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[11] In the presence of inhA mutations, significant cross-resistance between INH and ethionamide has been observed.
AMK, amikacin, amikacin; CAP, capreomycin; CIP, ciprofloxacin; CYS, cycloserine; EMB, ethambutol; ETH, ethionamide; KAN, kanamycin; LVX, levofloxacin; MXF, moxifloxacin; OFX, ofloxacin; PAS, para-aminosalicylic acid; PTH, prothionamide; PZA, pyrazinamide; STR, streptomycin; TRZ, terizidone.
In doses of 5 to 100 mg/kg of body weight, caraway extract has been found to be a highly efficacious bioenhancer, boosting the potency of cycloserine by 75%, of rifampicin by 110%, and of ethionamide by 68%.
However, higher adverse events were recorded with ethionamide and pyrazinamide while fluoroquinolones had minimal toxicity.
Capreomycin (2.5 [micro]g/mL), cycloserine (70 [micro]g/mL), ethionamide (2.5 [micro]g/mL), kanamycin (2.5 [micro]g/mL) and ciprofloxacin (1 [micro]g/mL).
The following regimen is used for MDRTB treatment: Kanamycin or Capreomycin, Levofloxacin, Cycloserine, Ethionamide, Pyrazinamide, and Ethambutol.
Final susceptibility results demonstrated resistance to isoniazid, rifampicin, rifabutin, clofazimine, and streptomycin with sensitivity to ethambutol, pyrazinamide, amikacin, capreomycin, ciprofloxacin, cycloserine, and ethionamide. The regimen was continued without rifabutin.
Patient was a known case of multidrug resistant tuberculosis and was being treated with the following drugs for two months: amoxicillin-clavulanate, ethionamide, intramuscular capreomycin, linezolid, and para-aminosalicylate (PAS) granules.
Considering the patient previous treatment schemes, and based on expert's opinion, after normalization of liver enzymes, a slower reintroduction of second-line drugs was made: starting with levofloxacin 750 mg/day and amikacin 750 mg/day, twenty days later adding ethionamide 500 mg/ day and 27 days later adding cycloserine 500 mg/day.
The second-line drugs are kanamycin, ciprofloxacin, ethionamide, and so on.
The pyridine nucleus is also a constituent of many structurally simple drugs such as ethionamide and isoniazid, both these drugs are important prodrugs for enoyl-acyl carrier protein reductase used in the treatment of tuberculosis, bupicomide used as dopamine, b-hydroxylase inhibitor in the treatment of hypertension and amrinone used as phosphodiesterase 3 inhibitor in the treatment of heart failure (Fig.