Villanueva, Charisse Mae G. N2D DRUG ANALYSIS Generic name/ Medication 1.

Isoniazid Class and Dosage Route Adults: 5-300 mg/kg/day Pediatrics: 1015-300 mg/kg/day Oral Intake OD Mechanism of Action Bactericidal: Interferes with lipid and nucleic acid biosynthesis in actively growing tubercle bacilli. Side Effects/Adverse Effects

Contraindications

Nursing Management Responsibilities

CNS: Peripheral neuropathy GI: Nausea and vomiting, epigastric distress, hepatitis Hematologic: Thrombocytopenia

Contraindicated with allergy to isoniazid, isoniazidassociated hepatic injury or other severe adverse reactions to isoniazid, acute hepatic disease Use cautiously with renal impairment, lactation, pregnancy

Give on an empty stomach, 1 hr before or 2 hr after meals; may be given with food if GI upset occurs. Give in a single daily dose. Reserve parenteral dose for patients unable to take oral medications. Tell the patient to decrease foods containing

tyramine or histamine in patients diet.

2. Rifampacin (Rifampin) Adults: 10 mg/kg/day; not to exceed 600mg Pediatric: Older than 5yr: 10-20 mg/kg/day Oral Intake OD Inhibits DNAdependent RNA polymerase activity in susceptible bacterial cells. CNS: Headache, drowsiness, fatigue, dizziness Dermatologic: Rash, pruritus GI: Heartburn, epigastric distress GU: Acute renal failure Hematologic: Eosinophilia, thrombocytopenia, transient leucopenia Contraindicated with allergy to any rifamycin, acute hepatic disease, lactation. Use cautiously with pregnancy

Assess for any allergic reactions Remind the patient that the medicine is to be taken once a day only Arrange for follow-up visits for liver and renal function tests, CBC, and opthalmologic examinations. Assess for any allergic reactions. Administer only in

3. Pyrazinamide Adults and pediatrics: 10-30 mg/kg/day

Bacteriostatic or bacteriocidal against M. tuberculosis; mechanism of

Dermatologic: Rashes, photosensitivity GI: Hepatoxicity, nausea and vomiting, Contraindicated with allergy to pyrazinamide, acute hepatic disease, lactation,

Oral Intake OD

action is unknown.

diarrhea, anorexia Hematologic: Clotting mechanism or vascular integrity

active gout. Use cautiously with DM, acute intermittent porphyria, pregnancy.

conjunction with other antituberculosi s.

Remind the patient that the medicine is to be taken once a day only. Assess for any allergic reactions.

4. Ethambutol HCl Adults: 15 mg/kg/day Pediatrics: Not recommended for patients younger than 13 yr. Oral Intake OD Inhibits the synthesis of metabolites in growing mycobacterium cells, impairing cell metabolism, arresting cell multiplication, and causing cell death. CNS: Optic neuritis, fever, malaise, headache GI: Anorexia, nausea and vomiting, Hypersensitivity: Allergic reactions dermatitis, pruritus Contraindicated with allergy to ethambutol; optic neuritis. Use cautiously with impaired renal function, lactation, pregnancy, visual problems.

Tell the patient to administer the medicine with food if GI upset occurs. Remind the patient that the medicine is to be taken once a day only.

 Ototoxicity, nausea, vomiting, eosinophilia, exfoliative dermatitis, hypersensitivity reaction

Antibiotic 5. Streptomycin Sulfate Adults: 15 mg/kg/day Intra Mascular 2-3 times a wk

Inhibits protein synthesis by binding directly to 30S ribosomal unit.

Contraindicated in patients hypersensitive to drugs or other aminoglycoside in patients with labyrinthine dose. Contraindicated for pregnant women.

Assess patients infection before starting therapy, and regularly thereafter to monitor the drugs effectiveness. Obtain specimen for culture and sensitivity tesst befre first dose except when treating tuberculosis. Start therapy pending test result. Be alert for adverse reactions and drug interactions. protect hands while

preparing the drug because drug is irritating. instruct patient to report hearing loss, roaring noises, or fullness in ears and dizziness immediately.