Tuberculosis Treatment Overview
24 Questions
0 Views

Choose a study mode

Play Quiz
Study Flashcards
Spaced Repetition
Chat to lesson

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

What is a primary reason for using combination therapy in the treatment of tuberculosis?

  • To enhance patient compliance
  • To shorten the duration of treatment
  • To prevent the emergence of resistance (correct)
  • To increase drug potency

    • Mycobacteria grow faster than most other bacteria.

    False

    Name two first-line anti-tuberculosis drugs.

    Isoniazid and Rifampicin

    The treatment for tuberculosis often lasts for several ______.

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

    Match the following anti-tuberculosis drugs with their effects:

    <p>Isoniazid = Inhibits cell wall synthesis Rifampicin = Inhibits RNA synthesis Ethambutol = Inhibits cell wall synthesis Streptomycin = Inhibits protein synthesis</p> Signup and view all the answers

    Which of the following statements is true regarding the mycobacterial cell wall?

    <p>It is rich in lipids and impermeable to many agents.</p> Signup and view all the answers

    Adverse effects monitoring is not necessary during anti-tuberculosis therapy.

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

    Explain why drug-resistant strains of Mycobacteria are a concern in tuberculosis treatment.

    <p>They can lead to treatment failure and prolonged infection.</p> Signup and view all the answers

    What is the mechanism of action of Ethambutol?

    <p>Inhibits mycobacterial arabinosyl transferases</p> Signup and view all the answers

    Rifampin can diminish the effectiveness of oral contraceptives.

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

    What are the common adverse effects associated with Ethambutol?

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

    Rifampin can increase the effectiveness of __________ medications, specifically protease inhibitors.

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

    Match the following nursing interventions with their related actions:

    <p>Monitor PT and INR = To assess blood clotting ability Instruct clients to avoid alcohol = To prevent hepatotoxicity Monitor liver function = To detect liver-related side effects Suggest alternative birth control = To ensure effective pregnancy prevention</p> Signup and view all the answers

    What is a primary consequence of concurrent use of Rifampin with INH and pyrazinamide?

    <p>Elevated liver toxicity risk</p> Signup and view all the answers

    Ethambutol should be used alone for treating tuberculosis due to its efficacy.

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

    What is an indication of effective tuberculosis treatment?

    <p>Three negative sputum cultures for tuberculosis.</p> Signup and view all the answers

    What is the primary mechanism of action of Ethionamide?

    <p>Blocks the synthesis of mycolic acids</p> Signup and view all the answers

    Streptomycin is safe to use for extended periods without any concerns for toxicity.

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

    List two common adverse effects of Streptomycin.

    <p>Vertigo and hearing loss</p> Signup and view all the answers

    Streptomycin should be limited to no more than ___ months to reduce toxicity.

    <p>6</p> Signup and view all the answers

    Under what circumstances are second-line drugs for tuberculosis typically considered?

    <p>In case of resistance to first-line agents</p> Signup and view all the answers

    Match the following second-line drugs with their daily dosages:

    <p>Amikacin = 15 mg/kg/d Clofazimine = 200 mg/d Levofloxacin = 500–750 mg/d Linezolid = 600 mg/d</p> Signup and view all the answers

    Isoniazid is a second-line drug for the treatment of tuberculosis.

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

    What should be monitored while administering Streptomycin due to its potential toxicity?

    <p>Renal function and hearing</p> Signup and view all the answers

    Study Notes

    Clinical Use in Tuberculosis

    • Streptomycin sulfate is used for injectable treatment options and antibiotic-resistant infections.
    • Typical dosage: 15 mg/kg/day intramuscularly or intravenously for adults, 20-40 mg/kg/day for children (max 1 g).
    • Initial treatment phase lasts several weeks, then 15 mg/kg two or three times weekly for several months.

    Adverse Reactions

    • Streptomycin is known for ototoxicity and nephrotoxicity.
    • Common adverse effects include vertigo and hearing loss, which may be permanent.
    • Dose-related toxicity is particularly risky for the elderly.
    • Dosage must be adjusted based on renal function and limited to 6 months to reduce toxicity.

