Anti-Infective – Antitubercular

You're watching a preview. 300,000+ students are watching the full lesson.
Master
To Master a topic you must score > 80% on the lesson quiz.
Take Quiz

Included In This Lesson

NURSING.com students have a 99.25% NCLEX pass rate.

Outline

Overview

  I.         Overview

A.    Mycobacterium

B.    Tuberculosis (TB) infections

1.     Pulmonary

2.     Extrapulmonary

     II.         Mechanism of Action

A.    Inhibit protein synthesis

B.    Inhibit cell wall synthesis

   III.         Types (RIPES)

A.    Rifampin

B.    Isoniazid

C.     Pyrazinamide

D.    Ethambutol

E.     Streptomycin

   IV.         Indications

A.    Mycobacterium

B.    Tuberculosis (TB) infections

1.     Pulmonary

2.     Extrapulmonary

3.     TB treatment failures / relapses

    V.         Contraindications

A.    Liver disease

B.    Kidney disease

   VI.         Side Effects

A.    CNS

1.     Ototoxicity

2.     Seizures

3.     Visual disturbances

4.     Dizziness

5.     Headache

Kidney / Liver

1.     Nephrotoxicity

2.     Hepatoxicity

B.    * Rifampin  / Isoniazid

1.     Red-orange-brown colored bodily secretion

2.     Urine

3.     Sweat

4.     Tears

5.     Sputum

Unlock the Complete Study System

Used by 300,000+ nursing students. 99.25% NCLEX pass rate.

200% NCLEX Pass Guarantee.
No Contract. Cancel Anytime.

Transcript

Welcome back and today we are going to discuss antitubercular medications.
Antitubercular medications treat mycobacterium and TB infections which are pulmonary and extrapulmonary (kidney, spine or brain). With the most common location is pulmonary.

The mechanisms of actions are the inhibition of protein synthesis (which work in RNA/DNA replication – how bacteria communicate) and cell wall synthesis (which provide structural support). There are many drugs in this drug class but each drug performs one of these actions. So this drug class stop the bacteria from being able to replicate and function. Antitubercular medications treat mycobacterium and TB infections which are pulmonary and extrapulmonary (kidney, spine or brain). With the most common location is pulmonary.

Now, the types of drugs in the antitubercular section include the following. An easy way to remember these is the word RIPES – with the top two being rifampin and isoniazid. Years ago, I had a patient (who visited Florida from Africa) on rifampin and isoniazid who had HIV. TB is a common cause of death in this patient population who reside in Africa.

Now, the indications are two-fold mycobacterium and TB. Mycobacterium comes in many forms, focus only on the word “mycobacterium” and you will be fine. If you see mycobacterium, I want to immediately think antitubercular medications. And TB is again pulmonary or extrapulmonary (kidney, spine, brain).  Now these drugs aren’t medications a patient is going to get for a few days. These drugs are usually given for 6-9 months on strict regimen and require strict monitoring for compliance. Please refer to the tuberculous lesson in the respiratory course for more details.

Contraindications are based in the drug’s excretion route (kidney and liver). If you have liver or kidney failure, you will not properly dispose of the drug. I had a patient with liver disease, who was administered rifampin, that drug lingered their system for days, causing all kinds of havoc.

The side effect profiles are CNS and liver/kidney based. In the CNS, think ears, brain and eyes. And the drugs cause kidney and liver toxicity, which explains the contraindications mentioned earlier.

Alright, rifampin and isoniazid both have a unique side effect of red-orange-brown colored bodily secretions. I had a patient with orange sputum once, it’s something you will not forget and something you must educate your patients as a possible side effect or they will be in in the hospital freaking out! As, rightfully so.

Priority nursing concepts for a patient taking antitubercular medications include: infection control and pharmacology.

Antitubercular medications treat mycobacterium and TB infections – pulmonary and extrapulmonary (kidney, spine or brain). Any easy way to remember the types is RIPES, with Contraindications are based in the drug’s excretion route (kidney and liver). Side effects focus on ears, brain and eyes. And a special note is isoniazid / rifampin’s ability to turn your bodily fluids red-orange-brown.

Study Faster with Full Video Transcripts

99.25% NCLEX Pass Rate vs 88.8% National Average

200% NCLEX Pass Guarantee.
No Contract. Cancel Anytime.

