Die, TB, Die!

A pharmacology presentation on the drugs used to treat active and latent Tuberculosis. A group of OUCOM PCC students make an interactive presentation. Enjoy!


A 35-year-old female patient presents with symptoms that include a productive cough, fever, night sweats, and weight loss. Sputum is submitted for smear, culture, and susceptibility testing. The sputum smear is positive for acid-fast bacilli (AFB) and a chest X-ray reveals upper lobe, patchy infiltrates. Laboratory tests requested include complete blood count (CBC), liver function enzymes, bilirubin, creatinine, and uric acid. The patient is hospitalized and is to remain in isolation during drug treatment until sputum becomes smear negative.

1) Describe the recommended regimen (first-line drugs) for the treatment of active tuberculosis. What is the duration of treatment? What is meant by the term first-line drugs and how do they differ from second-line drugs for the treatment of tuberculosis?
2) Many bacterial infections can be treated with a single antimicrobial agent. Why are so many drugs needed in combination for the treatment of active cases of Mycobacterium tuberculosis? Are the same number of drugs (multiple agents) indicated for the treatment of latent tuberculosis infection?
3) Describe the mechanism of action of each of the first-line agents.
4) In regard to isoniazid, discuss 'rapid' versus 'slow' acetylators.
5) For isoniazid, describe the adverse effects that may accompany its administration. What biochemical mechanisms may be responsible for some of the adverse effects? What types of patients may be more susceptible to some of the more serious adverse effects of isoniazid? Explain.
6) Describe the adverse effects of other first-line agents.
7) What is MDR-TB and XDR-TB?

Category:

Education

Tags:

• Tuberculosis
• Rifampin
• Izoniasid