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Chapter 24 Coordinating Care for Patients With Infectious Respiratory Disorders
Table 24.11 Medications Used in the Treatment of Tuberculosis
Medication Classification
Mechanism of Action Inhibits myco- bacterial cell wall formation
Exemplars
Nursing Implications
Antitubercular
Isoniazid (INH, Hydra, Hyzyd, Isovit, Nydrazid)
Baseline and ongoing laboratory monitoring: l CBC l Chemistries l Renal function l Liver panel
l Hepatitis panel l Vitamin B 6 level l Coagulation Monitor for:
l Onset of peripheral neuropathies (numbness and/or tingling of hands/ feet). Vitamin B 6 supplements should be taken for course of therapy. l Appearance of skin rashes or jaundice. l Orthostatic hypotension; may occur during dosing adjustments. Patient education: l Complete entire course of prescribed medication. l Avoid foods containing tyramine (pickled/cured/smoked meats, aged cheeses). l Avoid drinking alcohol during treatment. l Do not get pregnant or breastfeed during course of therapy. l Report any symptoms of toxicity (abnormal bleeding, decreased urine output, dark urine, clay-colored stools, skin rashes) or intolerance to medication. Baseline and ongoing laboratory monitoring: l CBC l Chemistries l Renal function l Liver panel l Hepatitis panel l Coagulation l Vitamin K level Monitor for: l Appearance of jaundice, persistent GI adverse effects l Abnormal bleeding l Loss of glycemic control in diabetic patients Patient Education: l Complete entire course of prescribed therapy. l Drug may cause a red/orange coloring of body fluids (tears, sweat, urine, sputum) and may permanently stain soft contact lenses. l Take this medication on an empty stomach (1–2 hours before or after meals). l Report any onset of abnormal bleeding (easy bruising, epistaxis, bleed- ing gums, blood in emesis or stool), especially if on anticoagulants. l Do not become pregnant or breastfeed during course of therapy.
Antibiotic
Inhibits DNA- dependent RNA synthesis
Rifampin (Rifadin, Rimactane, Rofact)
Continued
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