Anti TB

ANTI –TUBERCULOSIS
DRUG
 Drugs used to treat tuberculosis.
 Concurrent use of at least 3 drugs for treatment T.B
is recommended since;
I. Reduce population of viable bacteria as
rapidly as possible
II. To prevent or delay development of drug
resistant bacteria
III. Minimize the risk of ineffectiveness that
patient affected by drug resistant bacteria
Common drugs for treatment of T.B
(RIPES)/(PERIS)
 Streptomycin(S)
 Isoniazid(H)
 Rifampicin(R)
 Pyrazinamide(Z)
 Ethambutol(E)
The treatment of TB is continued for along
time to eradicate the disease and the
choice of drug depends on(determined )by
the sensitivity of the tubercle bacilli
Cont…
1.ISONIAZID
Mode of action.
 Acts by interfering with the bacterial respiration
 It has bacterial static and bactericidal ,effects on
the bacilli depending on the concentration and
temperature it stored.
 Rapidly absorbed from the small intestines and
excreted in the kidney
 Active against intracellular organism, it diffuses
widely in to the body, CSF. crossing meningeal

barriers to inhibit the growth of tubercle bacilli.
Cont……
Indications
 Milliary TB
 Other forms of TB
Contraindications
I. Drug induced liver disease because its metabolized in
the liver
II. Patients with liver/kidney problem
III. Epileptic patient because it inhibits the metabolism of
epanutin which is a drug used in the treatment of
epilepsy.
IV. Alcoholism
V. Pregnant /lactating mother(give drug with a lot of
caution)
cont…
Side effects
I. Optic neuritis
II. Nausea and vomiting
III. Hypersensitivity e.g. rashes
IV. Convulsions and psychotic episodes
V. Peripheral neuropathy- tingling sensation in the
feet and numbness. pain, touch and
temperature sensations are altered- to prevent
these, patient is given vitamin B (pyroxidine)
20mg OD – As an antidote.
VI. The patient may develop granulocytosis
resulting to anemia.
VII. Sometimes patient develops hepatitis(jaundice )
Cont….
2.ETHAMBUTAL
In tablets form
Mode of action
Acts on mycobacteria by inhibiting RNA
synthesis- its used in treatment of TB in
combination with rifampicin and isoniazid
Contraindications
 Children(very young)
 Elderly
 Patients with optic neuritis
 Patients with impaired renal functions
Cont….
Indications
 T.B meningitis
 Pulmonary T.B
Side effects
 Damage to optic nerves leading to
visual problems( colour blindness)

 Test visual state when patient is on this
drug
 Peripheral neuritis
 Hypersensitivity
3.RIFAMPICIN
Effective against gram + and gram –ve microorganisms
and tubercle bacilli and must be combined with other
drugs
 kills bacteria by binding it selves to DNA and stops

synthesis of RNA
 its fat soluble
 its well absorbed orally and excreted mainly in bile.
Indications
 Treatment of TB in combination with other drugs
 Meningitis caused by meningococcal
 Prostatis
 Severe legions disease- flu like infection of respiratory
tract.
Cont….
Contraindications
 Patients on steroids, digoxin ,oral
contraceptives, anti coagulants e.g.
warfarin
 Liver disease
- Well absorbed on an empty stomach(before
meal e.g. during breakfast)

Cont….
Side effects
 It colors body secretions e.g. urine, stool, sputum
- inform patient about it.
 It reduces the effectiveness of oral contraceptives
because it increases the rate of estrogen breakdown.

 Hypersensitivity-evidenced by fever, rashes,
headache, dyspnea, slight wheezing and this occur

after 2-4 weeks after treatment
 Pt may develop hepatitis which may lead to acute
hemolytic anemia and thrombocytopenia and as a

result patient develops renal failure and hemolysis
and if these happens stop drug.
Cont……
4.PYRAZINAMIDE
Mode of action
Acts by killing the persistent and
resistant tubercle bacilli which are
dormant
Indications
 TB meningitis
 Other forms of TB
Cont….
Contraindications
 Patient with liver disease
Side effects
 Pt may develop arthralgia- neurologic pain
on several joints, this may lead to formation of

gout.
 Patient may develop hepatitis evidenced by
jaundice
 Nausea and vomiting
 Rashes and fever
 It crosses the meningeal barriers to C.S.F
Cont….
ABBREVIATIONS SHOWING DRUGS REGIMEN
2RHZE4EH OR 2RHZ4EH
Relapse – 2SRHZE+5ERH
R-Rifampicin
H-Isoniazid
Z-Pyrazinamide
E-Ethambutal
S-Streptomycin
Are in fixed drug combination(FDC)….a tablets
with more than one drugs combined

Anti TB

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ANTI –TUBERCULOSIS

widely in to the body, CSF. crossing meningeal

visual problems( colour blindness)

 kills bacteria by binding it selves to DNA and stops

meal e.g. during breakfast)

because it increases the rate of estrogen breakdown.

headache, dyspnea, slight wheezing and this occur

hemolytic anemia and thrombocytopenia and as a

on several joints, this may lead to formation of

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