nausea

    Sulfonamides

    • Treat uncomplicated UTIs
    • Medications include: Fidaxomicin (Dificid)
    • Adverse effects: palpitations, jaundice, chest pain, hearing loss, headache, tinnitus, dizziness, vertigo, nausea

    Tetracyclines

    • Indications: treat infections such as acne, cholera, and plague
    • Medications include: Demeclocycline, Oxytetracycline, Tetracycline
    • Causes discoloration of teeth in fetus and throughout adulthood
    • Contraindications: children younger than 8 years, pregnant or lactating women
    • Patient education: avoid dairy products, antacids, and iron salts; take with water; avoid sunlight and tanning beds due to photosensitivity

    Aminoglycosides

    • Bacterial, kills mostly gram-negative bacteria; some gram-positive bacteria
    • Medications include: Gentamicin, Neomycin, Tobramycin, Amikacin, Plazomicin
    • Adverse effects: nephrotoxicity, ototoxicity (auditory impairment and vestibular impairment)

    Quinolones

    • Indications: complicated urinary tract, respiratory, bone and joint, GI, skin, and sexually transmitted infections
    • Medications include: Ciprofloxacin, Norfloxacin, Levofloxacin, Moxifloxacin, Gemifloxacin, Delfloxacin
    • Adverse effects: CNS body system (headache, dizziness, insomnia, depression, restlessness, convulsions), GI body system (nausea, vomiting, diarrhea, constipation, thrush), cardiac body system (prolonged QT interval)

    Miscellaneous Antibiotics

    • Clindamycin (Cleocin): used for chronic bone infections, genitourinary infections, intrabdominal infections, and other serious infections
    • Linezolid (Zyvox): used for serious bacterial infections, including MRSA
    • Metronidazole (Flagyl): used for intraabdominal and gynecologic infections, also used to treat C. difficile
    • Nitrofurantoin (Macrodantin, Furadantin): primarily used for UTIs (E. coli bacteria)
    • Quinupristin-dalfopristin (Synercid): used for serious bacterial infections
    • Daptomycin (Cubicin): used for serious skin infections and bacteremia
    • Telavancin (Vibativ): used for serious skin infections

    Anti-TB Medications

    • First-line drugs: INH (isoniazid)
    • Patient education: take medication for short-term use, drink at least 2 liters of fluid a day, and avoid dairy products, antacids, alcohol, and anticoagulants

    Opioid Drugs

    • Indications: used to alleviate moderate to severe pain
    • Medications include: morphine, fentanyl, oxycodone, hydrocodone, codeine
    • Contraindications: known drug allergy, severe asthma, respiratory insufficiency, elevated intracranial pressure, morbid obesity, sleep apnea, paralytic ileus
    • Adverse effects: CNS depression, nausea, vomiting, urinary retention, diaphoresis, flushing, pupil constriction, constipation
    • Management of overdose: naloxone (Narcan)

    Non-Opioid Analgesics

    • Acetaminophen (Tylenol): used for mild to moderate pain and fever
    • Indications: alternative for those who cannot take aspirin products
    • Contraindications: drug allergy, liver dysfunction, G6PD deficiency
    • Adverse effects: possible liver failure, overdose can cause hepatic necrosis
    • Antidote: acetylcysteine

    Antiplatelets

    • Used to prevent blood clots from forming by keeping platelets from sticking together
    • Medications include: aspirin, clopidogrel, ticagrelor

    Heparin-Induced Thrombocytopenia (HIT)

    • Complication caused by heparin that causes decreased platelets in the blood
    • Two types: type 1 HIT (gradual reduction in platelets) and type 2 HIT (acute fall in platelets)

    Warfarin

    • Indications: prevents blood clots from forming
    • Adverse effects: bleeding, petechiae, ecchymosis, bleeding gums, blood in stools, hematemesis
    • Antidote: vitamin K

    Anti-Inflammatory Medications (Corticosteroids)

    • Used to treat pulmonary diseases for their anti-inflammatory effects
    • Indications: chronic asthma, COPD
    • Medications include: beclomethasone, budesonide, ciclesonide, flunisolide, fluticasone, mometasone, triamcinolone

    Bronchodilators

    • Used to relieve bronchospasm
    • Indications: asthma, COPD
    • Medications include:
      • Beta-Adrenergic Agonists: albuterol, levalbuterol, formoterol, salmeterol, vilanterol
      • Anticholinergics: ipratropium, tiotropium, aclidinium
      • Xanthine Derivatives: theophylline
      • Corticosteroids: beclomethasone, budesonide, ciclesonide, flunisolide, fluticasone, mometasone, triamcinolone

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    Test your knowledge on medications used to treat tuberculosis and their contraindications. Learn about first-line drugs like Rifampin and Ethambutol, as well as second-line drugs like Bedaquiline and Pretomanid. Understand the adverse effects, interactions, and precautions associated with these medications.

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