PNN -- TB review QUESTIONS WITH COMPLETE SOLUTIONS

According to the current guidelines, which of the following should be included in the treatment plan of a patient taking INH? I. Monitoring Renal function II. Baseline liver function test III. Pyridoxine 50mg po QD correct answer: 2 & 3 INH (Isoniazid) reduces vitamin B6 level, therefore Vitamin B6 (Pyridoxine) is added to the treatment regimen. The recommended first line choice is INH 300 mg po qd PLUS Pyridoxine (Vitamin B6) 50 mg po qd, both for 9 months. Baseline LFT is obtained prior to starting INH, but periodic LFT check is NOT recommended, unless patient is high risk or signs and symptoms indicate otherwise Which of the following medications used to treat tuberculosis can cause hepatotoxicity? Select ALL that apply. A. Isoniazid B. Rifampin C. Pyrazinamide D. Ethambutol E. Bedaquiline correct answer: A, B, C, E Hepatotoxicity may be caused by isoniazid (INH), rifampin (RIF), pyrazinamide (PZA), and Bedaquiline. Patients receiving antituberculous therapy should undergo baseline measurement of LFT. Which TB medications can increase uric acid levels? correct answer: Pyrazinamide & Ethambutol Which TB medications need to be dose adjusted in renal impairment? correct answer: Pyrazinamide & Ethambutol What are some common side effects of Rifampin? correct answer: hypersensitivity (petechial rash) thrombocytopenia -- d/c, do not re-challenge red/orange discoloration of fluids flu-like syndrome How should rifampin be taken? correct answer: empty stomach Which of the following TB medications can decrease the effectiveness of oral contraceptives and warfarin?