VII.

DRUG STUDY

DRUG MECHANISM OF ACTION INDICATIONS CONTRAINDICATIONS ADVERSE EFFECTS NURSING RESPONSIBILITIES

Cycloserine is an antibiotic. Treating tuberculosis (TB)  Hypersensitivity More common  Be aware that oral
GENERIC NAME: It works by blocking the in the lungs and other  Alcohol use solution contains
CYCLOSERINE growth of the bacterial cell places in the body  Renal dysfunction,  Anxiety alcohol and shouldn’t
wall. (including the kidneys)  confusion be administered to
severe
BRAND NAME:  dizziness patient who drinks
when treatment with other  History of seizure  drowsiness heavily or has a
SEROMYCIN medicines has not been disorder, mental  increased irritability history of alcohol
effective. Cycloserine depression, severe  increased dependence.
CLASSIFICATION: should be used in anxiety or psychosis restlessness  Don’t add water to
ANTI-TUBECULAR AGENT combination with other  mental depression oral solution because
medicines. It may also be  muscle twitching or itwill alter drug’s
ROUTE:
used to treat certain trembling effectiveness.
ORAL 
urinary tract infections. nervousness  Avoid giving oral
 nightmares cyclosporine with
DOSAGE:  other mood or grape-fruit juice,
.
250mg, 2 TABLETS mental changes which may raise
 speech problems trough
FREQUENCY:  thoughts of suicide level,increasing risk of
ONCE A DAY nephrotoxicity.
Less common  Monitor blood
pressure, especially in
 Convulsions (seizures) patients with a
 numbness, tingling, history of
burning pain, or hypertension,because
weakness in the drug can worsen this
hands or feet condition.Expect to
 skin rashes decrease dosage if
hypertension
develops

DRUG MECHANISM OF ACTION
Ethambutol is bacteriostatic
GENERIC NAME: against actively growing TB
MYAMBUTOL bacilli, it works by
obstructing the formation
BRAND NAME: of cell wall. Mycolic acids
ETHAMBUTOL attach to the 5′-hydroxyl
groups of D-arabinose
CLASSIFICATION:
residues of arabinogalactan
ANTI-TUBERCULAR AGENT
and form mycolyl-
ROUTE: arabinogalactan-
ORAL peptidoglycan complex in
the cell wall. It disrupts
DOSAGE: arabinogalactan synthesis
400mg, 3 TABLETS by inhibiting the enzyme
arabinosyl transferase.
FREQUENCY: Disruption of the
ONCE A DAY arabinogalactan synthesis
inhibits the formation of
this complex and leads to
increased permeability of
the cell wall.
DRUG STUDY
INDICATIONS
Ethambutol eliminates
certain bacteria that cause
tuberculosis (TB). It is used
with other medicines to
treat tuberculosis and to
prevent you from giving the
infection to others.
CONTRAINDICATIONS
Contraindicated in patients
who are known to be
hypersensitive to this drug.
It is also contraindicated in
patients with known optic
neuritis unless clinical
judgment determines that
it may be used. Ethambutol
hydrochloride is
contraindicated in patients
who are unable to
appreciate and report visual
side ettects or changes in
vision (eg, young children,
unconscious patients).
ADVERSE EFFECTS NURSING RESPONSIBILITIES
 Loss of appetite  Assess patient for
 Upset stomach infection
 Vomiting (appearance of
 Numbness and wounds, sputum, VS,
tingling in the urine and stool and
hands or fee WBC.) at beginning
 Optic neuritis and during therapy.
blurring of vision  Obtain specimens
before initiating
therapy. Take drug
as indicated.
 Not to be given to
children 6 years
below due to optic
neuritis
 Provide
supplemental
vitamin A. if not
contraindicated
 DRUG STUDY

