Rifampicin Flashcards
What are the indications for rifampicin
Brucellosis
Endocarditis
Legionnaires disease
Meningococcal meningitis
Multibacillary and paucibacillary leprosy
Tuberculosis
What are the cautions and contraindications for rifampicin
Acute porphyrias
Jaundice
What are the monitoring requirements for rifampicin
Renal and hepatic function should be checked before
FBC should be monitored in patients on prolonged therapy
Whats rifampicins mechanism of action
Semisynthetic antibiotics; inhibits DNA dependent RNA polymerase activity so suppresses synthesis
Bactericidal
What bacteria is rifampicin effective against
Most atypical strains of myobacteria
What are the interactions associated with rifampicin
DOAC’s and warfarin
PDE-5 inhibitors
Ciclosporin
Macrolide
Clozapine
Contraception - pop, coc, ulipristak acetate
Mycophenolate
Verapamil
What are the patient and carer advice?
May discolour contact lenses
Discontinue treatment and seek immediate medical attention if symptoms such as persistent nausea, vomiting, malaise or signs of jaundice develop.
What is rifampicins effect on the cyp enzyme substrates?
Potent enzyme inducer - the mother of all inducers
Adverse effects of rifampicin
agranulocytosis
nausea/vomiting
menstrual disorders
thrombocytopenia
Tear discolouration
Urine discolouration
Soft contact lenses discolouration
Psychosis
IV use: bone pain, GI disorder, hyperbilirubinaemia, psychosis
