pyrazinamide


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Related to pyrazinamide: ethambutol

pyrazinamide

 [pir″ah-zin´ah-mīd]
an antibacterial derived from nicotinic acid, used in treatment of tuberculosis.

pyrazinamide

PMS Pyrazinamide (CA), Tebrazid (CA)

Pharmacologic class: Niacinamide derivative

Therapeutic class: Antitubercular

Pregnancy risk category C

Action

Unknown. Thought to exert bacteriostatic activity.

Availability

Tablets: 500 mg

Indications and dosages

Tuberculosis

Adults and children: 15 to 30 mg/kg/day P.O., not to exceed 2 g/day; or 50 to 70 mg/kg P.O. twice weekly, up to a maximum of 4 g/dose; or 50 to 70 mg/kg/dose P.O. three times weekly, up to a maximum of 3 g/dose

Dosage adjustment

• Renal impairment

Contraindications

• Hypersensitivity to drug

• Severe hepatic disease

• Acute gout

Precautions

Use cautiously in:

• renal failure, diabetes mellitus, porphyria, chronic gout, history of gout

• pregnant or breastfeeding patients

• children younger than age 13.

Administration

• Give with other antituberculars, as prescribed, to reduce risk of resistant organisms.

• Be aware that drug therapy may last 6 months or longer.

Adverse reactions

CNS: headache

GI: nausea, vomiting, diarrhea, peptic ulcer, abdominal cramps, anorexia

GU: dysuria, increased uric acid secretion

Hematologic: hemolytic anemia

Hepatic: hepatotoxicity

Metabolic: hyperuricemia, gout

Musculoskeletal: joint pain

Skin: urticaria, photosensitivity

Interactions

Drug-drug. Ethionamide: increased risk of hepatotoxicity

Probenecid: decreased probenecid efficacy (possibly precipitating gout)

Drug-diagnostic tests. Acetest or Ketostix urine test: false interpretation

Liver function tests: abnormal results

Uric acid: increased level

Patient monitoring

• Monitor CBC, uric acid level, and liver and kidney function tests.

• Assess for signs and symptoms of gout, hepatic failure, and hemolytic anemia.

Discontinue at first sign of hepatic impairment or hyperuricemia accompanied by acute gouty arthritis.

Patient teaching

• Advise patient to take regularly with other antituberculars, as prescribed.

Teach patient to recognize and immediately report signs and symptoms of gout and liver impairment.

• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs and tests mentioned above.

pyrazinamide

An antituberculosis drug that diffuses well into the CEREBRO-SPINAL FLUID and is used to treat tuberculous MENINGITIS. The drug is on the WHO official list. A brand name, with other antituberculosis drugs, is Rifater.
References in periodicals archive ?
Eligible individuals were allocated to the 2-month regimen with HUEXC030, isoniazid, rifampin, and pyrazinamide or the 3-month regimen with isoniazid and rifapentine.
Reference drug pyrazinamide (PZ) was obtained as a gift from Wyeth Pakistan Ltd.
Rats were treated with 1 ml/kg of 500 mg/kg PZA in saline daily, which was reported as a hepatotoxic dose of pyrazinamide in previous investigation.
isoniazid, years old Africa pyrazinamide, ethionamide, ethambutol/ ofloxacin * (3) Adler-Shohet Prospective 9 mon Children et al.
Of them, 56(34.36%) samples showed resistance to rifampicin, 47(28.8%) samples to streptomycin, 31(19%) to ethambutol, 16(9.82%) to pyrazinamide and 59(36.2%) to ofloxacin (Table-2).
* Our patient was discharged from the hospital after 2 weeks on an anti-TB medication regimen of INH, rifampin, and pyrazinamide, along with pyridoxine and a tapering dose of dexamethasone.
Some drugs used in management of MDR CNS TB penetrate the blood-brain barrier and these include quinolones, pyrazinamide, linezolid, cycloserine, and ethionamide [5-7].
TB drug TB resistant isolates n (%) Isoniazid mono-resistant 3 (1.7) Rifampicin mono-resistant 1 (0.6) Pyrazinamide mono-resistant 6 (3.5) Ethambutol mono-resistant 0 (0) Isoniazid plus rifampicin 3 (1.7) (multi-drug resistant) Table 2: Demographic characteristics of patients with culture-positive drug-sensitive and drug-resistant TB.
Almost 50% of the MDRTB cases were found to be resistant to Pyrazinamide and did not possess Pyrazinamidase activity.
MDR, KMRC 00116-00250, pathogenic-resistant to isoniazid, rifampicin, streptomycin, and pyrazinamide; XDR, KMRC 00203- 00197, pathogenic-resistant to isoniazid, rifampicin, ethambutol, kanamycin, ofloxacin, rifabutin and amikacin, but susceptible to capreomycin, streptomycin, moxifloxacin, prothionamide, p-aminosalicylic, and cycloserine.
Fifty-five Thai patients with tuberculosis were randomly assigned to receive, in double-blind fashion, 140 mg of silymarin 3 times per day or placebo, in addition to a standard antituberculosis treatment regimen of isoniazid (5 mg/kg/day), rifampicin (10 mg/ kg/day), pyrazinamide (25 mg/kg/day), and ethambutol (15 mg/ kg/day).
Patient first received primary anti-TB drugs including a combination of four drugs isoniazid, rifampicin, pyrazinamide, ethambutol for an initial phase of 2 months, followed by isoniazid and rifampicin for 4 months.