    First-line Anti-mycobacterial Agents

    • Isoniazid: 300 mg/day
    • Rifampin: 600 mg/day
    • Pyrazinamide: 25 mg/kg/day
    • Ethambutol: 15-25 mg/kg/day
    • Weekly Streptomycin: 15 mg/kg/day

    Second-line Drugs for Tuberculosis

    • Utilized for resistance to first-line agents, clinical failure of conventional therapy, or serious adverse reactions.
    • Requires expert guidance for managing toxic effects.
    • Includes:
      • Amikacin: 15 mg/kg/day
      • Aminosalicylic acid: 8-12 g/day
      • Bedaquiline: 400 mg/day
      • Capreomycin: 15 mg/kg/day
      • Clofazimine: 200 mg/day
      • Cycloserine: 500-1000 mg/day (divided doses)
      • Ethionamide: 500-750 mg/day
      • Levofloxacin: 500-750 mg/day
      • Linezolid: 600 mg/day
      • Moxifloxacin: 400 mg/day
      • Rifabutin: 300 mg/day
      • Rifapentine: 600 mg

    Ethionamide

    • Related to isoniazid; inhibits mycolic acid synthesis.
    • Poorly water-soluble; only available for oral use.
    • Metabolized in the liver and hepatotoxic.

    Introduction to Mycobacteria

    • Mycobacteria show intrinsic resistance to most antibiotics and grow slowly, limiting effectiveness of rapid-action antibiotics.
    • Mycobacterial cells can be dormant, presenting further resistance challenges.
    • Their lipid-rich cell wall is impermeable, necessitating combination therapy to prevent resistance.
    • Mycobacterial infections, such as tuberculosis and leprosy, require prolonged treatment, typically lasting months to years.

    Principles of Anti-tuberculosis Treatment

    • Combination therapy reduces the risk of developing resistance and quickly decreases bacterial load.
    • Fixed-dose combination (FDC) tablets are common to prevent resistance emergence.
    • First-line anti-TB drugs: isoniazid, ethambutol, rifampicin, pyrazinamide, and streptomycin.
    • Mild gastrointestinal discomfort is a side effect but usually requires no intervention.

    Contraindications/Precautions

    • Use caution in patients with liver dysfunction; monitor liver function closely.

    Drug Interactions and Client Education

    • Rifampin can accelerate metabolism of warfarin, oral contraceptives, and certain HIV medications, potentially necessitating dosage adjustments.
    • Recommend alternative birth control methods for clients on rifampin.
    • Avoid alcohol consumption alongside hepatotoxic agents like INH and pyrazinamide; monitor liver function.

    Nursing Evaluation of Medication Effectiveness

    • Effectiveness can be noted through improved symptoms (e.g., clear breath sounds, increased appetite) and resolution of temperature elevations.
    • Typically, achieving three negative sputum cultures for tuberculosis can take 3-6 months.

    Ethambutol

    • Water-soluble and heat-stable pharmacological agent.
    • Inhibits mycobacterial arabinosyl transferases crucial for cell wall integrity.
    • Rapid resistance develops if used as monotherapy.
    • Well absorbed from the gastrointestinal tract, metabolized in the liver, and excreted via urine.
    • Therapeutic levels reached in the central nervous system for tuberculosis treatment.
    • Common adverse effect is optic neuritis, leading to visual disturbances, especially in those with renal function impairment.

    Studying That Suits You

    Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

    Quiz Team

    Related Documents

    Lesson_7_antimycobacterial_agents[1].pptx

    Description

    This quiz covers the clinical use of streptomycin and other anti-mycobacterial agents in the treatment of tuberculosis. It discusses dosages, adverse effects, and the use of first and second-line drugs. Test your knowledge on the important aspects of tuberculosis therapy!

    More Like This

    Use Quizgecko on...
    Browser
    Open
    Browser
    Browser