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Finc nursing choaching agra antituberculin drug
- 2. INTRODUCTION- • THE DRUGS WHICH ARE USED IN THE TREATMENT OF TUBERCULOSIS ARE CALLED ANTITUBERCULAR DRUGS .
- 3. CLASSIFICATION- • ACCORDING TO THEIR CLINICAL UTILITY THE ANTITUBERCULAR DRUGS CAN BE DIVIDED INTO- • FIRST LINE DRUGS - THESE DRUGS HAVE HIGH ANTITUBERCULAR EFFICACY AS WELL AS LOW TOXICITY ARE USED ROUTINELY • SECOND LINE DRUGS – THESE DRUGS HAVE EITHER LOW ANTITUBERCULAR EFFICACY OR HIGHER TOXICITY OR BOTH AND ARE USED AS RESERVE DRUGS.
- 4. FIRST LINE DRUGS - • ISONIAZID • RIFAMPIN • PYRAZINAMIDE • ETHAMBUTOL • STREPTOMYCIN
- 5. SECOND LINE DRUGS - • ETHIONAMIDE • RIFAFABUTIN • OFLOXACIN • LEVOFLOXACIN • MOXIFLOXACIN • CIPROFLOXACIN • AMIKACIN • CAPREOMYCIN • PROTHIONAMIDE
- 6. ISONIAZID - • IT IS PRIMARILY TUBERCULOCIDAL . • ISONIAZID INHIBTS SYNTHESIS OF MYCOLIC ACIDS , WHICH ARE ESSENTIAL COMPONENTS OF MYCOBECTERIAL CELL WALLS • PHARMACOKINETICS – INH IS COMPLETELY ABSORBED ORALLY AND PENETRATES ALL BODY TISSUES , TUBERCULAR CAVITIES , PLACENTA AND MENINGES.
- 7. CONT… • METABOLISM- THE RATE OF INH ACETYLATION SHOWS GENETIC VARIATION • ADVERSE EFFECTS – -HEPATITIS -HEPATOTOXICITY PERIPHERAL NEURITIS
- 8. RIFAMPIN - • BACTERIOCIDAL • ACTS BEST ON SLOWLY OR INTERMITTENTLY DIVIDING ONES • BOTH EXTA AND INTACELLULAR ORGANISMS ARE AFFECTED • RIFAMPIN BINDS TO BACTERIAL DNA DEPENDENT RNA POLYMERASE AND THEREBY INHIBITS RNA SYNTHESIS
- 9. CONT… • PHARMACOKINETICS – IT IS WELL ABSORBED ORALLY . RIFAMPIN IS TO BE TAKEN IN EMPTY STOMACH • INTERACTIONS – RIFAMPICIN IS A MICROSOMAL ENZYME INDUCER
- 10. CONT… • ADVERSE EFFECT- • CUTENEOUS SYNDROME • FLU SYNDROME • ABDOMINAL SYNDROME • URINE AND SECRETIONS MAY BECOME ORANGE , RED BUT THIS IS HARMLESS
- 11. PYRAZINAMIDE - • CHEMICALLY SIMILAR TO INH . • IT IS WEAKLY TUBERCULOCIDAL • MORE ACTIVE IN ACIDIC MEDIUM • INHIBIT MYCOLIC ACID SYNTHESIS (CELL WALL SYNTHESIS INHIBITION)
- 12. CONT… • PARMACOKINETICS- PYRAZINAMIDE IS ABSORBED ORALLY , WIDELYBDISTRIBUTED -ADVERSE EFFECT – *HEPATOTOXICITY *HYPERURICEMIA *LOSS OF DIABETES CONTROL
- 13. ETHAMBUTOL- • TUBERCULOSTATIC • FAST MULTIPLYING BACILLI ARE MORE SUSCEPTIBLE • RENAL EXCRETION
- 14. CONT… • ADVERSE EFFECTS – • LOSS OF VISUAL ACUITY / COLOUR VISION , FIELD DEFECTS DUE TO OPTIC NEURITIS • HYPERURECEMIA
- 15. STREPTOMYCIN- • TUBERCULOCIDAL • ACTS ONLY ON EXTRACELLULAR BACILLI (BECAUSE OF POOR PENETRATION INTO CELLS)
- 16. SOME IMPORTANT POINTS- • ALL FIRST LINE DRUGS ARE BACTERIOCIDAL EXCEPT -ETHAMBUTOL • MOST POTENT FIRST LINE DRUG -RIFAMPIN • DRUG ACTING WEL IN ACIDIC AND INTRACELLULAR ENVIRONMENT – PYRAZINAMIDE
- 17. NURSING RESPONSIBILITY- • CARING WITH BEST ATTENTION ON MEDICATION • NURSES ARE PRIMARY RESPONSIBLE FOR DIRECT OBSERVATION THERAPY STRATEGY AND ADMINISTRATION OF ANTI TUBERCULOSIS • IDENTIFY SYMPTOMS THAT MAY INDICATE A SIDE EFFECT