DRUG STUDY

Drug Name Mechanism of Action  Inhibits cell-wall biosynthesis by interfering with lipids and nucleic acid, DNA synthesis in tubercle bacilli cells. Dosage
 Adult: (Active TB) 5mg/kg P.O. or I.M. (maximum of 300 mg/day) daily as a single dose, or 15 mg/kg (maximum of 900 mg/day) two to three times weekly; given with other agents. (Exposed to active TB) 300 mg P.O. daily as a single dose for 6 to 12 months. Children: (Active TB) 10 to 15 mg/kg P.O. or I.M. (maximum of 300 mg/day) daily as a single dose, or 20 to 40 mg/kg (maximum of 900 mg/day) two to three times weekly.

Indication

Contraindication

Adverse Reaction
 CNS: peripheral neuropathy, dizziness, memory impairment, slurred speech, psychosis, toxic encephalopathy, seizures. EENT: visual disturbances. GI: nausea, vomiting. GU: gynecomastia. Hematologic: eosinophilia, methemoglobinemia, hemolytic anemia, aplastic anemia, agranulocytosis, thrombocytopenia. Hepatic: hepatitis. Metabolic: pyridoxine deficiency, hyperglycemia, metabolic acidosis. Respiratory: dyspnea. Other: fever, pellagra, lupus like syndrome, injection site irritation, hypersensitivity reaction.

Nursing Management
 Patient Monitoring: *Assess hepatic enzyme levels. *Watch for adverse reaction, such as peripheral neuropathy. Patient Teaching: * Advise patient to take once daily on empty stomach, 1 hour before or 2 hours after meals. If GI upset occurs, tell him to take with small amount of food. * Caution patient to avoid foods containing tyramine (such as cheese, fish, salami, red wine, and yeast extracts), because drugfood interaction may cause chills,

INF (Isonicotinic Acid Hydrzide or Isoniazide)

 *Patient with active tuberculosis (TB). *For patients exposed to active disease.

 It is contraindicated to hypersensitivity drug and acute hepatic disease or previous hepatitis caused by isoniazide therapy.

(Exposed to active TB) 10 mg/kg P.O. daily as a single dose for up to 12 months.

diaphoresis, and palpitations.

 RIF (Refampin or Inhibits RNA Refampicin) synthesis by blocking RNA transcription in susceptible organisms (mycobacterium and some grampositive and gram-negative bacteria).

 Adult: (Tuberculosis) 10 mg/kg/day (up to 600 mg/day) P.O. or I.V. infusion as a single dose. (Asymptomati c- Neisseria meningitis car riers) 600 mg P.O. or I.V. infusion b.i.d. for 2 days.

 *For patient with tuberculosis. *For Neisseria Meningitis carrier or Asymptomatic.

 It is contraindicated to hypersensitivity drug or other rifamycin derivatives.

CNS: ataxia, confusion, drowsiness, fatigue, headache, asthenia, psychosis, generalized numbness. EENT: conjunctivitis; discolored tears, saliva, and sputum. GI: nausea, vomiting, diarrhea, abdominal cramps, dyspepsia, epigastric distress, flatulence, discolored feces, anorexia, sore mouth and tongue, pseudomembranous colitis. GU: discolored urine. Hematologic: eosinophilia, transient leukopenia , hemolytic anemia, hemolysis, disseminated intravascular coagulation (DIC), thrombocytopenia. Hepatic: jaundice. Metabolic: hyperuricemia. Musculoskeletal: myalgia, joint pain. Respiratory: dyspnea, wheezing. Skin: flushing, rash, pruritus, discolored sweat, erythematic multiform, toxic epidermal necrolysis, Stevens-Johnson syndrome. Other: flu like symptoms, hypersensitivity reactions including vasculitis.

 Patient Monitoring: * Monitor kidney and liver function tests, CBC, and uric acid level. Watch for signs and symptoms of bleeding tendency, especially DIC. * Assess for signs and symptoms of hepatic impairment. * Monitor bowel movements for diarrhea, which may signal pseudomembra nous colitis. Patient Teaching: * Advise patient to take oral dose 1 hour before or 2 hours after meals. If drug causes significant GI upset, instruct him to take it with meals. To

further minimize GI upset, teach him to eat small, frequent servings of food and drink plenty of fluids. * Instruct patient to immediately report easy bruising or bleeding, fever, malaise, appetite loss, nausea, vomiting, or yellowing of skin or eyes. * Tell patient drug may color his tears, urine, and other body fluids reddish or brownish orange. Instruct him not to wear contact lenses during therapy, because drug may stain them permanently. * As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the

drugs, tests, and behaviors mentioned above.

Montelukast

 An inhibitor that prevents leukotrienes from binding to cell receptors; taken over time, montelukast can reduce or prevent symptoms of asthma and allergies.

 Adult & Adolescents: 10 mg a day. Children(6-14 yrs. old): 5 mg, taken once daily. Children (23mos. 6yrs. old) 4mg oral granules, taken once daily. Young Children: 4 mg (either as a chewable tablet or packet of oral granules), taken once daily.

 It is used to treat chronic asthma.

 Contraindicated to hypersensitivity drug abuse.

Adverse effects include dizziness, fatigue, headache, abdominal pain, dyspepsia, abnormal liver function tests, rash, asthenia, influenza, cough, and nasal congestion.