Isoniazide Nursing Considerations, Side Effects, and Mechanism of Action Pharmacology for Nurses

Summary

This script discusses the treatment of tuberculosis (TB) with a focus on the medication isoniazid (INH). It explains how INH inhibits the synthesis of the mycobacterial cell wall, aiming to halt TB proliferation. The CDC recommends a first-line treatment involving INH, rifampin, pyrazinamide, and ethambutol for an initial two-month phase, followed by continuation with INH and rifampin for a total treatment duration of six to nine months. The script also addresses the challenges of drug-resistant TB and the importance of monitoring patients for side effects such as peripheral neuropathy, seizures, hepatitis, and jaundice.

Takeaways

• 👀 The term 'eyes on eyes' is an acronym for INH (Isoniazid), a medication used in the treatment of tuberculosis.
• 🛡 INH works by inhibiting the synthesis of the mycobacterial cell wall, which is crucial for stopping the proliferation of tuberculosis bacteria.
• 🏥 Active TB disease can occur when the immune system fails to control the growth of TB bacteria, often affecting those in close living quarters or underdeveloped regions.
• 💊 The US FDA has approved ten drugs for TB treatment, with four recommended by the CDC as first-line therapy: INH, Rifampin, Pyrazinamide, and Ethambutol.
• 📅 The CDC-recommended treatment regimen for TB involves an initial phase of two months, followed by continuation treatment for four to seven months, totaling six to nine months.
• 🔄 The preferred regimen includes taking all four first-line drugs for eight weeks, then continuing with INH and Rifampin for 18 weeks, or two times weekly for 18 weeks.
• 🚫 Patients on INH should avoid foods high in tyramine due to the risk of peripheral neuropathy, seizures, hepatitis, and jaundice.
• 🔍 Regular monitoring of liver function tests is essential for patients taking INH to manage potential side effects.
• ⚠️ Drug-resistant TB is a significant concern; if TB bacteria become resistant to one or more first-line drugs, it can lead to multi-drug-resistant TB, complicating treatment.
• 📢 The importance of closely monitoring patients on TB medication and the significance of adhering to the full treatment regimen to prevent drug resistance are emphasized.

Q & A

What is the primary function of INH in the treatment of tuberculosis?

INH, or isoniazid, works by inhibiting the synthesis of the mycobacterial cell wall, which helps to stop the proliferation of the tuberculosis bacteria.

How long is the initial phase of TB treatment recommended by the CDC?

The CDC recommends an initial phase of TB treatment that lasts for two months.

What are the four first-line drugs recommended by the CDC for treating TB?

The four first-line drugs recommended by the CDC for treating TB are isoniazid (INH), rifampin, pyrazinamide, and ethambutol.

What is the total duration of TB treatment as per the CDC guidelines?

The total duration of TB treatment according to the CDC guidelines is six to nine months.

What is the preferred regimen for the first eight weeks of TB treatment according to the CDC?

The preferred regimen for the first eight weeks of TB treatment is the combination of INH, rifampin, pyrazinamide, and ethambutol.

What are the continuation phase options after the initial eight weeks of TB treatment?

After the initial eight weeks, the continuation phase options are taking INH and rifampin for 126 doses or about 18 weeks, or taking two times weekly INH and rifampin for 36 doses over 18 weeks.

What is the concern with developing drug-resistant TB?

The concern with drug-resistant TB is that the bacteria can become resistant to one or more of the medications, making it much more difficult to treat.

What are some potential side effects of INH that patients should be monitored for?

Patients taking INH should be monitored for potential side effects such as peripheral neuropathy, seizures, hepatitis, and jaundice.

Why is it important to monitor liver function tests in patients taking INH?

It is important to monitor liver function tests in patients taking INH because it can cause liver damage, and close monitoring can help detect and manage this side effect.

What dietary advice should be given to patients taking INH to minimize side effects?

Patients taking INH should avoid foods high in tyramine, such as pickled meats, aged and smoked meats, alcohol, exotic foods, and certain types of cheese, to minimize the risk of side effects.