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Oabel, Xenia May C.

2Nur- 6
GENERIC
NAME
Rifampicin

BRAND
NAMES
Rifadin,
Rimactane,
Rofact

INDICATIONS
Active tuberculosis
(with other agents).
Elimination of
meningococcal
carriers. Unlabeled
Use: Prevention of
disease caused by
Haemophilus
influenza type B in
close contacts.

MECHANISM OF
ACTION
Inhibits RNA synthesis
by blocking RNA
transcription in
susceptible organisms.
Therapeutic Effects:
Bactericidal action
against susceptible
organisms.

CONTRAINDICA
TION/S
Hypersensitivity;
Concurrent
indinavir, nelfinavir,
pyrazinamide, or
saquinavir.

NURSING
RESPONSIBILITIES
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 examinati
on.

Isoniazid

INH

First-line therapy of
active tuberculosis, in
combination with
other agents.
Prevention of
tuberculosis in
patients exposed to
active disease
(alone).

Inhibits mycobacterial
cell wall synthesis and
interferes with
metabolism.
Therapeutic Effects:
Bacteriostatic or
bactericidal action
against susceptible
mycobacteria.

Hypersensitivity;
Acute liver disease;
Previous hepatitis
from isoniazid.

Assess laboratory
examinations.
Monitor liver/renal
function.
Instruct patient that
compliance with dosage
schedule for duration is
necessary to gain benefits.
Caution patient in
alcohol while in therapy
may increase risk of liver
damage.

Pyrazinamide

Zynaphar

Used in combination
with other agents in
the treatment of
active tuberculosis.

Mechanism not known.


Therapeutic Effects:
Bacteriostatic action
against susceptible
mycobacteria.

Hypersensitivity;
Cross-sensitivity
with ethionamide,
isoniazid, niacin, or
nicotinic acid may
exist; Severe liver
impairment.

Tell patient to report


peripheral neuritis
Assess patients condition
before therapy and
regularly thereafter to
monitor drug
effectiveness.
Monitor serum uric acid
which may be elevated
and cause gout symptoms.
Regularly assess for
hepatoxicity.

Regularly assessrenal
status.
Instruct patient to take
drug continuously as
prescribed.

Ethambutol

Myambutol

Active tuberculosis
or other
mycobacterial
diseases (with at least
one other drug).

Inhibits the growth of


mycobacteria.
Therapeutic Effects:
Tuberculostatic effect
against susceptible
organisms.

Hypersensitivity;
Optic neuritis.

Remind patient to report


with follow-up schedule.
Perform visual acuity and
color discrimination tests
before and during therapy.
Assess liver and renal
status and function before
and during therapy.
Assess patient for visual
disturbance that may
indicate optic neuritis.
Advise patient that
compliance with dosage
schedule and duration is
necessary to eradicate
disease.
Remind patient to come
for follow up consultations

Streptomycin

Generic only

In combination with
other agents in the
management of active
tuberculosis.

Inhibits protein
synthesis in bacteria at
level of 30S ribosome.
Therapeutic Effects:
Bactericidal action.

Hypersensitivity to
aminoglycosides;
Most parenteral
products contain
bisulfites and should
be avoided in
patients with known
intolerance; Pedi:
Products containing
benzyl alcohol
should be avoided in
neonate; Intestinal
obstruction
(neomycin only).

including ophthalmic
appointments.
Lab tests: Obtain C&S
tests prior to and
periodically during course
of therapy
Be alert for and report
immediately symptoms of
ototoxicity.
Early damage to vestibular
portion of eighth cranial
nerve (higher incidence
than auditory toxicity) is
initially manifested by
moderately severe
headache, nausea,
vomiting, vertigo in
upright position, difficulty
in reading, unsteadiness,
and positive Romberg
sign.
Be aware that auditory
nerve damage is usually
preceded by vestibular
symptoms and highpitched tinnitus, roaring
noises, impaired hearing
(especially to high-pitched
sounds), sense of fullness
in ears.

Monitor Input and Output.