Pharmacology Ch 43-47;

Front 1

Isoniazid (INH); Pharmacotherapeutics

Back 1

1. Active TB
2. Prophylaxis for TB
3. Unlabeled: severe tremors in MS

Front 2

Isoniazid (INH);Pharmacodynamics

Back 2

1. Interferes with lipid and nucleic acid biosynthesis in actively growing TB cells

Front 3

Isoniazid (INH); Contraindication/Precautions

Back 3

1. Acute hepatic disorders
2. Precaution:
➢ Chronic hepatic disease
➢ Alcoholism
➢ Severe renal impairment
➢ DM, malnutrition, alcoholism → risk for peripheral neuropathy (because already an AE risk)
➢ Seizures

Front 4

Isoniazid (INH); AE's

Back 4

Serious:
hepatitis, peripheral neuropathy, seizures, psychosis, blood dyscrasias, optic neuritis

Common:
n/v, epigastric discomfort

Front 5

Isoniazid (INH); Nursing Implications

Back 5

1. Administer on a empty stomach and avoid antacids
2. Instruct s/s hepatic dysfunction: nausea, vomiting, fatigue, weakness and anorexia
3. Advise to have periodic eye examinations
4. Advise to avoid alcohol because of the risk of hepatotoxicity
5. Give pyridoxine (B6) concurrently to prevent peripheral neuropathy
6. Monitor liver function (look for jaundice)

Front 6

Isoniazid (INH); Pt education

Back 6

1. Advise the importance of taking the drug exactly as prescribed for the entire length of time
2. Caution the patient that stopping and starting the medication increases the risk of developing drug-resistant TB and AE’s of the drug
3. Explain the need for serial laboratory testing, especially with a history of alcohol or drug abuse.
4. Explain the importance of avoiding alcohol.
5. DOT therapy. Direct observation therapy. House pt for 2 years and have nurse watch them take the drugs. We have this in OC. Cheaper than an epidemic.

Front 7

Rifampin; Pharmacotherapy

Back 7

1. TB
2. neisseria meningitidis
3. prophylaxis against H. influenzae, type B
4. Hansen’s disease (Leprosy)
5. Legionnaires’ disease
6. atypical mycobacterial and staphylococcal infections

Front 8

Rifampin; Pharmacodynamics

Back 8

Inhibits DNA-dependent RNA polymerase activity in bacterial cells

Front 9

Rifampin; contraindications/precautions

Back 9

1. If parenteral: sulfite sensitivity
2. Precautions: hepatic dysfunction, alcoholism
3. cannot give with other drugs generally, especially anti retrovirals

Front 10

Rifampin; AE's

Back 10

Serious:
blood dyscrasias, pseudomembranous colitis, hepatitis

Common:
n/v/d. sore mouth and tongue, headache, dizziness, mental confusion, red-orange discoloration of sweat, skin, urine, tears, and feces

Front 11

Rifampin; Nursing implications

Back 11

1. Advise about color change to body fluids. Advise may stain clothes, linen and soft contact lenses.
2. Administer on an empty stomach as a single daily dose.
3. Arrange for serial laboratory testing to include CBC, liver and renal function.
4. messes with other drugs, especially anti retroviral drugs (can’t give it to HIV positive pts)

Front 12

Rifampin; Pt education

Back 12

same as INH