Isoniazid Ciprofloxacin

Chloral hydrate Chloramphenicol Cimetidine Ciprofloxacin Clofibrate Danazol Disulfiram Doxycycline Erythromycin Fenofibrate Fluconazole Fluorouracil Fluoxetine Fluvoxamine Gemfibrozil Influenza vaccine Isoniazid Itraconazole Fovastatin Metronidazole Miconazole Moxalactam Neomycin Norfloxacin Ofloxacin Omeprazole Phenylbutazone Piroxicam Propafenone Propoyxphene Quinidine Sertraline Sulfamethoxazole Sulfinpyrazone Tamoxifen Testosterone Vitamin E Zafirlukast... 

Elevations of serum transaminase concentrations generally are not correlated with the residual capacity of the liver to metabolize drugs, so these markers cannot be used directly as guides for residual metabolic capacity. Hepatically cleared TB drugs include isoniazid, rifampin, pyrazinamide, ethionamide, and p-aminosalicylic acid.39 Ciprofloxacin is about 50% cleared by... 

Antibacterials Ciprofloxacin Erythromycin Isoniazid Antidepressants Flnoxetine Huvoxamine Paroxetine Antifungal drugs Fluconazole Itraconazole Ketoconazole Miconazole Antiviral drugs Indinavir Ritonavir Saquinavir Cardiovascular drugs Amiodarone Diltiazem Quinidine Verapamil... 

Quinolones are important recent additions to the therapeutic agents used against M. tuberculosis, especially in MDR strains. Clinical trials of ofloxacin in combination with isoniazid and rifampin have indicated activity comparable to that of ethambutol. In addition, quinolones, particularly ciprofloxacin, are used as part of a combined regimen in HIV-infected patients. 

M kansasii Resembles tuberculosis Ciprofloxacin, clarithromycin, ethambutol, isoniazid, rifampin, trimethoprim-sulfamethoxazole... 

Drugs that may inhibit cytochrome P450 metabolism of other drugs include amiodarone, androgens, atazanavir, chloramphenicol, cimetidine, ciprofloxacin, clarithromycin, cyclosporine, delavirdine, diltiazem, diphenhydramine, disulfiram, enoxacin, erythromycin, fluconazole, fluoxetine, fluvoxamine, furanocoumarins (substances in grapefruit juice), indinavir, isoniazid, itraconazole, ketoconazole, metronidazole, mexile-tine, miconazole, nefazodone, omeprazole, paroxetine, propoxyphene, quinidine, ritonavir, sulfamethizole, verapamil, voriconazole, zafirlukast, and zileuton. 

Moxifloxacin s MIC90 value of 1 mg L"1 means that it has the same in vitro activity against M. tuberculosis as levofloxacin, and is more effective than ofloxacin (MIC90 = 2 mg L"1) and ciprofloxacin (MIC90 = 4 mg IT1) [192-194]. A combination of moxifloxacin and isoniazid proved to be more effective in vivo than the individual compounds [195,196], whereas a combination with ethambutol was less effective [196]. Based on the mutant prevention concentration (MPC), which is a parameter for the selection of resistant pathogens during antibiotic treatment, moxifloxacin was found to be the most effective fluoroquinolone against M. tuberculosis [197]. 

A 35-year old Caucasian man with AIDS and multiple opportunistic infections, including Mycobacterium kansasii and Mycobacterium avium complex (MAC) disease developed moderate to severe primary sensorineural hearing loss after 4—5 months of therapy with oral azithromycin 500 mg/day. Other medications included ethambutol, isoniazid, rifabutin, ciprofloxacin, co-trimoxazole, fluconazole, zidovudine (later switched to stavudine), lamivudine, indinavir, methadone, mod-ified-release oral morphine, pseudoephedrine, diphenhydramine, megestrol acetate, trazodone, sorbitol, salbutamol by metered-dose inhaler and nebulizer, ipratropium, and oral morphine solution as needed. Significant improvement of the hearing impairment was documented 3 weeks after drug withdrawal. 

