Generic name: name: Isoniazid Brand name: Niazid name: Niazid General Action: Antituberculotic Action: Antituberculotic This medication is used with other o ther medications to treat active tuberculosis (TB) infections or alone to prevent those who have a positive TB test from developing symptoms of TB. Isoniazid belongs to a class of drugs known as antibiotics that are active against tuberculosis. Interferes with lipid and nucleic acid biosynthesis in actively growing tubercle bacilli. Indications:
Tuberculosis of all forms
Prophylaxis in specific patients who are tuberculin reactors (positive Mantoux test) or who are considered to be high risk for TB.
Contraindication: Isoniazid is contraindicated in patients who develop severe hypersensitivity reactions, including drug -induced hepatitis; previous isoniazid-associated hepatic injury; severe adverse reactions to isoniazid such as drug fever, chills, arthritis; and acute liver disease of any etiology. Stock dose: Tablets: 100,300 mg; syrup 50mg/5ml; injection 100 mg/ml
Side effects:
Peripheral neuropathy
Nausea and vomitting
Thrombocytopenia
Local irritation at IM site
Epigastric distress
Elevated AST
Nursing Responsibilities:
History: allergy to the drug.
Can cause peripheral neuropathy which is manifested by tingling sensation on extremities. It can be prevented through use of supplemental vitamin B6 (pyridoxine).
Physical: skin color, lesions, T; orientation, reflexes, peripheral sensirivity, bilaterally grip strength ophthalmologic examination; R, adventitious sounds; liver evaluation; CBC;LFTs renal fxn tests, blood glucose.
Give in an empty stomach 1 hr before or 2 after meals; may be given with food if GI UPSET OCCURS.
Give in a single daily dose. Reverse parenteral dose for pt unable to take oral meds.
Dec. foods containing tyramine or histamine in pt diet.
Consult doctor and arrange for daily pyridoxine in diabetic, alcoholic or malnourished pt also for pt that develops peripheral neuritis, and those with HIV.
Family health teachings:
Take this drug in single daily dose.
Take drug on an empty stomach, 1 hour before or 2 hours after meals. If GI distress occurs, may be taken with food.
Take this drug regularly, avoid missing doses, do not discontinue without first consulting your health care provider.
Do not drink alcohol or drink as little as possible. There is an inc. risk of heap if these two drugs are combined.
Avoid foods containing tyramine, consult a dietitian to obtain a list of foods containing tyramine or histamine.
Have periodic medical check-ups, including an eye examination and blood test, to evaluate the drug effects.
Report for weakness, fatigue, loss of appetite, n/v, yellowing of skin or eyes, darkening of the urine, numbness or tingling in hands or feet.
Generic Name: rifampicin/rifampin Brand Name: Rifadin, Rimactane General Action: Antibiotic, Antituberculotic (first line) Stock Dose: Capsules-150,300mg; powder-600mg Specific Action: Inhibits DNA-dependent RNA polymerase activity in susceptible bacterial cells.
Indications of Rifampicin
Treatment of Pulmonary TB in conjunction with at least one other effective antituberculotic.
Neisseria meningitidis carriers, for asymptomatic carriers to eliminate meningococci from nasopharynx; not for treatment of meningitis.
Unlabeled uses: Infections caused byStaphylococcus aureus and Staphylococcus epidermis,
usually
in
combination
infancy; Legionella
pneumophilia,
combination
dapsone); prophylaxis
with
not
therapy; gram-negative responsive of
to
bacteremia in
erythromycin;leprosy (in
meningitis caused
by Haemophilis
influenzae.
Contraindications of Rifampicin
Contraindicated with allergy to any rifamycin, acute hepatic disease, lactation.
Use cautiously with pregnancy (teratogenic effects have been reported in preclinical studies; safest antituberculous regimen for use in pregnancy is condidered to be rifampin, isoniazid, and ethambutol).
Adverse Effects of Rifampicin
CNS: headache, drowsiness, fatigue, dizziness, inability to concentrate, mental confusion, generalized numbness, muscle weakness, visual disturbances.
Dermatologic: Rash, pruritus, urticaria, flushing, reddish discoloration of body fluids — tears, saliva, urine, sweat, sputum.
GI: heartburn,
distress,
anorexia,
vomiting
gas,
cramps,
diaarhea,
hepatitis,
pancreatitis.
GU: hemoglobinuria, hematuria, renal insufficiency, acute renal failure, menstrual disturbances.
Hematologic: eosinophilia,
thrombocytopenia,
transient
leucopenia,
hemolytic
anemia, decreased Hgb, hemolysis.
Other: pain in extremities, osteomalacia, myopathy, fever, flulike symptoms
Nursing Responsibilities of Rifampicin
Administer on an empty stomach, 1 hr before or 2 hr after meals.
Administer in a single daily dose.
Consult pharmacist for rifamoin suspension for patients unable to swallow capsules.
Prepare patient for the reddish-orange coloring of body fluids (urine, sweat, sputum, tears, feces, saliva); soft contact lenses may be permanently stained; advise patients not to wear them during therapy.
Warning: arrange for follow-up visits for liver and renal function tests, CBC, and ophthalmic examinations.
Health Teachings during Rifampicin Therapy
Teach client to take drug in a single daily dose. Take on an empty stomach, 1 hr before or 2 hrs after meals.
Inform client to take this drug regularly; avoid missing any doses; do not discontinue this drug without consulting the health care provider.
Tell client to have periodic medical checkups, including eye examinations and blood test, to evaluate the drug effects.
Inform client that he may experience the drug’s side effects (especially the red colored secretion)
Instruct client to see his physician if he experience fever, chills, muscle and bone pain, excessive tiredness or weakness, loss of appetite, N/V, yellowing of eyes/skin, unusual bleeding or bruising, skin rash or itching.
Instruct client to remove contact lenses as they may discolor
