Antitubercular Drugs

Question 1

Isoniazid

Chemical Classification

Answer 1

Isonicotinic acid hydrazide

Question 2

Isoniazid

Mechanism of Action

Answer 2

Bactericidal interference with lipid, nucleic acid biosynthesis

Question 3

Isoniazid

Uses

Answer 3

Treatment, prevention of TB

Question 4

Isoniazid

Contraindications

Answer 4

Hypersensitivity

Acute Hepatic Disease

Question 5

Isoniazid

Side Effects

Answer 5

CNS: Peripheral Neuropathy, Dizziness, memory impairment, TOXIC ENCEPHALOPATHY, SEIZURES, psychosis, slurred speech
EENT: blurred vision, optic neuritis
GI: Nausea, Vomiting, epigastric distress, JAUNDICE, FATAL HEPATITIS
HEMA: AGRANULOCYTOSIS, HEMOLYTIC, APLASTIC ANEMIA, THROMBOCYTOPENIA, EOSINOPHILIA, METHEMOGLOBINEMIA
HYPERSENSITIVITY: fever, skin eruptions, lymphadenopathy, vasculitis
MISC: Dyspnea, B6 deficiency, pellagra, hyperglycemia, metabolic acidosis, gynecomastia, rheumatic syndrome, SLE-like syndrome

Question 6

Isoniazid

Nursing Considerations

Answer 6

ASSESS:

• Hepatic studies weekly: ALT, AST, bilirubin; increased test results may indicate hepatitis; hepatic status: decreased appetite, jaundice, dark urine, fatigue
• mental status often: affect, mood, behavioral changes; psychosis may occur
• paresthesia in hands, feet

Question 7

Isoniazid

Overdose Treatment

Answer 7

Pyridoxine

Question 8

Rifampin

Functional Classification

Answer 8

Antitubercular

Question 9

Rifampin

Chemical Classification

Answer 9

Rifamycin B derivative

Question 10

Rifampin

Mechanism of Action

Answer 10

Inhibits DNA-dependent polymerase, decreases tubercle bacilli replication

Question 11

Rifampin

Uses

Answer 11

Pulmonary TB, meningococcal carriers (prevention)

Question 12

Rifampin

Contraindications

Answer 12

Hypersensitivity to this product, rifamycins; active Neisseria meningitidis infection

Question 13

Rifampin

Side Effects

Answer 13

CNS: headache, fatigue, anxiety, drowsiness, confusion
EENT: visual disturbances
GI: Nausea, Vomiting, Anorexia, Diarrhea, PSEUDOMEMBRANOUS COLITIS, Heartburn, sore mouth and tongue, PANCREATITIS, increased LFTs
GU: HEMATURIA, ACUTE RENAL FAILURE, HEMOGLOBINURIA
HEMA: HEMOLYTIC ANEMIA, ANEMIA, EOSINOPHILIA, THROMBOCYTOPENIA, LEUKOPENIA
INTEG: rash, pruritus, urticaria
MISC: flulike symptoms, menstrual disturbances, edema, SOB, STEVENS-JOHNSON SYNDROME, TOXIC EPIDERMAL NECROLYSIS, ANGIEDEMA, ANAPHYLAXIS
MS: ataxia, weakness

Question 14

Rifampin

Nursing Considerations

Answer 14

ASSESS:

• INFECTION: sputum culture, lung sounds, characteristics of sputum
• Signs of anemia: Hct, Hgb, fatigue
• Hepatic studies monthly: ALT, AST, bilirubin
• Renal status before, each mo: BUN, creatinine, output, specific gravity, urinalysis
• Hepatic status: decreased appetite, jaundice, dark urine, fatigue
• SERIOUS SKIN REACTIONS: fever, sore throat, fatigue, ulcers; lesions in mouth, lips, rash; can be fatal
• PSEUDOMEMBRANOUS COLITIS: diarrhea, fever, abdominal pain/cramping, bloody stools, product should be discontinued, prescriber notified

Question 15

Isoniazid

Functional Classification

Answer 15

Antitubercular