Ateneo de Zamboanga University

College of Nursing
Level II
School Year 2021-2022
A. Drug Study
Drug Mechanism of action/Side
effects
Brand name: Natricin® Mechanism of Action:
Forte Pyrazinamide diffuses into
Generic name: active M. tuberculosis that
Pyrazinamide express pyrazinamidase
Classification: enzyme that converts
Antitubercular Agents pyrazinamide to the active
Route: PO form pyrazinoic acid.
Dosage: 3.5 ml Pyrazinoic acid can leak
Frequency: T.I.W out under acidic
conditions to be
converted to the
protonated conjugate
acid, which is readily
diffused back into the
bacilli and accumulate
intracellularly. The net
effect is that more
pyrazinoic acid
accumulates inside the
bacillus at acid pH than at
neutral pH. Pyrazinoic
acid was thought to
inhibit the enzyme fatty
acid synthase (FAS) I,
which is required by the
bacterium to synthesise
fatty acids. However, this
theory was thought to
have been discounted.
Side Effects:
Liver toxicity is the most
serious side effect of
pyrazinamide and it
depends on the dosage,
duration of treatment and
concomitant therapy.
Other side effects are
anorexia, nausea,
vomiting, arthralgia,
malaise, fever,
sideroblastic anemia and
dysuria.
Indication/
Contraindication
Indication:
All fomrs of pulmonary and
extrapulmonary
tuberculosis is sensitive to
pyrazinamide. When
treating all forms of
tuberculosis, pyrazinamide
is used as part of multi-
drug regimens for the
treatment of tuberculosis,
primarily in the initial 8-
week phase of short-course
treatment.
Contraindication:
 Hypersensitivity
 Liver Damage
Nursing Responsibilities
 Follow 14 rights of
medications
 Observe and
supervise closely.
Patients should
receive at least one
other effective
antituberculosis
agent concurrently.
 Examine patients at
regular intervals and
question about
possible signs of
toxicity: Liver
enlargement or
tenderness, jaundice,
fever, anorexia,
malaise, impaired
vascular integrity
(ecchymoses,
petechiae, abnormal
bleeding).
 Hepatic reactions
appear to occur
more frequently in
patients receiving
high doses.