🎉 Special Offer 🎉

Nursing School Doesn't Have To Be So Hard

Go from discouraged and stressed to motivated and passionate

Exam 4

Concepts Covered:

  • Hematologic Disorders
  • Hematologic Disorders
  • Labor Complications
  • Respiratory Disorders
  • Proteins
  • Oncologic Disorders
  • Oncology Disorders
  • Cardiac Disorders
  • Medication Administration
  • Immunological Disorders
  • Renal Disorders
  • Eating Disorders
  • Liver & Gallbladder Disorders
  • Substance Abuse Disorders
  • Intraoperative Nursing
  • Infectious Respiratory Disorder
  • Pregnancy Risks
  • Upper GI Disorders
  • Microbiology
  • Shock
  • Postpartum Complications
  • Studying
  • Shock
  • Disorders of the Posterior Pituitary Gland
  • Emergency Care of the Trauma Patient
  • Integumentary Disorders
  • Central Nervous System Disorders – Brain
  • Neurological Trauma
  • Respiratory Emergencies
  • Emergency Care of the Cardiac Patient
  • Acute & Chronic Renal Disorders
  • Endocrine and Metabolic Disorders
  • Urinary System
  • Urinary Disorders

Study Plan Lessons

Sickle Cell Anemia
Nursing Care and Pathophysiology for Sickle Cell Anemia
Types of Anemia Nursing Mnemonic (Always Introduce Special Patients)
Treatment of Sickle Cell Nursing Mnemonic (HOP to the hospital)
Blood Transfusions (Administration)
Anti-Infective – Antivirals
Blood Transfusions (Administration)
Hemoglobin (Hbg) Lab Values
Hemoglobin (Hbg) Lab Values
Hemoglobin and Myoglobin
Red Blood Cell (RBC) Lab Values
Red Blood Cell (RBC) Lab Values
Nursing Care Plan (NCP) for Sickle Cell Anemia
Sickle Cell Anemia
Nursing Care Plan (NCP) for Sickle Cell Anemia
Leukemia Case Study (60 min)
Nursing Care Plan (NCP) for Leukemia
Leukemia
Leukemia – Signs and Symptoms Nursing Mnemonic (ANT)
Nursing Care Plan (NCP) for Leukemia
Leukemia
Leukemia
Antimetabolites
Alkylating Agents
Nursing Care Plan (NCP) for Thrombocytopenia
Nursing Care Plan (NCP) for Neutropenia
Hematocrit (Hct) Lab Values
Platelets (PLT) Lab Values
Chemotherapy Patients
Anti-Platelet Aggregate
Nursing Care Plan (NCP) for Neutropenia
Nursing Care Plan (NCP) for Thrombocytopenia
Platelets (PLT) Lab Values
Hematocrit (Hct) Lab Values
Oncology Module Intro
Nursing Care Plan (NCP) for Lymphoma (Hodgkin’s, Non-Hodgkin’s)
Lymphoma
Lymphoma – Signs and Symptoms Nursing Mnemonic (NURSE For Pete’s Sake)
Nursing Care Plan (NCP) for Lymphoma (Hodgkin’s, Non-Hodgkin’s)
Lymphoma
Anti Tumor Antibiotics
Brain Tumors
Head/Neck Assessment
Corticosteroids
Pediatric Oncology Basics
Head/Neck Assessment
Corticosteroids
Multiple Myeloma
Nursing Care Plan (NCP) for Acute Kidney Injury
Nursing Care Plan (NCP) for Nephrotic Syndrome
Nursing Care Plan (NCP) for Acute Kidney Injury
Calcium-Ca (Hypercalcemia, Hypocalcemia)
Nursing Care and Pathophysiology for Hepatitis (Liver Disease)
Nursing Care and Pathophysiology for Cirrhosis (Liver Disease, Hepatic encephalopathy, Portal Hypertension, Esophageal Varices)
Nursing Care and Pathophysiology for Hepatitis (Liver Disease)
Nursing Care and Pathophysiology for Cirrhosis (Liver Disease, Hepatic encephalopathy, Portal Hypertension, Esophageal Varices)
Liver Cancer
Nursing Care Plan for Cirrhosis (Liver)
Nursing Care Plan for Cirrhosis (Liver)