DRUG MECHANISM OF ACTION INDICATIONS CONTRAINDICATIONS ADVERSE EFFECTS NURSING RESPONSIBILITIES

The severe or irreversible  Review dosing
GENERIC NAME: Prothionamide is clinically Prothionamide is taken as Prothionamide is adverse effects of schedule and
PROTHIONAMIDE effective in the treatment part of a treatment contraindicated in Prothionamide, which give prescribed length of
of TB; the precise regimen, usually involving conditions like Hepatic rise to further therapy with patient.
BRAND NAME: mechanisms of action 5 medicines, to treat MDR disease,General complications include Liver  Emphasize to patient
NO BRANDS AVAILABLE that treatment will be
remain unknown, but a TB. It has the same active dose,Chronic resistant damage, Hepatitis, GI
lengthy and that the
cell-based activation substances and cross vaginal candidiasis. dysfunction.
CLASSIFICATION: entire course of
method causes an resistance with Prothionamide produces treatment must be
ANTI-TUBERCULAR AGENT
inhibiting complex. ethionamide; Leprosy. potentially life-threatening completed to avoid
effects which include relapse or
ROUTE:
Convulsions, Hepatitis. development of
ORAL
which are responsible for resistance.
the discontinuation of  Advise patient to take
DOSAGE:
Prothionamide therapy. each dose with food
250mg, 3 TABLETS
The symptomatic adverse to prevent or reduce
reactions produced by GI adverse reactions.
FREQUENCY:
Prothionamide are more or  Instruct patient to
ONCE A DAY
less tolerable and if they report the following
to health care
become severe, they can
provider: intolerable
be treated GI adverse reactions,
symptomatically, these changes in thinking or
include Sleepiness, mood, dizziness,
Headache, Insomnia, blurred vision or loss
Depression, Paresthesias. of vision, with or
without eye pain.
 DRUG STUDY

DRUG MECHANISM OF ACTION INDICATIONS CONTRAINDICATIONS ADVERSE EFFECTS NURSING RESPONSIBILITIES

 Assess patient if
GENERIC NAME: Pyridoxine is required for This medication is a Hypersensitivity; Patients Severe allergic reactions he/she has any
PYRIDOXINE VITAMIN B6 the proper function of vitamin, prescribed for the with Heart disease (rash; hives; itching; known allergies.
sugars, fats, and proteins in treatment and prevention difficulty breathing;  Educate patient
BRAND NAME: the body. It is also required of vitamin B6 deficiency. It tightness in the chest; with the side effects
NO BRAND AVAILABLE for the proper growth and is important for the swelling of the mouth, of the drug and
development of the brain, breakdown of protein, fats, face, lips, or tongue); contact his/her
CLASSIFICATION:
nerves, skin, and many and carbohydrates from decreased sensation of physician
VITAMINS
other parts of the body. foods. touch, temperature, or immediately if he
Pyridoxine is also used to vibration; loss of experiences severe
ROUTE:
overcome certain harmful coordination; numbness of allergic reactions.
ORAL
side effects related to the feet or around the  Stress importance
DOSAGE: radiation treatment and mouth; numbness or of compliance and
50mg, 2 TABLETS treatment with tingling of the skin. of good nutrition if
medications such as drug is prescribed
FREQUENCY: mitomycin, procarbazine, for maintenance
ONCE A DAY cycloserine, fluorouracil, therapy to prevent
hydrazine, isoniazid, recurrence of
penicillamine, and deficiency.
vincristine.  Carefully monitor
patient’s diet.
Excessive protein
intake increases
daily pyridoxine
requirements.

