pharm

SULFONAMIDES

• Effective antibiotic drugs against infections

• Antibacterial agent: Active against bacteria

Examples:

1. Silvadene, silver sulfadizine

2. Bactrim, sulfamethoxazole/trimethoprim

3. Azulfidine, sulfasalazine

4. Trixazole, sulfisoxazole

• Inhibit the activity of folic acid in bacterial cell metabolism

• Slow the rate of bacterial multiplication

• Control urinary tract infections caused by certain bacteria

• Treat infections caused by second- and third-degree burns

ADVERSE REACTIONS

• Common reactions: Anorexia, nausea, vomiting, diarrhea, abdominal pain, chills, fever, stomatitis

• Urine and skin take on an orange-yellow color: This is not abnormal

  Crystalluria: Increase fluid intake

• Photosensitivity: Wear protective clothing or sunscreen

HYPERSENSITIVITY

• Hypersensitivity reactions:

• Pruritus (itching)

• Urticaria (hives)

• Generalized skin eruptions

• Severe reactions leading to potentially lethal conditions such as toxic epidermal necrolysis or Stevens-Johnson syndrome

Antitubercular medications

Tuberculosis

Tuberculosis (TB) is caused by Mycobacterium tuberculosis (Fungal bacteria)

Three kinds of infection: latent, active, and extrapulmonary Prevalent in Asia and sub-Saharan Africa

Significance

• Global travel and latent TB

• Resistance to drug therapy

Classified into two tiers:

Primary (first line)

Secondary (second line)

TB responds well to long-term treatment with a combination of three or more antitubercular drugs

Bacteriostatic and bactericidal against M. tuberculosis bacillus

Action: inhibits bacterial cell wall synthesis, which slows the multiplication rate of the bacteria

Example of bactericidal

Isoniazid

Examples that have some bactericidal properties

Rifampin

Streptomycin

Latent TB treatment

Given to prevent individuals from developing active TB who have a positive skin/blood test for M. tuberculosis but are not infectious

Standard latent TB treatment is 6 to 9 months of isoniazid with a biweekly dosing schedule

-Difficulty with adherence

Standard Treatment for Active TB

Initial phase (~2 months)

• Drugs are used to kill rapidly multiplying M. tuberculosis and to prevent drug resistance

• Rifampin, isoniazid, pyrazinamide, and ethambutol

  Continuing phase (~4 months)

  -Only rifampin and isoniazid

  ETHAMBUTOL

  Generalized Reactions:

  • Dermatitis and pruritus

  • Joint pain

  • Anorexia

  • Nausea and vomiting

  Serious Adverse Effects:

  • Anaphylaxis

  • Optic neuritis

  Used cautiously in clients with:

  • pregnancy (pregnancy category B)

  • hepatic or renal impairment

  • diabetic retinopathy

  -cataracts

  ISONIAZID

  Generalized Reactions:

  Nausea and vomiting

  Epigastric distress

  Fever

  Skin eruptions

  Hematologic changes

  Jaundice

  Hypersensitivity

  Toxicity:

  Peripheral neuropathy

  Severe hepatitis

  Pyrazinamide

  Generalized Reactions:

  Nausea and vomiting

  Diarrhea

  Myalgia

  Rashes

  Toxicity:

  - Hepatotoxicity

  Contraindicated in clients with: a history of hypersensitivity acute gout

  severe reaction to the drug like jaundice

  Rifampin

  Generalized Reactions:

  Nausea and vomiting

  Epigastric distress, heartburn

  Fatigue

  Vertigo

  Rash

  Reddish-orange discoloration of body fluids

  Hematologic changes, renal insufficiency

  Nursing Diagnoses

  • Risk for Injury related to extremity numbness caused by neurotoxicity

  • Imbalanced Nutrition: Less Than Body Requirements related to gastric upset and general poor health status

  • Risk for Ineffective Health Management related to indifference, lack of knowledge, long-term treatment regimen, other factors

  Risk for Injury Related to Extremity Numbness Caused by Neurotoxicity

  Teach client the reason and importance of taking vitamin B6 if prescribed

  Vitamin B6 will prevent neurotoxicity

  Carefully monitor monthly for liver dysfunction (anorexia, nausea, vomiting, fatigue, weakness, yellowing of skin or eyes, darkening of the urine, or numbness in hands and Feet