Introduction to Antitubercular Drugs

Introduction to Antitubercular Drugs

This presentation, part of the Introduction to Clinical Pharmacology series, focuses on Antitubercular Drugs. The presentation covers the actions and uses of these drugs, which are primarily bacter

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PowerPoint presentation about 'Introduction to Antitubercular Drugs'. This presentation describes the topic on This presentation, part of the Introduction to Clinical Pharmacology series, focuses on Antitubercular Drugs. The presentation covers the actions and uses of these drugs, which are primarily bacter. The key topics included in this slideshow are . Download this presentation absolutely free.

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Slide1Copyright © 2014  Wolters Kluwer Health | Lippincott Williams & Wilkins Introduction to Clinical Pharmacology Chapter 10 Antitubercular Drugs Introduction to Clinical Pharmacology Chapter 10 Antitubercular Drugs

Slide2Copyright © 2014  Wolters Kluwer Health | Lippincott Williams & Wilkins Antitubercular Drugs: Actions and Uses Antitubercular Drugs: Actions and Uses • Bacteriostatic against the  M. tuberculosis bacillus: Act to inhibit bacterial cell wall synthesis, which slows the multiplication rate of the bacteria • Used with other drugs to treat active TB— exception isoniazid (INH)

Slide3Copyright © 2014  Wolters Kluwer Health | Lippincott Williams & Wilkins Antitubercular Drugs: Treatment Antitubercular Drugs: Treatment • Standard treatment: – Initial phase – Continuing phase • Retreatment: – Includes the use of four or more antitubercular drugs – Treatment is individualized based on the susceptibility of the microorganism

Slide4Copyright © 2014  Wolters Kluwer Health | Lippincott Williams & Wilkins Ethambutol: Adverse Reactions Ethambutol: Adverse Reactions • Generalized reactions: – Dermatitis and pruritus; joint pain; anorexia; nausea and/or vomiting • More severe reactions: – Anaphylactoid reactions; optic neuritis

Slide5Copyright © 2014  Wolters Kluwer Health | Lippincott Williams & Wilkins Ethambutol: Contraindications and Precautions Ethambutol: Contraindications and Precautions • Contraindicated in patients: – With a history of hypersensitivity to the drug; younger than 13 years • Used cautiously in  patients : – During pregnancy (pregnancy category B); with hepatic or renal impairment; with diabetic retinopathy or cataracts

Slide6Copyright © 2014  Wolters Kluwer Health | Lippincott Williams & Wilkins Isoniazid: Adverse Reactions Isoniazid: Adverse Reactions • Generalized reactions: – Nausea and/or vomiting; epigastric distress; fever; skin eruptions; hematologic changes; jaundice; hypersensitivity • Toxicity: – Peripheral neuropathy – Severe, and sometimes fatal

Slide7Copyright © 2014  Wolters Kluwer Health | Lippincott Williams & Wilkins Isoniazid: Contraindications and Precautions Isoniazid: Contraindications and Precautions • Contraindicated in patients: – With a history of hypersensitivity to the drug • Used cautiously in  patients : – D uring pregnancy (pregnancy category C) or lactation and in patients with hepatic and renal impairment

Slide8Copyright © 2014  Wolters Kluwer Health | Lippincott Williams & Wilkins Isoniazid: Interactions Isoniazid: Interactions Interactant drug Effect of interaction Aluminum salts Reduced absorption of isoniazid Anticoagulants Increased risk for bleeding Phenytoin (Dilantin) Increased serum levels of phenytoin Alcohol (in beverages) Higher incidence of drug-related hepatitis

Slide9Copyright © 2014  Wolters Kluwer Health | Lippincott Williams & Wilkins Pyrazinamide: Adverse Reactions Pyrazinamide: Adverse Reactions • Generalized reactions: – Nausea and/or vomiting; diarrhea; myalgia; rashes • Hepatotoxicity: – Symptoms may range from none (except for slightly abnormal hepatic function test results) to a more severe reaction such as jaundice

Slide10Copyright © 2014  Wolters Kluwer Health | Lippincott Williams & Wilkins Pyrazinamide: Contraindications, Precautions, and Interactions Pyrazinamide: Contraindications, Precautions, and Interactions • Contraindicated in patients with known hypersensitivity to the drug; acute gout; severe hepatic damage • Use cautiously in patients during pregnancy and lactation; with hepatic and renal impairment; with HIV; with diabetes mellitus • Interaction: With allopurinol, colchicine, and/or probenecid—its effectiveness decreases

Slide11Copyright © 2014  Wolters Kluwer Health | Lippincott Williams & Wilkins Rifampin: Adverse Reactions Rifampin: Adverse Reactions • Generalized reactions: – Nausea, vomiting – Epigastric distress, heartburn, fatigue – Vertigo, rash – Reddish-orange discoloration of body fluids – Hematologic changes, renal insufficiency