DRUG MECHANISM OF ACTION
Levofloxacin is a broad-spectrum
GENERIC NAME: antibiotic that is active against
LEVOFLOXACIN both Gram-positive and Gram-
negative bacteria. Like all
quinolones, it functions by
BRAND NAME: inhibiting the two type
AMESOL IItopoisomerase enzymes,
namely DNA
CLASSIFICATION: gyrase and topoisomerase
ANTIBACTERIAL, IV.[51] Topoisomerase IV is
FLURUOQUINOLONE necessary to separate DNA that
has been replicated (doubled)
prior to bacterial cell division.
ROUTE:
With the DNA not being
ORAL separated, the process is
stopped, and the bacterium
DOSAGE: cannot divide. DNA gyrase, on
the other hand, is responsible
250mg, 2 TABLETS
for supercoiling the DNA, so that
it will fit in the newly formed
FREQUENCY: cells. Both mechanisms amount
ONCE A DAY to killing the bacterium, that is,
levofloxacin acts as
a bactericide.[52]
DRUG STUDY
INDICATION
Levofloxacin is used to treat
infections of the sinuses, skin,
lungs, ears, airways, bones, and
joints caused by susceptible
bacteria. Levofloxacin also is
frequently used to treat urinary
infections, including those
resistant to other antibiotics, as
well as prostatitis (infection of
the prostate). Levofloxacin is
effective in treating
infectious diarrhea caused byE.
coli, Campylobacter jejuni,
and Shigella bacteria.
Levofloxacin also can be used to
treat various obstetric
infections, including mastitis
(infection of the
breast). Inhalational
anthrax exposure also is treated
with levofloxacin.
Contraindication ADVERSE REACTION NURSING RESPONSIBILITIES
 Hypersensitivity to the Most Common:  Tell patient to take
drug, tendon drug as prescribed if
 nausea or
disorders,epilepsy. signs and symptoms
 Used cautiously in  vomiting, disappear.
patients with history of  diarrhea, headache, and  Advised patient to take
Seizure disorders or  constipation. drug with plenty of
other CNS diseases fluids and to space
Less common side effects include
such as cerebral antacids sucralfate in
 difficulty sleeping,
atherosclerosis. products containing
 Used cautiously and  dizziness, iron and zinc.
with dosage  abdominal pain,  Tell patient to take oral
adjustment in patients  rash, solution 1 hour before
with renal impairment. or 2 hours after eating.
 abdominal gas, and
 Safety and  Instruct patient to stop
 itching.
effectiveness of drugs drug and notify
in children younger  Rare allergic reactions have prescriber if rash or
than age 18 and in been described, such as: other signs and
pregnant and bf symptoms of
 hives and
women. hypersensitivity
 anaphylaxis (shock).
develop.
 Instruct patient to
notify prescriber of
loose stools or
diarrhea.
 DRUG STUDY

DRUG MECHANISM OF ACTION INDICATIONS CONTRAINDICATIONS ADVERSE EFFECTS NURSING RESPONSIBILITIES

GENERIC NAME: Pyrazinamide is a prodrug that
PYRAZINAMIDE stops the growth
of Mycobacterium tuberculosis.
BRAND NAME:
NO BRANDS AVAILABLE Pyrazinamide diffuses into M.
tuberculosis, where the
CLASSIFICATION:
enzyme pyrazinamidase converts
ANTI-TUBERCULAR AGENT
pyrazinamide to the active
form pyrazinoic acid. Under
ROUTE:
ORAL acidic conditions, the pyrazinoic
acid that slowly leaks out
DOSAGE: converts to the protonated
50mg, 2 TABLETS conjugate acid, which is thought
to diffuse easily back into the
FREQUENCY:
ONCE A DAY bacilli and accumulate. The net
effect is that more pyrazinoic
acid accumulates inside the
bacillus at acid pH than at
neutral pH.
Is indicated for the initial
treatment of active tuberculosis
in adult and children when
combine with other tuberculous
agents. It is also indicated after
treatment failure with other
primary drugs in any form of
active tuberculosis.
Pyrazinamide should only be
used in conjuction with other
effective anti tuberculous
agents.
 Severe hepatic damage; More common
acute gout.  Pain in large and small joints
 Used cautiously in
patients with diabetes Rare
mellitus, renal failure or  Loss of appetite
gouts.
 pain and swelling of joints,
especially big toe, ankle, and
knee
 tense, hot skin over affected
joints
 unusual tiredness or
weakness
 yellow eyes or skin
Rare
 Itching
 skin rash
 Emphasize need to be
compliant with regimen
and that doses should
not be missed.
 Explain that long-term
therapy (6 mo to 2 yr)
will be necessary.
 Instruct patient to
report the following
symptoms to health
care provider: fever;
loss of appetite;
malaise; nausea and
vomiting; darkened
urine; yellowish skin or
eye discoloration; pain
or swelling joints.
 Advise patient to avoid
intake of alcoholic
beverages and alcohol-
containing products.