Term
| can a positive PPD differentiate latent infection from active infection? |
|
Definition
|
|
Term
|
Definition
|
|
Term
| Does pior exposure to PPD affect subsequent TST's |
|
Definition
| NO, repeated TST's with PPD will NOT convert someone with a negative response to positive |
|
|
Term
| Will treatment with INH convert my PPD? |
|
Definition
| NO, if you're positive you're always positive, need proof you took the INH and new PPD's to monitor disease progression |
|
|
Term
| Does BCG give a positive PPD? |
|
Definition
| 5-10mm indurations may be seen with BCG, However, unless the vaccination was very recent >10mm is NOT due to the BCG. This person is positive. |
|
|
Term
| Gold standard for TB testing |
|
Definition
| IFN gamma, can rule out a positive PPD |
|
|
Term
|
Definition
prodruge which is converted to its active form by the mycobacterial catalase-peroxidase
the active INH metabolite prevents the synthesis of mycoic acid by covalently binding to the acyl carrier protein and the B-ketoacyl carrier protein synthetase |
|
|
Term
|
Definition
| static for latent, cidal for actively dividing bacilli |
|
|
Term
|
Definition
| INH 9 months treatment, 50% reduction of rate of dev active Tb |
|
|
Term
|
Definition
by hepatic N-acetylation;
slow acetylators, increased rick for hepato and neuro toxicity |
|
|
Term
|
Definition
35+ y.o. and unknown date of seroconversion
alcohol increases hepatotoxicity |
|
|
Term
| Prevention of INH neurotoxicity |
|
Definition
| Vitamin B6 prevents and reverses neuropathy, at risk are pregnant women and diabetics, uremia, malnutrition, HIV or seizures |
|
|
Term
| Rifampine and Rifabution MOA |
|
Definition
inhibit mRNA synthesis by binding to the B-subunit of bacterial DNA-dependent RNA polymerase
Both drugs are cidal, and kill intracellularly and in abcesses |
|
|
Term
| When to use Rifampin vs Rifabutin |
|
Definition
| Rifampin induced CYP450 and enhance HIV drug clearance, so for HIV use Rifabutin |
|
|
Term
| Rifampin is also active against |
|
Definition
| meningococci, pneumococci, and staph, MRSA, and PCN res strep pneumo |
|
|
Term
|
Definition
Preg category C
CYP450 inducer
Elev LFT's
ORANGE
Rifabutin: Yellow, polymyalgies, uveitis |
|
|
Term
|
Definition
unkonwn MOA, but it kills in Mphages
Never single agent: Rapid Res when single agent |
|
|
Term
|
Definition
MOA inh arabinosyl transferase which inh cell wall synthesis
NEVER single agent - rapid Res |
|
|
Term
|
Definition
Ocular damage, retrobulbar neuritis
NEED a basal vision exam before beginning and q/4-6 weeks |
|
|
Term
| Streptomycinc MOA and use |
|
Definition
sometimes replaces EMB in INH-rif-PZA reg.
i.m. or i.v. to treat meningitis or disseminated infection - milliary
aminoglycoside inhibitis bacterial pr synthesis, binds 30s and inh 50s binding and cidal |
|
|
Term
|
Definition
vestibular toxicity, vertigo
less auditory and renal tox than other aminoglycosides |
|
|
Term
|
Definition
| ciprofloxacin, levofloxacin, and Moxifloxacin |
|
|
Term
|
Definition
Rifampin, rifabut if HIV
INH
pyrazinamide
Ethambutol or streptomycin
FOR 9 months, all 4 given for 1 month while suscep is det. |
|
|
Term
|
Definition
| Daily tx with INH-rifampin, PZA,EMB at home or in hospital |
|
|
Term
| Treatment of Mycobacterium avium in HIV pats |
|
Definition
| clarithromycin or azithroxycin + ethambutol + rifampin, or rifabutin |
|
|
