CMN 568 Exam 3 - TB #1- Solved 100%

Treatment for LTBI purpose - ANSWER-- Essential to controlling and eliminating TB disease - Reduces risk of LTBI to TB disease progression - Use targeted testing to find persons at high risk for TB who would benefit from LTBI treatment - Several treatment regimens available LTBI TX meds - ANSWER-- Isoniazid (INH) - INH-rifapentine (RPT) - Rifampin (RIF) Isoniazid (INH) 9 month regimen - ANSWER-- Preferred - 270 doses within 12 months - Effective for HIV-infected as well as HIV-uninfected persons - Can be given twice weekly via DOT (76 doses within 12 months) - Preferred for children 2-11 years of age Isoniazid (INH) 6 month regimen - ANSWER-- Generally acceptable - 180 doses within 9 months - Can be given twice weekly via DOT (52 doses within 9 months) - Shorter regimen not recommended for children, immunosuppressed persons, persons whose x-rays suggest previous TB Adverse Reactions to INH - ANSWER-- Peripheral neuropathy (give vitamin B6 if patient has risk factors, or if s/s develop) - Fetal hepatitis (pregnant/postpartum women at increased risk; monitor closely) - Elevated liver enzymes (discontinue if liver enzyme levels exceed 3x normal with symptoms, or 5x upper limit of normal with no symptoms.Closely monitor if signs/symptoms of liver injury) INH-rifapentine (RPT) - ANSWER-- 3 month duration usually - Given in 12 once-weekly doses under DOT - Offers equal option to 9 months daily INH, but does not replace other treatment options for LTBI -Recommended for treating LTBI in other wise healthy people - 12 years of age who had recent contact with infectious TB, or who had a tuberculin skin test conversion or a positive blood test for TB infection -Can be considered for specific groups that would benefit (e.g., need to complete treatment in short time) Rifampin (RIF) - ANSWER-- Alternative to INH is 4 months daily - 120 doses within six months - Should not be used in HIV-infected persons being treated with some ART