Comprehensive Nursing Pharmacology Q 145

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Antitubercular therapy may be determined ineffective when:

  

     A. Sputums are negative

     B. Symptoms resolve

     C. Hepatitis results

     D. Drug-resistant bacteria emerge

    

    

Correct Answer: D. Drug-resistant bacteria emerge.

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The emergence of drug-resistant bacteria indicates that antitubercular therapy is ineffective because the drug(s) are no longer ending bacterial multiplication. A feared complication of tuberculosis therapy is multi-drug-resistant tuberculosis(MDR-TB). MDR-TB is distinguished from its resistance to first-line medications isoniazid and rifampin. Therapy for MDR-TB is steadily advancing, and suggestions are continually changing.

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Option A: A negative sputum is the desired effect. Second-line drugs that are in common use for MDR-TB are kanamycin, capreomycin, and amikacin via injections.[4] Fluoroquinolones such as levofloxacin, moxifloxacin, and gatifloxacin and are also amongst the common second-line agents used when drug resistance develops to the first-line agents.

Option B: Resolved symptoms is the desired effect of the therapy. Drugs that have recently received FDA approval for the multi-drug resistant TB are pretomanid, used in sequence with bedaquiline, and linezolid.

Option C: Liver function tests should be monitored routinely as rifampin, isoniazid, pyrazinamide, and ethambutol all may exert hepatotoxic effects. All first-line antitubercular medications, rifampin, isoniazid, pyrazinamide, and ethambutol can exert hepatotoxic effects. A continual rise in liver functions test should prompt discontinuation of treatment.

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