The Role of the Pharmacist in Tuberculosis Management is organized by Alaska Pharmacists Association (AKPhA) and will be held from Feb 15, 2018 - Feb 15, 2021. This CME Conference has been approved for a maximum of 1.5 CPE Hours.
The goal of this lesson is to provide an overview of the official American Thoracic Society/Centers for Disease Control and Prevention/Infectious Diseases Society of America clinical practice guidelines for the treatment of drug-susceptible tuberculosis.
Tuberculosis is one of the most deadly diseases worldwide. It is spread from person to person via inhalation of airborne droplets containing Mycobacterium tuberculosis, an acid-fast bacillus. Patients with latent TB show no outward signs or symptoms of infection and, therefore, are generally unable to spread TB bacteria to others. Those with active TB, however, commonly display symptoms of infection (i.e., excessive cough, chest pain, weakness/fatigue, etc.) and are capable of spreading TB bacteria to others as an airborne pathogen. It has been well-established that appropriate treatment of TB renders the patient noninfectious, prevents drug resistance, minimizes the risk of TB-related disability or death, and nearly eliminates the potential for relapse.
Treatment of TB focuses on both curing the individual patient and minimizing the transmission of M. tuberculosis to others. Hence, successful treatment of TB is beneficial for both the individual patient and the community in which the patient resides.
A four-drug treatment regimen of isoniazid, rifampin, pyrazinamide, and ethambutol remains the recommended initial treatment for drug-susceptible TB. Pharmacologic therapy should be initiated promptly, often before microscopy, molecular tests, and/or bacterial culture results are known. While INH, RIF, PZA, and EMB are the four most common agents utilized for treatment of active TB, other agents such as fluoroquinolones, cycloserine, and ethionamide may be necessary in specific complex patient populations such as patients with extensive TB disease, those with documented treatment failure to the preferred therapeutic agents, patients with cavitation on chest X-ray, and those with concomitant HIV.
At the completion of this activity, the participant will be able to:
• recognize both the national and worldwide impact of tuberculosis;
• identify risk factors and clinical presentation of patients with active tuberculosis infection;
• demonstrate an understanding of the goals of therapy and treatment modalities associated with latent infection and active disease;
• recognize the role of therapeutic drug monitoring in specific patient populations;
• identify pharmacologic options for the treatment of latent, active, and drug-resistant tuberculosis, including common adverse effects; and
• identify common drug-drug interactions associated with particular antituberculosis agents.
Infectious Disease, Pulmonary Medicine, Pharmacy and Medicine