Antitubercular

Pyridinecarbonitriles, -carboxamides, and -carboxylic Acids. 3-Cyanopyridine (25) is used for the production of niaciu (27), or vitamin 4-Cyanopyridine (15) is used for making the antitubercular dmg isonia2id (31) (101). 

Aminosalicylic acid and its salts have been used in the treatment of tuberculosis, Aminosalicylic acid can be prepared by the carboxylation of m- am in oph en o1 (32). Aminosalicylic acid USP assays not less than 98.5% and not more than 100.5%, calculated on the anhydrous basis. The antitubercular agents are likely to be used as the more tolerated salts calcium [133-15-3] potassium [133-09-5] sodium [133-10-8] and the ethyl [6069-17-2] and phenyl [133-11-9] esters of -aminosalicylic acid. 

Monoamine Oxidase Inhibitors. MAOIs inactivate the enzyme MAO, which is responsible for the oxidative deamination of a variety of endogenous and exogenous substances. Among the endogenous substances are the neurotransmitters, norepinephrine, dopamine, and serotonin. The prototype MAOI is iproniazid [54-92-2] (25), originally tested as an antitubercular dmg and a close chemical relative of the effective antitubercular, isoniazid [54-85-3] (26). Tubercular patients exhibited mood elevation, although no reHef of their tuberculosis, following chronic administration of iproniazid. In... 

L-Dopa and Trimethoprim are two other dmgs that can be made from vanillin. u-Dopa is used for the treatment of Parkinson s disease Trimethoprim is an antiinfective agent used mainly for urinary tract infections and certain venereal diseases. Also, Mebeverine, an antispasmodic agent, and Verazide, a generic antitubercular agent, are dmgs that can be made from vanillin or its derivatives. 

In addition, various pyridopyridazines have been claimed to have activity as antibacterials and antiseptics, antitubercular agents, analgesics, anti-inflammatories, antiallergics, tranquillizers, CNS depressants and muscle relaxants. 

The thiophene analog of chloramphenicol (255) has been synthesized,as also have been similar structures. The antibacterial activity of all was much lower than that of the natural antibiotic. The thioamide of 2-thenoic acid has been prepared in a study of potential antitubercular compounds. It did not surpass thioisonico-tinamide in antitubercular activity. The thiosemicarbazones of thio-phenealdehydes and ketones (cf. Section VII,D) show high activity against Mycobacterium tuberculosis, but are very toxic. The thiosemi-carbazone of 4-(2-thienyl)-3-buten-2-one has been reported to be capable of completely inhibiting the in vitro growth of M. tuberculosis even in relatively low concentrations. ... 

Control of tuberculosis, long one of the scourges of mankind, began with the introduction of effective antibacterial agents. Thus, this disease was treated initially with some small measure of success with various sulfa drugs the advent of the antibiotic, streptomycin, provided a major advance in antitubercular therapy, as did the subsequent discovery of isoniazid and its analogs. 

Therapeutic Function Antitubercular Chemical Name Cyclic polypeptide antibiotic Common Name Caprolin Structural Formula ... 

Therapeutic Function Antitubercular Chemical Name D-4-amino-3-isoxazolidinone Common Name Orientomycin Structural Formula o... 

Therapeutic Function Antitubercular Chemical Name See structural formula Common Name —... 

Discuss the uses, general drug action, contraindications, precautions, interactions, and general adverse reactions associated with the administration of the antitubercular drugs. 

Discuss important preadministration and ongoing assessment activities the nurse should perform on the patient taking an antitubercular drug. 

Discuss ways to promote an optimal response to therapy, how to manage adverse reactions, and important points to keep in mind when educating patients about the use of the antitubercular drugs. 

The expected outcomes for the patient may include an optimal response to antitubercular therapy, management of common adverse reactions, and an understanding of and compliance with the prescribed treatment regimen. 

When administering die antitubercular drug by die parenteral route, die nurse is careful to rotate the injection sites. At die time of each injection, die nurse inspects previous injection sites for signs of swelling, redness, and tenderness. If a localized reaction persists or if die area appears to be infected, it is important to notify die primary health care provider. 

The nurse should give antitubercular dragp by die oral route and on an empty stomach, unless gastric upset occurs. If gastric upset occurs, it is important to notify die primary healdi care provider before the next dose is given. 

Monitoring and Managing Adverse Reactions Managing adverse reactions in patients taking antitubercular drug s is an important responsibility of die nurse The nurse must continuously observe for signs of adverse reactions and immediately report them to tlie primary health care provider. Some information specific to die different antitubercular drug s is provided below. 

Older adults are particularly susceptible to a potentially fatal hepatitis when taking isoniazd, especially if they consume alcohol on a regular basis. Two other antitubercular drugs rifampin and pyrazinamide, can cause liver dysfunction in the older adult. Careful observation and monitoring for signs of liver impairment are necessary (eg, increased serum aspartate transaminase, increased serum alanine transferase, increased serum bilirubin, and jaundice). 

The nurse reviews the dosage schedule and adverse effects associated with the prescribed antitubercular drug with the patient and family. Information that applies to all patients taking these drugs includes ... 

The results of antitubercular therapy will be monitored at periodic intervals. Laboratory and diagnostic tests and visits to the primary health care provider s office or clinic are necessary. 

The nurse includes the following information in the teaching plan when a specific antitubercular drug is prescribed ... 

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