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Antitubercular medications: rifampin, isoniazid, pyrazinamide, and ethambutol are FDA approved to treat Mycobacterium tuberculosis infections. Antitubercular medications are a group of drugs used to treat tuberculosis. Tuberculosis (TB) is a disease caused by Mycobacterium tuberculosis (M-TB), an acid-fast aerobic bacteria that can grow on gram stain as either gram-positive or gram-negative. This review will outline the indications, contraindications, and other aspects of these drugs. Objectives: Identify the mechanism of action of antitubercular therapy. Describe the potential adverse effects of antitubercular therapy. Review the risk factors for developing drug resistance to antitubercular therapy. Summarize interprofessional team strategies for improving care coordination and communication to advance antitubercular therapy and improve outcomes. Access free multiple choice questions on this topic.

All first-line anti-tubercular medications, rifampin, isoniazid, pyrazinamide, and ethambutol, can exert hepatotoxic effects.[27][36] A continual rise in liver functions test should prompt discontinuation of treatment.[27] Aminoglycoside-induced nephrotoxicity is reversible when stopping the medication.[37] Renal toxicity depends on the patient if any underlying renal disease is present and on the dose of the medication being administered. Renal insufficiency is avoidable in most patients.[37]

Rifampin, isoniazid, pyrazinamide, and ethambutol are first-line antitubercular medications, which are FDA-approved and indicated for the treatment of Mycobacterium tuberculosis infections. The care for patients suffering from tuberculosis prompts critical care from an interprofessional team of healthcare professionals as the preventable infectious disease can lead to medication resistance and mortality. These healthcare professionals include a primary care clinician, an infectious disease specialist, a nurse, and a pharmacist. The primary care physicians and specialists should educate the patients about the consequences of non-adherence to pharmacotherapy for the full duration and how resistance to treatment can further develop into MDR-TB and cause mortality. Primary care clinicians should routinely monitor labs, as all four agents are hepatotoxic drugs. Counseling and careful monitoring should be conducted during pregnancy, as some second-line medications are teratogenic. Clinicians should be up to date with the newly FDA-approved MDR-TB and their effects in the event drug resistance develops. Interprofessional communication between all team members is key to building patient rapport and developing a therapeutic alliance, so the patients adhere to therapy adequately to eradicate the bacteria and prevent further spread. This interprofessional approach with open communication channels between team members will drive better patient outcomes with fewer adverse events. [Level 5]