Nutrition (Diet) in Disease
Liver Function Tests
Liver/Gallbladder Module Intro
Cirrhosis Case Study (45 min)
Barbiturates
Anti-Infective – Antitubercular
Benzodiazepines
Nursing Care and Pathophysiology for Disseminated Intravascular Coagulation (DIC)
Creatinine (Cr) Lab Values
Coagulation Studies (PT, PTT, INR)
Albumin Lab Values
Furosemide (Lasix) Nursing Considerations
Anti-Infective – Antitubercular
Barbiturates
Enteral & Parenteral Nutrition (Diet, TPN)
Cholesterol (Chol) Lab Values
Atorvastatin (Lipitor) Nursing Considerations
Creatinine (Cr) Lab Values
Total Bilirubin (T. Billi) Lab Values
Cholesterol (Chol) Lab Values
Albumin Lab Values
Benzodiazepines
Nursing Care and Pathophysiology for Disseminated Intravascular Coagulation (DIC)
Antimicrobial Vaccinations
Nursing Care Plan (NCP) for Systemic Lupus Erythematosus (SLE)
Diuretics (Loop, Potassium Sparing, Thiazide, Furosemide/Lasix)
Fluid Volume Overload
Nursing Care Plan (NCP) for Hypovolemic Shock
Septic Shock (Sepsis) Case Study (45 min)
Nursing Care Plan (NCP) for Cardiogenic Shock
Hypovolemic Shock Case Study (OB sim) (60 min)
Nursing Care and Pathophysiology for Distributive Shock
Nursing Care and Pathophysiology for Hypovolemic Shock
Nursing Care and Pathophysiology for Cardiogenic Shock
Shock – Signs and symptoms Nursing Mnemonic (TV SPARC CUBE)
Nursing Care Plan (NCP) for Hypovolemic Shock
Nursing Care Plan (NCP) for Cardiogenic Shock
Shock
Shock Module Intro
Nursing Care and Pathophysiology for Hypovolemic Shock
Nursing Care and Pathophysiology for Cardiogenic Shock
Nursing Care and Pathophysiology for Distributive Shock
Sepsis Concept Map
Sepsis Concept Map
Nursing Care Plan (NCP) for Diabetes Insipidus
Massive Transfusion Protocol
Disseminated Intravascular Coagulation Case Study (60 min)
Burn Injury Case Study (60 min)
Spinal Cord Injury Case Study (60 min)
Cerebral Perfusion Pressure Case Study (60 min)
Nursing Care Plan (NCP) for Spinal Cord Injury
Nursing Care Plan (NCP) for Acute Respiratory Distress Syndrome
Nursing Care Plan (NCP) for Atrial Fibrillation (AFib)
Nursing Care and Pathophysiology of Acute Kidney (Renal) Injury (AKI)
Metabolic Acidosis (interpretation and nursing diagnosis)
Burn Injuries
Disseminated Intravascular Coagulation (DIC)
Norepinephrine (Levophed) Nursing Considerations
Vasopressin (Pitressin) Nursing Considerations
Nursing Care Plan (NCP) for Atrial Fibrillation (AFib)
Fluid Volume Deficit
Nursing Care and Pathophysiology for Sepsis
Trauma – Complications Nursing Mnemonic (TRAUMATIC)
ARDS causes Nursing Mnemonic (GUT PASS)
Nursing Care Plan (NCP) for Spinal Cord Injury
Altered Mental Status Nursing Mnemonic (AEIOU TIPS)
Nursing Care Plan (NCP) for Sepsis
Nursing Care Plan (NCP) for Renal Calculi
Nursing Care Plan (NCP) for Diabetes Insipidus
Nursing Care Plan (NCP) for Blunt Chest Trauma
Nursing Care Plan (NCP) for Anaphylaxis
Nursing Care Plan (NCP) for Acute Respiratory Distress Syndrome
Penetrating Thoracic Trauma
Renin Angiotensin Aldosterone System (RAAS)
Burn Injuries
Hematomas in OB Nursing: Causes, Symptoms, and Nursing Care
Nursing Care and Pathophysiology of Acute Kidney (Renal) Injury (AKI)
Dialysis & Other Renal Points
Blunt Chest Trauma
Spinal Cord Injury