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Antituberculosis drugs
1. PREPARED BY:
USHA RANI KANDULA,
ASSISTANT PROFESSOR,
DEPARTMENT OF ADULT HEALTH NURSING,
ARSI UNIVERSITY,ASELLA,ETHIOPIA,
SOUTH EAST AFRICA.
2. Antituberculosis drugs are medicines used to
treattuberculosis, an infectious disease that can
affect the lungs and other organs.
Tuberculosis management refers to the medical
treatment of the infectious
disease tuberculosis (TB).
6. Mechanism of action:
bactericidal, may inhibit the synthesis of mycolic
acid,which are important component of
mycobacterial cell wall resulting in cell wall
disruption.
Dose : 300-400mg/oral
7. Mechanism of action:
It is a bactericidal drug, it inhibits DNA-
dependent RNA polymerase activity in bacterial
cells .
Dose : 450-600 mg oral
8. Mechanism of action:
Bactericidal drug, which inhibits the acid PH in
M. tuberculosis.
Dose : 1,200-1,500 mg oral
10. Mechanism of action:
It is bacteriostatic, it inhibits the incorporation of
mycolic acids into the mycobacterial cell wall by
inhibiting certain enzymes ( arabinosyl
transferases ) involved it .
Dose : 800-1,000 mg or 25mg/kg oral.
11. Mechanism of action:
It is bacteriostatic drug.
Dose : 150 mg or 2.5 mg/kg oral.
12. Mechanism of action:
It inhibits mycolic acid synthesis, an essential
component of the bacterial cell wall.
Dose: 10-20 mg/kg/day divided bid/tid oral
No more than 1,000 mg/day.
13. Mechanism of action:
There are two mechanisms responsible for PAS
bacteriostatic action against M.tuberculosis.
Firstly, PAS inhibits bacterial folic acid synthesis.
Secondly,PAS may inhibit the synthesis of the cell
wallcomponent,
Mycobactin, thus reducing iron uptake by
M.tuberculosis.
14. Dose : 200-300 mg/kg/day as devided in 2-4
equal doses,
Not to exceed 10g/day.
15. Mechanism of action:
It inhibits alanine racemase and D-alanine.
D-alanine ligase, both enzymes are essential in
the synthesis of peptidoglycan and subsequently
in cell wall biosynthesis and maintenance.
Dose : 500-750 mg oral in 2-3 devided doses or
10-20 mg/kg/day.
16. Mechanism of action:
Same as Rifampicin
Dose and route :
300 mg daily oral or 5-10mg/kg.
17. Mechanism of action:
Same as Rifampicin
Weekly once
-10-14 kg : 300mg
>14-25 kg : 450 mg
>25-32kg : 600mg
>32-49.9 kg : 750 mg
50kg or more : 900 mg maximum.
18. Mechanism of action:
Inhibition of phospholipase and effects on
potassium transporters.
Dose and route :
50-100mg oral bd/od
19. Mechanism of action:
Inhibits mycobacterial adenosine 5-triphosphate
(ATP) synthase , an enzyme essential for the
generation of energy in mycobacterium
tuberculosis.
20. Weeks 1-2: 400mg/day for 2 weeks.
Weeks 3-24 : 200 mg 3 times / week for 22 weeks.
21. Ciprofloxacin
Ofloxacin
Moxifloxacin
Gatifloxacin
Levofloxacin
Sparfloxacin
-used as second line tuberculosis drugs.
25. The government of india along with world health
organization (WHO) and world bank has
reviewed national TB programme and has now
revised the strategy as Revised national
tuberculosis control programme ( RNTCP), which
was introduced in 1993.
26. The directly observed treatment short - course
therapy (DOTS) has emerged as a possible
solution to the rising number of TB cases in
different parts of the world and has been
incorporated in india”s RNTCP
27. For the treatment of drug - resistant , the current
TB drugs are grouped according their
effectiveness, experience of use and drug class
by WHO :
33. Drugs that are active against resistant forms of
TB are less potent, more toxic and need to be
taken for a long time > 18 months.
34. Assess
Signs of anemia ( Hb),fatigue,liver function
test,renal function test.
Allergy to any of the drugs in the regimen
Isolation of patients and barrier nursing.
35. Isoniazid (INH) and Rifampicin 1 hour before
food.
Other agents 2 hour after food.
Antiemitics as prescribed if vomiting .
36. Importance of compliance with dosage schedule,
duration if necessary.
Rifampicin may colour the body fluids
red/orange.
That scheduled follow up with prescriber should
be kept since relapse can occur.
To avoid alcohol while taking the drug.
37. To report flu-like symptoms : excessive fatigue,
anorexia,vomiting, sore throat, unusual
bleeding, and yellow discoloration of skin / eyes.
38. To dispose of sputum carefully and to wear mask
to prevent transmission.
Advise the patient to take foods rich in vitamin
B6 other wise neuropathies can develop.