TB DRUGS Pharmacology 4th Semester slide.pptx

TB Drugs Pharmacology 4th Semester

1. DRUGS AFFECTING
THE RESPIRATORY
SYSTEM

2. Objectives
By the end of this presentation learners will be
able to:
 Define Anti-tuberculosis drugs
 List the category of Anti-tuberculosis drugs
 Describe indications, contraindications, and
adverse effects
 Discuss the nursing care and teaching for the
client taking drugs Anti-tuberculosis

3. CATEGORY

4. 11. ANTI-TUBERCULAR
Drugs are used to treat TB.
The drugs include:
RIPE
1.Isoniazid (INH)
2.Ethambutol
3.Pyazinamide
4.Rifampin
Streptomycin

5. ISONIAZID (INH)
Action:
•Prevents synthesis of mycolic acid ( integral part of the
mycobacteria cell wall)
Indication:
•Treatment or prophylaxis of TB
Contraindication:
•Acute liver disease
•Hypersensitivity
•Use cautiously in lactation, chronic alcoholism, individuals
over 35 years of age, chronic liver disease, seizure disorder

6. Cont…
Side effects/adverse effects:
•CNS: Peripheral neuropathy, paresthesias
•EENT: Visual disturbances, optic neuritis
•Fluid and electrolyte: Hyperkalemia, hypocalcemia,
hypophosphatemia
•GI: Elevated liver enzymes, hepatitis, decreased pyridoxine
(Vitamin B6)
•GU: Urinary retention in males
•Hematologic: Aplastic or hemolytic anemia
•Resp: Dyspnea
•Other: Hypersensitivity

7. Cont…
Nursing consideration:
•Compliance tends to be a problem as treatment is long
•Client education is very important for compliance
•Baseline tests of sputum culture and sensitivity and chest
X-ray are generally ordered
•Give PO and IM
•Monitor liver function tests
•Assess eye functions
•Assess BP during initial therapy as orthostatic
hypotension may occur

8. Cont…
•Ensure client is taking supplemental pyridoxine (Vitamin
B6)
•Administer on empty stomach. Can be given with food if
GI upset occurs
Teaching:
•Do not drink alcohol
•Do not breast-feed
•Stop drug if : jaundice, dark urine, clay-colored stools,
chills, fever, skin rash
•Report numbness or tingling in hands and feet to
physician

9. ETHAMBUTOL
Action:
•Prevents RNA synthesis in the mycobacteria cell wall
(stopping growth)
Indication:
•treat pulmonary TB(Combination with other anti-tubercular
agents)
•Contraindication:
•Hypersensitivity
•Lactation
•Children less than 13 years of age
•Optic neuritis

10. Cont…
Side effects/adverse effects:
•CNS: Dizziness, hallucinations, confusion, paresthesias
•EENT: Optic neuritis, loss of red-green color spectrum,
photophobia, eye pain
•GI: Abdominal pain, anorexia
•Other: Hypersensitivity
Nursing consideration:
•Treatment of TB involves a combination of drugs
•Compliance tends to be a problem as treatment is
long

11. Cont…
•Client education is very important for compliance
•Baseline tests of sputum culture and sensitivity and chest
X-ray are generally ordered
•Give PO
•Can give with food
•Monitor IO
•Assess eyes using ophthalmoscope
Teaching:
•Do not breast feed
•Report any eye problems

12. PYAZINAMIDE
Indication:
•Treat TB after primary drugs have not worked. (best in
early stages of treatment)
Contraindication:
•Liver disease
Side effects/adverse effects:
• Headache, Urticaria , Urination problems
•Hemolytic anemia, Photosensitivity, elevated uric acid,
gout, arthralagia,Liver failure

13. Cont…
Nursing consideration:
•Treatment of TB involves a combination of drugs
•Compliance tends to be a problem as treatment is
long
•Client education is very important for compliance
•Baseline tests of sputum culture and sensitivity and
chest X-ray are generally ordered

14. Cont…
•Give PO
•Assess for liver toxicity and bleeding tendencies
•Stop drug if gout or liver reactions occur
•Assess uric acid levels
Teaching:
•Do not breast-feed
•Tell physician of any urination problems
•Increase fluids

15. RIFAMPIN
Indication:
•Drug of choice for pulmonary TB
•Combination with other anti-tubercular agents
•Also used in treatment of leprosy
Contraindication:
•Hypersensitivity
•Lactation
•Disease caused by meningococci
•Use cautiously with alcoholics and in liver disease

16. Cont…
Side effects/adverse effects:
•CNS: Fatigue, drowsiness, confusion, dizziness, extremity
pain
•EENT: Visual impairments
•GI: Nausea, vomiting, abdominal cramps, diarrhea, liver
injury, hepatitis
•GU: Hematuria, renal failure
•Hematologic: Anemia, thrombocytopenia
•Other: Red-orange color of body secretions,
hypersensitivity, flu like syndrome

17. Cont…
Nursing consideration:
•Treatment of TB involves a combination of drugs
•Compliance tends to be a problem as treatment is long
•Client education is very important for compliance
•Baseline tests of sputum culture and sensitivity and chest
X-ray are generally ordered
•Give PO and IV
•Give on empty stomach
•Open capsule and mix with food or fluid if client is unable
to swallow
•Assess LFTs

18. Cont…
•Daily PT if client receiving anticoagulant
Teaching:
•Do not breast feed
•Do not stop and restart drug as flu-like syndrome may
occur
•Body secretions will be red-orange colored

19. STREPTOMYCIN
Action:
•It interfere with protein synthesis in bacteria. They enter
bacterial cell walls and bind to ribosomes. These
structures are necessary for protein synthesis to occur.
Indication:
•The main use is in the parenteral form to combat serious
infections that are caused by aerobic gram-negative
organisms.

20. Cont…
Contraindication:
•Allergic to streptomycin
•Cautiously in clients with Parkinson's disease
•Dehydration, liver or kidney disease, myasthenia gravis,
and hearing loss
Side effects/adverse effects:
•CNS: Weakness, depression, confusion, numbness,
tingling and neuromuscular blockade
•CV: Hypertension, hypotension and palpitations
•EENT: Ototoxcity

21. Cont…
•GI: Nausea, vomiting, diarrhea, stomatitis and weight loss
•GU: Nephrotoxicity
•Hematologic: Bone marrow depression
•Other: Hypersensitivity, joint pain, apnea
Nursing consideration:
•Give PO, topically, IM and IV
•Review history of any streptomycin reactions with client
•Do not mix penicillin's with streptomycin sides in same IV
solutions, as penicillin’s can deactivate streptomycin
•IV doses should be administered slowly at least over 30 or
more.

22. Cont…
•Clients hearing should be monitored
•Monitor BUN, Cr clearance and IO
•Clients needs to be well-hydrated
•IV calcium gluconate can reverse neuromuscular blockade
cause by streptomycin
•Use caution if administering ototoxic and/or nephrotoxic
drugs with streptomycin

23. Cont…
Teaching:
•Should be taken if a previous allergic reaction has been
experienced
•Oral form should be taken on an empty stomach
•Take full course of medication

24. REFERENCES
Clinical Pharmacology by:
 P. N. Bennet, Fraz A.
Mir,
 Pankaj Sharma, Morris Jonathan Brown
(2018)