Slide12Copyright © 2014  Wolters Kluwer Health | Lippincott Williams & Wilkins Rifampin: Contraindications, Precautions, and Interactions Rifampin: Contraindications, Precautions, and Interactions • Contraindicated in patients with known hypersensitivity to the drug • Used cautiously in patients with renal or hearing impairment; during pregnancy and lactation • Interactions: With digoxin; oral contraceptives; isoniazid; oral anticoagulants; oral hypoglycemics; chloramphenicol; phenytoin; verapamil

Slide13Copyright © 2014  Wolters Kluwer Health | Lippincott Williams & Wilkins Nursing Process: Assessment Nursing Process: Assessment • Preadministration assessment: – Assess a family history and a history of contacts, if the patient has active TB • Ongoing assessment: – Observe the patient daily for the appearance of adverse reactions and report if found – Carefully monitor vital signs daily

Slide14Copyright © 2014  Wolters Kluwer Health | Lippincott Williams & Wilkins Nursing Process: Nursing Diagnoses Nursing Process: Nursing Diagnoses • Acute Pain • Imbalanced Nutrition: Less Than Body Requirements • Risk of Ineffective Self-Health Management

Slide15Copyright © 2014  Wolters Kluwer Health | Lippincott Williams & Wilkins Nursing Process: Planning Nursing Process: Planning • The expected outcome includes an optimal response to therapy: – Management of adverse drug reactions – Understanding of and compliance with the prescribed treatment regimen

Slide16Copyright © 2014  Wolters Kluwer Health | Lippincott Williams & Wilkins Nursing Process: Implementation Nursing Process: Implementation • Promoting an optimal response to therapy: – Allow time for the patient and family members to ask questions • Refer the patient to other health care workers, such as a social service worker or a dietitian

Slide17Copyright © 2014  Wolters Kluwer Health | Lippincott Williams & Wilkins Nursing Process: Implementation (cont.) Nursing Process: Implementation (cont.) • Monitoring and managing patients’ needs: – Acute Pain: Frequent parenteral injections • Be careful to rotate the injection sites • Inspect previous injection sites for signs of swelling, redness, and tenderness • Notify if necessary

Slide18Copyright © 2014  Wolters Kluwer Health | Lippincott Williams & Wilkins Nursing Process: Implementation (cont.) Nursing Process: Implementation (cont.) • Monitoring and managing patients’ needs (cont.): – Imbalanced Nutrition: Less Than Body Requirements • Be aware of dosing regimen with/without food for ethambutol, pyrazinamide; monitor for gastric upset; use alternative dosing regimen or combination drugs; explain coloration of bodily fluids

Slide19Copyright © 2014  Wolters Kluwer Health | Lippincott Williams & Wilkins Nursing Process: Implementation (cont.) Nursing Process: Implementation (cont.) • Monitoring and managing patients’ needs (cont.): – Ineffective Therapeutic Regimen Management: • To help prevent the problem of noncompliance—directly observed therapy (DOT)

Slide20Copyright © 2014  Wolters Kluwer Health | Lippincott Williams & Wilkins Nursing Process: Implementation (cont.) Nursing Process: Implementation (cont.) • Educating the patient and family: Careful patient and family education and close medical supervision are necessary – Explain that short-term therapy is of no value in treating this disease – Remain alert for statements made by the patient or family that may indicate future noncompliance with the drug regimen

Slide21Copyright © 2014  Wolters Kluwer Health | Lippincott Williams & Wilkins Nursing Process: Evaluation Nursing Process: Evaluation • The therapeutic effect is achieved • Adverse reactions are identified, reported, and managed successfully • Pain or discomfort following IM or IV administration is relieved or eliminated • Patient and family demonstrate understanding of the drug regimen • Patient complies with the prescribed drug regimen

Slide22Copyright © 2014  Wolters Kluwer Health | Lippincott Williams & Wilkins Question Question • Is the following statement true or false? • The nursing diagnosis of Ineffective Self-Health Management may be especially important with patients considering the short-term therapy required to treat TB.

Slide23Copyright © 2014  Wolters Kluwer Health | Lippincott Williams & Wilkins Answer Answer • False • The nursing diagnosis of Ineffective Self-Health Management may be especially important with patients considering the long-term therapy required to treat TB.

Slide24Copyright © 2014  Wolters Kluwer Health | Lippincott Williams & Wilkins Question Question • Is the following statement true or false? • Directly observed therapy (DOT) involves a patient being directly watched by a health care provider when taking the antitubercular drugs.

Slide25Copyright © 2014  Wolters Kluwer Health | Lippincott Williams & Wilkins Answer Answer • True • Directly observed therapy (DOT) involves a patient being directly watched by a health care provider when taking the antitubercular drugs.

Slide26Copyright © 2014  Wolters Kluwer Health | Lippincott Williams & Wilkins Question Question • How long does a patient have to be on preventive therapy for exposure to tuberculosis? • A. 1 month • B. 2 months • C. 4 months • D. 6 months to 1 year

Slide27Copyright © 2014  Wolters Kluwer Health | Lippincott Williams & Wilkins Answer Answer • D • Preventive therapy (prophylaxis for those exposed but who do not have active disease) involves one drug taken for 6 months to 1 year.