ANTI-TUBERCULOSIS

DRUGS

Action: appears to inhibit RNA synthesis,
thus
stops tubercle bacilli from multiplying
(first line) or functioning (second line)
LINES OF DEFENSE

First line Second line
Isoniazid (INH) Cycloserin
Rifampicin (Rifadin) Kanamycin
Ethambutol Ethonamide
Pyrazinamide Para-aminosalicylic acid
Streptomycin

Stuff to Remember:
active tuberculosis are treated
with drug combination for 6-9 mos.
multidrug-resistant strain
(MDRTB) are medicated for 1 year
up to2 years
given before meals
Isoniazide

should be given 1 hr before or 2 hrs
after meals because food may delay
absorption.
should be given at least 1 hr before antacids.
instruct to notify physician for signs of
hepatoxicity (jaundice), and neurotoxicity
numbness of extremities.
administer with Vitamin B6 to
counteract the neurotoxic side effects.
avoid alcohol.
Suppresses mycobacterial cell-wall synthesis
Rifampicin
given on an empty stomach with 8 0z. of
water, 1 hour before or 2hours after
meals and avoid taking antacids with
medications.
hepatotoxic thus avoid alcohol.
instruct the client that urine, feces,
sweat, and tears will be red
orange in color.
Pyrazinamide

given for 2 months.
increase serum uric acid and cause
photosensitivity.

Ethambutol

contraindicated in children under 13
years old.
obtain a baseline visual acuity because
it can cause optic neuritis.
Instruct the client to notify the physician
immediately if any visual problems
occurs.
Decreases mycobacterial RNA synthesis

Streptomycin

aminoglycoside antibiotic given IM.
nephrotoxic and ototoxic.
obtain baseline
audiometric test and repeat every 1-
2 months because the medications
impairs the CN VIII.
Adverse Effects

gastric irritation
CNS disturbances
liver disturbances
blood dyscrasias
Rifampicin Hepatotoxicity, Discoloration
of bodily fluids
Streptomycin - ototoxicity
Ethambutol - visual disturbances
Isoniazid - Liver Toxicity, Peripheral
Neuropathy due to suppressed absorption
of fat and vitamin B complex

Nursing Interventions

monitor client response to therapy
monitor blood work during therapy
if CNS disturbances are evident, take safety
precautions
teach client
to take medication as ordered
to eat foods rich in B-complex vitamins
avoid use of alcohol
report if become pregnant
ethambutol: report eye problems, have
regulareye exams

Just know your R.I.P.E.S!!!!

Antihypertensive Drugs

Action: dilates peripheral blood vessels

5 Major Types: ACE Inhibitor &
Angiotensin antagonists
Beta - blockers
Calcium channel blockers
Diuretics

Examples:
Hydralazine HCL (Apresoline)
Enalapril maleate (Vasotec)
Reserpine (Serpasil)
Prazosin HCL (Minipress)
Methyldopa (Aldomet)
Clonidine (Catapress)
Adverse Side Effects
orthostatic hypotension
dizziness
bradycardia
tachycardia
sexual dysfunction
deterioration in renal function
agranulosis

Nursing Interventions

monitor vital signs and blood pressure, sitting
and standing
monitor for hearing changes, renal functioning
if hypotension, closely monitor client
encourage intake of foods high in vitamin B
Teach client:
- low sodium diet
- change positions slowly
- take medication as instructed
- avoid hazardous activities
- protect medication from heat and light