Generic name:

Brand name: Myambutol, Servambutol

Classification: Antituberculotic

Action

Ethambutol is bacteriostatic against actively growing TB bacilli, it works by obstructing the formation of cell wall. Mycolic acids attach to the 5′-hydroxyl groups of D-arabinose residues of arabinogalactan and form mycolyl-arabinogalactan-peptidoglycan complex in the cell wall. It disrupts arabinogalactan synthesis by inhibiting the enzyme arabinosyl transferase. Disruption of the arabinogalactan synthesis inhibits the formation of this complex and leads to increased permeability of the cell wall.

Indication

Ethambutol eliminates certain bacteria that cause tuberculosis (TB). It is used with other medicines to treat tuberculosis and to prevent you from giving the infection to others.

This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.

Side-effects

• loss of appetite
• upset stomach
• vomiting
• numbness and tingling in the hands or fee
• optic neuritis–blurring of vision

Contraindication

Ethambutol hydrochloride is contraindicated in patients who are known to be hypersensitive to this drug. It is also contraindicated in patients with known optic neuritis unless clinical judgemnet determines that it may be used. Ethambutol hydrochloride is contraindicated in patients who are unable to appreciate and report visual side ettects or changes in vision (eg, young children, unconscious patients).

Stock Dose

• 100mgs

Nursing Responsibilities

• Assess patient for infection (appearance of wounds, sputum, VS, urine and stool and WBC.) at beginning and during therapy.
• Obtain specimens before initiating therapy. Take drug as indicated.
• Not to be given to children 6 years below due to optic neuritis
• Provide supplemental vitamin A. if not contraindicated

Ethambutol (Myambutol) Drug Study Original source at: Nurseslabs

Generic name

Brand name: Niazid

General Action: Antituberculotic

This medication is used with other 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,

Isoniazid (Niazid) Drug Study Original source at: Nurseslabs

Generic Name:

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 by Staphylococcus aureus and Staphylococcus epidermis, usually in combination therapy; gram-negative bacteremia in infancy; Legionella pneumophilia, not responsive to erythromycin; leprosy (in combination with dapsone); prophylaxis of 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

Rifampicin (Rifadin) Drug Study Original source at: Nurseslabs

Generic Name:

General Action: Antibiotic, anti-tubercular,anti-infective

Streptomycin Specific Action

• Inhibits CHON synthesis strains of gram negative bacteria, mechanisms of lethal action and fully understood, but functional integrity of cell membrane appears to be disrupted.

Streptomycin Indication

• Infections caused by susceptible strain of mycobacterium tuberculosis.
• Serious infections caused by susceptible strains of Yersinia Pestis

Streptomycin Contraindication

• Allergy to aminoglycosides, pregnancy, lactation, Herpes vacinia fungal infection.

Streptomycin Stock Dose

• 1 gram* / vial
• *Each vial contains Streptomycin Sulfate USP equivalent to 1 gram Streptomycin.

Streptomycin Nursing Responsibilities

• Use in route only: give by deep IM injection.
• Ensure adequate hydration of patient before and during the therapy.
• Monitor for hearing changes.
• This drug can only be given by injection.
• Report hearing changes,dizziness, pain at injection site, rash.

Streptomycin Drug Study Original source at: Nurseslabs