Antitubercular drugs may interact with many other drugs.
• Cycloserine and ethionamide may produce additive CNS effects, such as drowsiness, dizziness, headache, lethargy, depression, tremor, anxiety, confusion, and tinnitus (ringing in the ears), when administered with isoniazid.
• Isoniazid may increase levels of phenytoin, carbamazepine, diazepam, ethosuximide, primidone, theophylline, and warfarin.
• When corticosteroids and isoniazid are taken together, the effectiveness of isoniazid is reduced while the effects of corticosteroids are increased.
• Isoniazid may reduce the plasma levels of ketoconazole, itraconazole, and oral antidiabetic agents.
• Oral contraceptives and rifampin taken together may decrease the effectiveness of the oral contraceptive.
• When given together, rifampin, isoniazid, ethionamide, and pyrazinamide increase the risk of hepatotoxicity.
• Pyrazinamide combined with phenytoin may increase phenytoin levels.
Adverse reactions to antitubercular drugs 抗结核病药的不良反应
Ethambutol 乙胺丁醇
Itching, joint pain, GI distress, malaise, leukopenia, headache, dizziness, numbness and tingling of the extremities, optic neuritis, and confusion may occur. Although rare, hypersensitivity reactions to ethambutol may produce rash and fever. Anaphylaxis may also occur.
Peripheral neuropathy is the most common adverse reaction. Severe and occasionally fatal hepatitis associated with isoniazid may occur even many months after treatment has stopped. The patient must be monitored carefully.
The most common adverse reactions include epigastric pain, nausea, vomiting, abdominal cramps, flatulence, anorexia, and diarrhea.
最常见不良反应包括心口痛、恶心、呕吐、腹部绞痛、气胀、厌食和腹泻。
Pyrazinamide 吡嗪酰胺
Liver toxicity is the major limiting adverse reaction. GI disturbances include nausea, vomiting, hyperuricemia, arthralgia, and anorexia.
肝毒性为主要的限制性不良反应。GI障碍包括恶心、呕吐、高尿酸血症、关节痛和厌食
Vocabulary for Today
cycloserine – n. 环丝氨酸
ethionamide – n. 乙硫异烟胺
phenytoin – n. 苯妥英
carbamazepine – n. 卡马西平
diazepam – n. 地西泮
ethosuximide – n. 乙琥胺
primidone – n. 扑米酮
theophylline – n. 茶碱
pyrazinamide – n. 吡嗪酰胺
This medication can cause inflammation of the optic nerve. Therefore, it is very important the nurse asks the patient about their vision. If the patient has blurred vision or reports a change in colors, the MD must be notified immediately.
2. C. Vitamin B6
This medication can lead to low Vitamin B6 levels. Most patients will take a supplement of B6 while taking this medication.