Medications for Primary Complex Rifampicin, pyrazinamide and isoniazid.

Name of drug/stock dose Mechanism of action indication Treatment of Pulmonary TB in conjunction with at least one other effective antituberculotic. Contraindication Contraindicated with allergy to any rifamycin, acute hepatic disease, lactation. Use cautiously with pregnancy (teratogenic effects have been reported in preclinical studies; safest antituberculous regimen for use in pregnancy is considered to be rifampin, isoniazid, and ethambutol). Side/adverse effects Adverse effects Hepatotoxic Hepatitis, jaundice, liver failure in severe cases Respiratory breathlessness Nursing responsibilities Administer on an empty stomach, 1 hr before or 2 hr after meals. Administer in a single daily dose. Prepare patient for the reddishorange coloring of body fluids soft contact lenses may be permanently stained; advise patients not to wear them during therapy. Arrange for follow-up visits for liver and renal function tests, CBC, and ophthalmic examinations.

rifampicin/rifampin Inhibits DNAdependent Stock Dose: RNA Capsulespolymerase 150,300mg; activity in powder-600mg susceptible bacterial cells.

Isoniazid Stock dose Tablets: 100,300 mg; syrup 50mg/5ml; injection 100 mg/ml

This medication is used with other medications to treat active tuberculosis (TB) infections or alone to prevent those who have a positive TB test from developing symptoms of TB. Isoniazid belongs to a class of drugs known as antibiotics that are active against tuberculosis. Interferes with lipid and nucleic acid biosynthesis in actively growing tubercle bacilli.

Tuberculosis of all forms Prophylaxis in specific patients who are tuberculin reactors (positive Mantoux test)) or who are considered to be high risk for TB.

Isoniazid is contraindicate d in patients who develop severe hypersensitivi ty reactions, including drug -induced hepatitis; previous isoniazidassociated hepatic injury; severe adverse reactions to isoniazid such as drug fever, chills, arthritis; and acute liver disease of any etiology.

Side effects Peripheral neuropathy Nausea and vomitting Thrombocytopen ia Local irritation at IM site Epigastric distress Elevated AST

History: allergy to the drug. Can cause peripheral neuropathy which is manifested by tingling sensation on extremities. It can be prevented through use of supplement al vitamin B6 (pyridoxine) . Give in an empty stomach 1 hr before or 2 after meals; may be given with food if GI UPSET OCCURS. Give in a single daily dose Dec. foods containing tyramine or histamine in pt diet.

Pyrazinamide

Pyrazinamid e is a prodrug that stops the

For the initial treatment of active tuberculosis in adults and children

Pyrazinamide is contraindicate d in persons:

Pyrazinamide side effects. - darkened urine;

History: allergy to the drug, liver

growth of Mycobacteri um tuberculosis. M. tuberculosis has the enzyme pyrazinamida se which is only active in acidic conditions.[6 ] Pyrazinamida se converts pyrazinamid e to the active form, pyrazinoic acid which accumulates in the bacilli.

when combined with other antituberculous agents.

- with severe hepatic damage. - who have shown hypersensitivi ty to it. - with acute gout.

- difficult urination; - fatigue; - fever; - loss of appetite; - pain and swelling in the joints; - skin rash; - unusual bleeding or bruising; - upset stomach; - vomiting; - yellowing of the skin or eyes;

disease, gout, kidney disease and diabetes mellitus may not be able to take Pyrazinamid e, or you may require a lower dose or special monitoring during treatment breast feeding mothers should consult first the doctor before taking it because Pyrazinamid e passes into breast milk and may affect a nursing baby. Milk is not usually recommend ed for infants under one year of age because of the possibility of allergic reaction, but yogurt contains more

Probiotics Scientific Name: L. acidophilus Common Name(s): Probiotics , yogurt , sour milk , VSL-3

Probiotics counter experimental and human gastrointesti nal inflammation (human inflammator y bowel disease) by their effects on epithelial cell function, including

treatment and prevention of acute diarrhea and antibiotic-induced diarrhea, as well as for the prevention of cow milk-induced food allergy in infants and young children. probiotics may be useful for prevention of respiratory

The use of probiotics is not advised in patients at risk of opportunistic infections and in those with badly damaged GI tracts.

Probiotics Adverse Reactions Probiotics are considered relatively safe. There are isolated reports linking probiotics to adverse reactions.

epithelial cell barrier function, epithelial cytokine secretion, and their antibacterial effects relating to colonization of the epithelial layer.

infections in children, dental caries, irritable bowel syndrome, and inflammatory bowel disease.

Multivitamins Dietary supplement for the 1-2 cap daily. treatment and prevention of vitamin deficiencies. These vitamins are necessary for normal growth and

Promotes normal biochemical reactions, strengthens the immune system, supports normal growth and development and helps prevent growth retardation in children and young adult.

