Isoniazid Cycloserine

Bacterial cell wall j3-Lactams Glyoopeptides Cycloserine Isoniazid Ethambutol Inhibit peptidoglycan synthesis Inhibit peptidoglycan synthesis Inhibits peptidoglycan synthesis Inhibits mycolic acid synthesis Inhibits arabinogalactan synthesis None in mammalian cells None in mammalian cells None in mammalian cells None in mammalian cells None in mammalian cells... 

CYCLOSERINE ISONIAZID Risk of drowsiness and dizziness Uncertain Be aware watch for t sedation... 

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

Second phase (4—7 mo) Isoniazid, rifampin Isoniazid, rifampin, ethamhutol Isoniazid, rifampin, capreomycin or cycloserine Isoniazid, rifampin, ethamhutol, streptomycin or kanamycin or ciprofloxacin or clarithromycin or capreomycin... 

Over 250 analogues of the B vitamers have been reported (11,100). Nearly all have low vitamin B activity and some show antagonism. Among these are the 4-deshydroxy analogue, pyridoxine 4-ethers, and 4-amino-5-hydroxymeth5i-2-methyipyrimidine, a biosynthetic precursor to thiamine. StmcturaHy unrelated antagonists include dmgs such as isoniazid, cycloserine, and penicillamine, which are known to bind to pyridoxal enzyme active sites (4). 

Because they are hepatically cleared, isoniazid and rifampin do not require dose modification in renal failure.31,36,39 Pyrazinamide and ethambutol typically are reduced to three times weekly to avoid accumulation of the parent drug (ethambutol) or metabolites (pyrazinamide).28,31 Renally cleared TB drugs include the aminoglycosides (e.g., amikacin, kanamycin, and streptomycin), capreomycin, ethambutol, cycloserine, and lev-ofloxacin.28,31,33,39 Dosing intervals need to be extended for... 

Drugs of choice are isoniazid, rifampin, ethambutol, along with streptomycin and pyrazinamide. Less well tolerated, second-line agents include p-aminosal-icylic acid, cycloserine, viomycin, ka-namycin, amikacin, capreomycin, ethionamide. 

Drugs that may interact with cycloserine include alcohol, ethionamide, and isoniazid. 

It is indicated to prevent and treat isoniazid, hydralazine, penicillamine and cycloserine induced neurological disturbances, mental symptoms in women on oral contraceptives, pyridoxine responsive anaemia and homocystinuria, morning sickness and hyperemesis gravidarum, convulsions in infants and children. 

Mycobacterium tuberculosis Isoniazid + rifampin + ethambutol + pyrazinamide Streptomycin, moxifloxacin, amikacin, ethionamide, cycloserine, PAS, linezolid... 

Isoniazid Isoniazid is incompatible with sugars. Isoniazid overdose may be severe to fatal, and treatment is symptomatic and supportive, including stomach wash for control of convulsions and treating metabolic acidosis. Administration of pyridoxine and hemodialysis may be needed. Isoniazid interacts with carba-mazepine, phenytoin, diazepam, triazolam, chlorzoxazone, theophylline, ethosux-imide, enflurane, cycloserine, and warfarin. 

Aminosalicylic acid - Cycloserine - Ethambutol - Ethionamide - Isoniazid - Pyrazinamide Rifampin... 

The drugs used to treat TB include capreomycin, cycloserine, ethambutol, isoniazid, pyrazinamide, rifabutin, rifampicin and streptomycin. Resistance is most likely with long courses of treatment of antimicrobial agents and treatment courses are six (or even nine) months long. 

Acid-fast bacilli Mycobaazerium tubercu/osis isoniazid + rifampicin pyrazinamidc a quinolone or cycloserine or capreomycm or... 

There are mild to moderate increases in liver transaminases during treatment with rifampicin plus isoniazid in most patients. However, biochemical hepatitis is diagnosed when transaminase activities increase to more than four times the upper limit of the reference ranges on two occasions at least 1 week apart, or more than five times on any single occasion. This calls for withdrawal of all potentially hepatotoxic drugs (rifampicin, isoniazid, and pyrazinamide) until the enzymes return to the reference ranges. During this period, streptomycin plus etham-butol, with or without cycloserine and a fluoroquinolone, is recommended in seriously ill patients. 

Pyridoxine hydrochloride is indicated in the treatment and prevention of vitamin deficiency. It is also approved forcon-current administration with isoniazid and cycloserine to decrease their toxicity. Concurrent administration of pyridux-ine hydrochloride and Icvodopa is nut recommended. The decarboxylation of levudopa to dopamine in the peripheiy is increased by pyridoxine. so that less levodupa reaches IIk central nervous system. 

Patients with CNS tuberculosis usually are treated for longer periods (9 to 12 months instead of 6 months) (Table 110-4). In general, isoniazid, pyrazinamide, ethionamide, and cycloserine penetrate the cerebrospinal fluid (CSF) readily, but rifampin, ethambutol, and streptomycin have variable CNS penetration." Of the quinolones, levofloxacin may be preferred based on current data. Extrapulmonary TB of the soft tissues can be treated with conventional regimens. 

Data are not available for dosing the TB drugs in patients with morbid obesity." Relatively hydrophilic drugs (isoniazid, pyrazinamide, the aminoglycosides, capreomycin, ethambutol, p-aminosalicylic acid, and cycloserine) can be dosed initially based on ideal body weight... 

M. tuberculosis Isoniazid -1- rifampin - -pyrazinamide -1- ethambutol or streptomycin Moxifloxacin or gatifloxacin cycloserine capreomycin kanamycin amikacin ethionamide clofazimine aminosalicylic acid... 

---