Antitubercular Agents

Tuberculosis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Tb Infection may not cause disease ,[object Object],[object Object],[object Object]

Tuberculosis: Types ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Tuberculosis: Risk Factors ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Antitubercular Agents Trecator Ethionamide Seromycin Cycloserine Streptomycin (SM) Myambutol Ethambutol HCl (EMB) Pyrazinamide (PZA) Rifandin, Rimactane Rifampin (RIF) Laniazid Isoniazid (INH) TRADE GENERIC

Indications for drug therapy ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Patient Variables ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Prophylaxis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Treatment of active disease ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Tuberculosis: Resistance ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Patient Monitoring ,[object Object],[object Object],[object Object],[object Object],[object Object]

Patient Monitoring ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Isoniazid (INH) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

INH Pharmacokinetics ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Isoniazid (INH) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

INH: Patient Education ,[object Object],[object Object],[object Object],[object Object]

Pharmacokinetics Renal: active drug & metabolites Hepatic 80% & rapid Ethionamide Renal Hepatic Well absorbed Cycloserine Renal: Glomerular Filtration Hepatic PO: poor IM: rapid SM Renal: 80% Feces: 20% Hepatic-oxidation 75-80% EMB Renal Hepatic Well absorbed PZA Bile: 70% Urine: 30% Hepatic Readily RIF Renal Hepatic-acetylation genetic Interference with food INH EXCRETION METABOLISM ABSORPTION DRUG

Pharmacokinetics Wide Wide Well distributed Most tissues Most tissues Wide distribution 80% protein bound Diffuses to all body tissue DISTRIBUTION & PROTEIN-BINDING 3 hr Ethionamide 25-30 mcg/ml 12 hr 4-8 hr Cycloserine 25-50 mcg/ml 5-6 hr 1 hr SM Requires special assay 24 hr 2-4 hr EMB 9-12 mcg/ml 9-10 hr 2 hr PZA 4-32 mcg/ml 2-3 hr varies RIF 24 hr 1-2 hr varies INH THERAPEUTIC SERUM LEVEL ½-LIFE PEAK DRUG

Tuberculosis: Symptoms ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Tuberculosis: Exposure Testing ,[object Object],[object Object],[object Object],[object Object],[object Object]

Criteria for Positive Tb Skin Test ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Testing for Tb Exposure ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Testing for Tb Exposure ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Diagnosis of Active Tb ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Rifampin ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Rifampin ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Rifampin: Patient Education ,[object Object],[object Object],[object Object],[object Object]

Pyrazinamide (PZA) ,[object Object],[object Object],[object Object],[object Object],[object Object]

Pyrazinamide (PZA) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

PZA: Patient Education ,[object Object],[object Object]

Ethambutol HCl ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Ethambutol HCl ,[object Object],[object Object],[object Object]

Ethambutol HCl ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

EMB: Patient Education ,[object Object],[object Object],[object Object],[object Object],[object Object]

Cycloserine ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Cycloserine ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Cycloserine: Pt Education ,[object Object],[object Object],[object Object],[object Object]

Ethionamide (when 1st line Tx has failed) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Ethionamide: Pt Education ,[object Object],[object Object],[object Object]

Antitubercular Agents

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Antitubercular Agents