Avoid taking more than one multivitamin product at the same time unless your doctor tells you to. Taking similar vitamin products together can

Multivitamins side effects allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. When taken as directed, multivitamins are

calcium than milk. Probiotics are completely safe and have even been given to premature infants. Those given to infants, however, should be specially formulated for children and should not be given to anyone whose immune system is compromise d. Advise the client to always consult a physician before giving probiotics as a health supplement. Take your multivitami n with a full glass of water. The chewable tablet must be chewed or allowed to dissolve in your mouth

development . Many acts as coenzyme or catalyst in numerous metabolic processes

Supplement to correct vit B deficiencies & for nutritional support in chronic illnesses, decreased resistance to infection, metabolic disorders, general body weaknesses, easy fatigability, nervous exhaustion, mental & physical stress. Prevention & treatment of anemia, beriberi, pellagra, traumatic injuries, burns & fractures.

result in a vitamin overdose or serious side effects. Avoid the regular use of salt substitutes in your diet if your multivitamin contains potassium. If you are on a low-salt diet, ask your doctor before taking a vitamin or mineral supplement. Do not take this medication with milk, other dairy products, calcium supplements, or antacids that contain calcium. Calcium may make it harder for your body to absorb certain ingredients of the multivitamin.

not expected to cause serious side effects. Less serious side effects may include: upset stomach; headache; or unusual or unpleasant taste in your mouth.

before swallowing. May be taken with or without food (May be taken w/ meals to reduce GI discomfort.) Advise patient to never take more than the recommend ed dose of a multivitami n. Avoid taking more than one multivitami n product at the same time unless your doctor tells you to. Taking similar vitamin products together can result in a vitamin overdose or serious side effects

Ascorbic acid

Assists in collagen formation, tissue repair; involved in

Vitamin C is used for prevention and treatment of scurvy, acidification of urine, dietary

Ascorbic acid is contraindicate d in patients with

Side Effects and Adverse Reactions of Vitamin C

May give without regard to food. Assess for

oxidation reduction reactions, other metabolic reactions. Vitamin C is involved in metabolism; carbohydrate utilization; synthesis of lipids, proteins, carnitine. It also preserves blood vessel integrity.

supplement, prevention of and reduction in the severity of colds.

hyperoxaluria (Dollery, 1991) and G6-PD deficiency.

Paracetamol PO: ADULTS, ELDERLY: 325-650 mg q4-6h or 1g 3-4 time/day. Maximum: 4 g/day. CHILDREN: 10-15 mg/kg/dose q4-6h as needed.

Inhibits prostaglandi n synthesis in the CNS and blocks the pain impulse through a peripheral action. It acts on the hypothalami c heatregulating center, producing peripheral vasodilation. It results in antipyresis and produces analgesic effect.

Fever, Relief of mild to moderate pain like headaches, muscular aches and pain, toothache, colds, earache, fever due to tonsillectomy, inoculations, and vaccinations.

Hypersensitivi ty to acetaminophe n or phenacetin; use with alcohol

Side Effects of Vitamin C Abdominal cramps Nausea Vomiting Diarrhea Increased urination with doses exceeding 1 gram Flushing Headache Dizziness Sleepiness or insomnia Adverse Reactions of Vitamin C Urine acidification that may lead to crystalluria Side Effects of Paracetamol Side effects are well tolerated. Cramping, heartburn, abdominal distention can be experienced. On a rarity, hypersensitivity reactions. Adverse Reactions or Toxic Effects of Paracetamol Early signs of toxicity: Anorexia, nausea, diaphoresis (excessive sweating), generalized

clinical improveme nt (improved sense of well-being and sleep patterns). Observe for reversal of deficiency symptoms (gingivitis, bleeding gums, poor wound healing, digestive difficulties, joint pain).

If to be given as analgesia, assess onset, type, location, duration of pain. Can be given without regards to meals. Tablets can be crushed. Assess temperatur e directly before and 1 hour after giving medication. If respirations are <12/min

weakness within the first 12-24 hours.

Ambroxol Oral Mucolytic Adult: 60-120 mg daily, in 2-3 divided doses. Child: <2 yr: 7.5 mg bid; 25 yr: 7.5 mg bid/tid; 6-12 yr: 15 mg bid/tid.

Ambroxol is a metabolite of bromhexine and is used similarly as a mucolytic.

All forms of tracheobronchitis, emphysema with bronchitis pneumoconiosis, chronic inflammatory pulmonary conditions, bronchiectasis, bronchitis with bronchospasm asthma. During acute exacerbations of bronchitis it should be given with the

Contraindicati on : Hypersensitivi ty, saying disease stomach and duodenal ulcers, pregnancy (I term), breastfeeding (for the period of treatment should be stopped).

SIDE EFFECTS: GI irritation, Nausea and vomiting, headache and drowsiness, hypotension ADVERSE EFFECTS: Skin rash, anaphylactic shock

(<20/min in children), withhold the medication and contact the physician. Evaluate for therapeutic response: relief of pain, stiffness, swelling; increasing in joint mobility; reduced joint tenderness; improve grip strength. Therapeutic blood serum level: 10-30 mcg/mL; toxic serum level: >200 mcg/mL. Observe the 10 rights of drug administrati on - Check the medical order - Instruct to report any signs of unusualities or presence of signs and symptoms of adverse/sid

appropriate antibiotic.

e effects - Check VS - Monitor I&O

Antikoch meds INA