Antitubercular Flashcards
Kills bacteria
Bactericidal
Prevents growth of bacteria (keeps them in the stationary phase of growth
Bacteriostatic
Antitubercular drugs are either
bactericidal or bacteriostatic
General side effects of antitubercular drugs
Differ according to the drug prescribed
INH- peripheral neuropathy
Rifampin might cause body fluids to turn orange
Hepatotoxicity adverse reaction of many antitubercular drugs
Headaches, blood dyscrasias, GI distress, ocular toxicity may be developed
Intended responses of antitubercular drugs
Reduced cough
Reduced sputum production
Reduced fatigue
Weight gain
Negative sputum culture
Antitubercular drug used to treat active TB and as a prophylactic measure against TB (inhibits bacterial cell-wall synthesis).
Bactericidal or bacteriostatic depending on drug concentration.
Isoniazid (INH)
Side effects & adverse effects of INH
Side effects:
Drowsiness, tremors, photosensitivity, tinnitus, N/V, dry mouth, constipation
Adverse effects:
Peripheral neuropathy, hepatotoxicity, psychotic behavior, seizures, optic neuropathy (usually reversible but may cause permanent vision loss), blood dyscrasias, thrombocytopenia, agranulocytosis
NOTE: risk of neuropathy decreased with Vitamin B-6
What is the most serious side effect w/ INH?
Hepatitis is the most serious adverse effect associated with INH
Pt teaching for INH
Take INH 1 hour before meals or 2 hours after meals.
Avoid caffeine, avoid alcohol.
Collect sputum specimen in early morning.
Take pyridoxine (vitamin B6) to prevent peripheral neuropathy.
Check liver enzymes, CBC.
Need frequent eye examinations
Report numbness, tingling, burning.
Teach sun precautions, to avoid antacids
Antitubercular drug that inhibits enzyme needed for protein synthesis
Rifampin
Side effects & adverse effects of Rifampin
Side effects: Abdominal pain, urinary retention, reddish-orange secretions
Adverse effects: Liver toxicity (so use caution in older patients, alcoholics, and chronic liver disease)
Generally well tolerated, most common adverse reactions include N/V, rash
Antitubercular drug that is bacteriostatic; inhibits cell wall synthesis
Ethambutol
Side effects & adverse effects of Ethambutol
Side effects: increase uric acid (use with caution in patients with gout)
Adverse effects: hepatotoxicity, optic neuropathy (in high doses)
Most important adverse effect of Ethambutol
optic neuritis- results in visual acuity and loss of ability to discriminate between red and green
Antitubercular drug with unknown mechanism of action
Pyrazinamide (PZA)
Side effects & adverse effects of Pyrazinamide (PZA)
Side effects: increase uric acid, aches, pains, photosensitivity, acne
Adverse effects: Liver toxicity
First line TB drugs
Isoniazid (INH), Ethambutol, Pyrazinamide, and Rifampin
Nursing interventions for antitubercular drugs
-Administer INH 1 hour before or 2 hours after meals.
-Give pyridoxine (vitamin B6) as prescribed with INH to prevent peripheral neuropathy.
-Monitor hepatic function tests.
-Monitor blood glucose and CBS
-Emphasize importance of complying with drug regimen.
-Referral for public health recommendations
What is Directly Observed Therapy (DOT)?
Health-care worker watches patient swallow each dose.
DOT is preferred management strategy for all patients.
Can reduce acquired drug resistance, treatment failure and relapse.
Nearly all regimens can be intermittent if given as DOT.
DOT reduces total number of doses and encounters.
For drug-resistant TB, use daily regimen and DOT.
Pt teaching for antitubercular drugs
-Keep supply of prescribed drugs on hand at all times
-Continue taking drugs exactly as prescribed!
-Avoid alcohol
-Manage side effects
-No OTC drugs, including herbal supplements, unless approved by prescriber
