Internal Diseases – Part 1 (Rheumatology, Pulmonology, Phthisiatrics, Cardiology, Haematology) · MU Plovdiv
22. Treatment of tuberculosis
Inside: 25 sections · 6 labelled pictures · 6 tables · 25 flashcards · 24 min
Topic 27 of 68 in the MU Plovdiv syllabus for Internal Diseases – Part 1 (Rheumatology, Pulmonology, Phthisiatrics, Cardiology, Haematology) (Medicine, Year 4). The free AceMed note covers it in 23 sections, about 3,143 words (24 min of reading), with 25 flashcards.
In this note
- First line drugs
- Second line drugs
- Essay 22- Treatment of TB
- Synthetic
- Antimycobacterial antibiotics
- Definition
- Etiology
- Transmission and risk factors
- Immunopathogenesis
- Clinical presentation
- Diagnosis
- Treatment
- Prevention
- Complications
- Antituberculosis and Antileprosy Drugs
- Classification / Examples
- Pharmacodynamics
- Pharmacokinetics
- Side Effects
- Drug Interactions
- Therapeutic Uses
- Pregnancy and Milk Safety
- Recap Questions
First line drugs
- Isoniazid
- MoA
- Inhibits the synthesis of mycolic acid (main component of the mycobacterial cell wall)
- Pharmacokinetics
- A- good oral absorption
- D- high conc in CSF, good intracellular distribution
- Can cross BBB and FPB
- M- liver
- Enzyme inhibitor
- E- urine
- ADR
- Neurotoxicity- (in slow metabolizers – neuritis, paresthesia – can be countered with vit. B6 administration)
- Hepatotoxicity
- Both are dose dependant and reversible
- Allergies
- Tinnitus
- Arthalgia
- Rifampicin
- MoA
- Selectively inhibits DNA-dependent RNA-polymerase
- Pharmacokinetics
- A- good oral absorption
- D- penetrates BBB and FPB
- M- liver
- E- bile and partially urine
- ADRs
- Hepatotoxicity
- Red discolouration of urine
- Can stain contact lenses
- Allergies
- Nausea
- Vomiting
- Contraindications
- Liver impairment
- Ethambutol
- MoA
- Inhibits mycobacterial arabinosyltransferase
- Pharmacokinetics
- A- oral
- D- good tissue distribution
- Can cross BBB when inflamed
- M-
- E- urine
- Contraindications
- Liver impairment
- Children < 13 yrs
- Clients who cannot report visual changes
- ADRs
- Optic neuritis
- Decreased visual acuity
- Color blindness
- Hypersensitivity
- Hepatotoxicity
- Nephrotoxicity
- Pyrazinamide
- MoA
- Inhibits bacterial fatty acid synthesis (not fully understood)
- ADRs
- Hepatotoxicity
- Hypersensitivity
- Contraindications
- Liver impairment
- Gout
- Streptomycin
- MoA
- Inhibits bacterial protein synthesis at the ribosomal level
- Pharmacokinetics
- A- poor oral absorption (only given IV or IM)
- D-
- M- not metabolised
- E- urine
- ADRs
- Nephrotoxicity
- Ototoxicity
- Optic neuritis
- Hypersensitivity
- Contraindications
- Liver impairment
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