As far as synthetic agents were concerned, isoniazid (a pyridine hydrazide structure) was found to be effective against human tuberculosis in 1952, and in 1962 nalidixic acid (Fig. 10.74) (the first of the quinolone antibacterial agents) was discovered. A second generation of this class of drugs was introduced in 1987 with ciprofloxacin (Fig. 10.74). 

Unfortunately, MAC is resistant to the standard drugs used for tuberculosis, such as isoniazid and pyrazinamide. Multiple agents such as rifampin, rifabutin (ansamycin), clofazimine, imipenem, amikacin, ethambutol, ciprofloxacin, clarithromycin, and azithromycin have varying degrees of in vitro anti-MAC activity. Controversy formerly existed as to whether treatment for MAC is beneficial, but data indicate that an aggressive therapeutic approach decreases symptoms... 

Antibiotics (selected) Potential for reduced bioavailability due to complexation of drug with divalent and trivalent cations found in enteral feeding May influence quinolone antibiotics, penicillin, tetracycline, isoniazid, and rifampin Consider holding tube feeding before and after administration Avoid jejunal administration of ciprofloxacin Monitor clinical response... 

Among anti-bacterial agents, the simplest must be isoniazide (Rimifon), an important anti-tuberculosis drug. Heterocyclic contributions to mainstream antibiotics include a group of quinolones e.g. the broad-spectrum anti-bacterial ciprofloxacin (Cipro) perhaps best known in connection with terrorist use of anthrax and the diamino-pyrimidine trimethoprim (Triprim). Many of the sulfonamides, the hrst synthetic antibiotics, contain heterocyclic residues. 

Anti-infective drugs Ciprofloxacin can greatly increase the risk of seizure induction in patients taking anticonvulsants. Erythromycin produces a rapid 100-200% rise in carbamazepine levels. There is a possibility of reduced plasma levels of the protease inhibitors indinavir and saquinavir with carbamazepine. Isoniazid increases carbamazepine serum levels, and leads to the possible emergence of toxicity (disorientation and aggression). Mefloquine may antagonize the anticonvulsant effect of carbamazepine. Ritonavir, a protease inhibitor, may cause toxicity by raising carbamazepine plasma levels. 

A) Amikacin, isoniazid, pyrazinamide, streptomycin Ciprofloxacin, cycloserine, isoniazid, PAS Ethambutol, isoniazid, rifabutin, streptomycin Ethambutol, pyrazinamide, rifampin, streptomycin Isoniazid, rifampin, pyrazinamide, ethambutol... 

Recently, ofloxacin, ciprofloxacin, and more recently sparfloxacin have been duly administered either with ethambutol, pyrazinamide, or isoniazid (INH), and rifobutin, and also in other combinations. Though one may observe certain promising results, but no specific and definite inferences may be drawn with regard to the clinical value of these new glaring approaches to the observed therapeutic efficacy. 

First phase (2 mo) Isoniazid, rifampin Isoniazid, rifampin, P5 razinamide Isoniazid, rifampin, streptomycin Isoniazid, rifampin, phrazin amide, kanamycin or ciprofloxacin... 

Ciprofloxacin may cause a modest increase in the bioavailability of isoniazid. 

In a single-dose study ciprofloxacin 500 mg was found to increase the absorption of isoniazid 300 mg by about 15%. The time to reaeh maximum plasma levels was increased from 3 hours to 4 hours. The rate of elimination and plasma half-life of isoniazid were not signifieantly affeeted. The effects on isoniazid absorption may be due to inhibition of gastrie motility and emptying by ciprofloxacin. However, these effeets are modest and unlikely to be clinically significant. 

Multidrug-resistant tuberculosis (MDR-TB) no longer can be cured by the leading TB antibiotics isoniazid (2) and rifampicin (3). Extensively drug-resistant TB (XDR-TB) is a form of TB caused by organisms that are resistant to isoniazid (2) and rifampicin (3), as well as fluoroquinolones such as ciprofloxacin (7), and ofloxacin (8) and any of the second-line anti-TB injectable drugs such as amikacin, kanamycin, or capreomycin. 

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