Antibiotics - Antimycobacterials: Nursing Pharmacology
ANTIBIOTICS: ANTIMYCOBACTERIALS, PART 1/5 | |||
DRUG NAME | isoniazid (INH) | ethambutol (EMB): Myambutol | rifapentine (RPT): Priftin |
CLASS | Antimycobacterial antibiotics (first line) | ||
MECHANISM of ACTION | Inhibition of the synthesis of cell wall components | Inhibits DNA-dependent RNA polymerase | |
INDICATIONS | Tuberculosis | ||
ROUTE(S) of ADMINISTRATION | PO; IM | PO IV (rifampin) | |
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ANTIBIOTICS: ANTIMYCOBACTERIALS, PART 2/5 | |||
DRUG NAME | rifampin (RIF): Rifadin | pyrazinamide (PZA) | streptomycin (SM) |
CLASS | Antimycobacterial antibiotics (first line) | ||
MECHANISM of ACTION | Inhibits DNA-dependent RNA polymerase | Inhibits bacterial fatty acid synthesis (not fully understood) | Inhibits bacterial protein synthesis at the ribosomal level |
INDICATIONS | Tuberculosis | ||
ROUTE(S) of ADMINISTRATION | PO IV (rifampin) | IM, IV | |
SIDE EFFECTS |
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CONTRA-INDICATIONS and CAUTIONS |
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ANTIBIOTICS: ANTIMYCOBACTERIALS, PART 3/5 | |||
DRUG NAME | dapsone | bedaquiline: Sirturo | capreomycin: Capastat Sulfate |
CLASS | Antimycobacterial antibiotics (first line) | Antimycobacterial antibiotics (second line) | |
MECHANISM of ACTION | Inhibits of folic acid pathway in bacteria | Inhibits bacterial ATP synthesis | Inhibits bacterial protein synthesis at the ribosomal level |
INDICATIONS | Leprosy | Multidrug-resistant tuberculosis | |
ROUTE(S) of ADMINISTRATION | PO | IV, IM | |
SIDE EFFECTS |
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CONTRA-INDICATIONS and CAUTIONS |
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ANTIBIOTICS: ANTIMYCOBACTERIALS, PART 4/5 | |||
DRUG NAME | cycloserine: Seromycin | ethionamide: Trecator | rifabutin: Mycobutin |
CLASS | Antimycobacterial antibiotics (second line) | ||
MECHANISM of ACTION | Inhibits bacterial cell wall synthesis | Inhibits DNA-dependent RNA polymerase | |
INDICATIONS | Multidrug-resistant tuberculosis | Mycobacterium avium Complex | |
ROUTE(S) of ADMINISTRATION | PO | ||
SIDE EFFECTS |
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CONTRA-INDICATIONS and CAUTIONS |
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ANTIBIOTICS: ANTIMYCOBACTERIALS, PART 5/5 | ||
DRUG NAME | amikacin: Amikin | aminosalicylic acid |
CLASS | Antimycobacterial antibiotics (second line) | |
MECHANISM of ACTION | Inhibits bacterial protein synthesis at the ribosomal level | Inhibits bacterial cell wall synthesis |
INDICATIONS | Multidrug-resistant tuberculosis | |
ROUTE(S) of ADMINISTRATION | IV; IM, INH (amikin) PO (aminosalicylic acid) | |
SIDE EFFECTS |
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CONTRAINDICATIONS and CAUTIONS | Renal impairment |
NURSING CONSIDERATIONS FOR ANTIBIOTICS: ANTIMYCOBACTERIALS | ||
ASSESSMENT and MONITORING | isoniazid, rifampin, pyrazinamide, and ethambutol treatment regimen | |
Monitoring
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CLIENT EDUCATION |
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Mycobacterium is a genus of bacteria that includes many species that are pathogenic to humans. It’s known to cause tuberculosis, leprosy, and some non-tuberculosis lung infections. Antimycobacterials are a class of antibiotics effective against mycobacterium species. The primary targets of antimycobacterial drugs are the enzymes that mycobacteria use to build their cell walls. Antimycobacterial drugs are typically administered in combination to target different enzymes and minimize bacterial resistance to these antibiotics.
The first-line antimycobacterials for tuberculosis include rifampin, isoniazid, pyrazinamide, and ethambutol. Second-line antimycobacterials include bedaquiline, cycloserine, ethionamide, rifabutin, aminosalicylic acid, capreomycin, and amikacin. There is also dapsone used to treat leprosy. There may be cases that are multidrug resistant, and these are treated with drugs like bedaquiline, capreomycin, cycloserine, and amikacin.
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- "Ethambutol: An overview" (2021)
- "Rifamycins (rifampin, rifabutin, rifapentine)" (2021)
- "Capreomycin" (2018)
- "TUBERCULOSIS MEDICATION DRUG AND FOOD INTERACTIONS" (2010)
- "Mosby's 2021 Nursing Drug Reference" Mosby (2020)
- "Saunders Comprehensive Review for the NCLEX-RN Examination" Saunders (2016)
- "Focus on Nursing Pharmacology" LWW (2019)
- "Pharmacology" Elsevier Health Sciences (2014)
- "Lehne's Pharmacology for Nursing Care" Saunders (2018)