Tuberculosis Medications Sheet PDF

Lakeland Community College NURS 1250/1610 Antitubercular Agents I. Antitubercular agents are...

Lakeland Community College NURS 1250/1610 Antitubercular Agents I. Antitubercular agents are used to treat tuberculosis (TB) caused by Mycobacterium tuberculosis, a necrotizing infection most commonly affecting the lungs. II. Common Antitubercular Agents A. Isoniazid (INH) 1. Pharmacodynamics/action: INH inhibits cell wall synthesis and metabolism as well as growth of dormant organisms; it also actively kills growing bacteria in the extracellular environment. 2. Pharmacotherapeutics/indications: Used for prophylaxis in patients exposed to active disease and treatment of active TB. 3. Side/adverse effects: a. CNS: insomnia, muscle twitching, peripheral neuropathy from vitamin B6 deficiency (this is the most common effect and is manifested as tingling and numbness in the extremities), convulsions, psychotic episodes. b. Derm: skin rash. c. GI: hepatitis, GI distress, transient elevation of liver enzymes, nausea, vomiting. d. Heme: blood dyscrasias. e. Other: fever. 4. Nursing management: a. Be aware that pyridoxine deficiency increases the risk of peripheral neuropathy. Vitamin B6, 50 mg daily, may be prescribed to prevent neuropathy. B. Rifampin 1. Pharmacodynamics/action: Rifampin inhibits RNA synthesis by blocking RNA transcription in susceptible organisms 2. Pharmacotherapeutics/indications: Used in combination with other tubercular agents because resistance develops rapidly when used alone. 3. Nursing management: Teach the patient that red-orange discoloration of body fluids (urine, saliva, sweat, tears) occurs with this drug and note possible permanent staining of contact lens. C. Ethambutol  1. Pharmacodynamics/action: The exact mechanism is unknown; ethambutol probably inhibits bacterial RNA synthesis affecting protein metabolism, arresting cellular multiplication and causing cell death. 2. Pharmacotherapeutics/indications: Used for treatment of active TB in combination with other drugs 3. Side/adverse effects: EENT: optic neuritis, decreased visual acuity. 4. Nursing management: Instruct the patient regarding the need for visual acuity testing and red-green color perception screening before and during treatment. Report visual changes immediately. D. Pyrazinamide: used in combination with other antitubercular agents; dose related hepatotoxicity is the major adverse side effect. E. Rifater (rifampin/isoniazid/pyrazinamide) 1. Rifater is a combination product used in the initial phase of short-course treatment of pulmonary TB. *This overview has been provided to enhance learning. Use a published drug source to identify data important to a specific patient.