Ethionamide Rifampin

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... 

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. 

A. Ethambutol is associated with retrobulbar neuritis, resulting in loss of central vision and impaired red-green discrimination. Ethionamide (B) is an analogue of isonicotinic acid and is associated with GI intolerance and peripheral neuropathy, but not the optic neuritis or color vision discrimination problems. Aminosalicylic acid (C) can cause GI irritation and bleeding problems, so caution is required in peptic ulcer patients. It has no neurological side effects. Rifampin (D) is associated with red-orange discoloration of saliva, tears, and urine but not the color vision problems. Isoniazid (E) is associated with peripheral neuritis in chronic alcoholics and malnourished individuals and requires pyridoxine supplements. It is not associated with optic neuritis. 

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

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

Pattyn SR, Janssens L, Bourland J, Saylan T, Davies EM, Grillone S, Feracci C. Hepatotoxicity of the combination of rifampin-ethionamide in the treatment of multibacillary leprosy. Int J Lepr Other Mycobact Dis 1984 52(l) l-6. 

The most common drugs responsible for acneform eruptions are ACTH, androgenic hormones, anticonvulsants (hydantoin derivatives, phenobarbital, trimethadione), corticosteroids, danazol, disulfiram, halogens (bromides, chlorides, iodides), lithium, oral contraceptives, tuberculostatics (ethionamide, isoniazid, rifampin), vitamins B2, B6, and B12. 

Sulfonamides Choramphenicol Rifampin Ethionamide Metronidazole Therapeutic Levels Penicillin G Carbenicillin Nafcillin Piperacillin Cefotaxime Ceftriaxone Imipenem Meropenem Vancomycin Vidarabine Flucytosine Pyrimethamine Acyclovir Linezolid Colistin... 

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. 

Antituberculosis drugs that rely on hepatic clearance for most of their elimination include isoniazid, rifampin, pyrazinamide, ethionamide. 

Ethionamide, which has bacteriostatic actions against M. tuberculosis (0.5 to 1 g/day in divided doses) is indicated in the treatment of tuberculosis where first-line drugs such as isoniazid and rifampin have failed. The side effects of ethionamide may include nausea and vomiting, diarrhea, metallic taste, hepatitis, jaundice, stomatitis, depression, drowsiness, asthenia, peripheral neuritis, olfactory disturbances, diplopia, blurred vision, optic neuritis, convulsions, postural hypotension, thrombocytopenia, gynecomastia, impotence, menorrhagia, or diabetes mellitus. 

Ethionamide is an antituberculosis agent that causes inhibition of peptide synthesis in susceptible organisms. It is indicated in the treatment of tuberculosis, in combination with other agents, in patients with M. tuberculosis resistant to isoniazid or rifampin, or when there is intolerance to other antituberculous agents. 

Extracted bromazepam, caffeine, carbamazepine, chloramphenicol, chlorothiazide, diazepam, droperidol, ethionamide, fiirosemide, isoniazid, methadone, penicillin G, phenobar-bital, phen3doin, prazepam, propoxyphene, pyrazinamide, rifampin, trimeprazine, trimethoprim... 

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

M. avium complex Clarithromycin or azithromycin -1- ethambutol with or without rifabutin Rifabutin rifampin ethionamide cycloserine moxifloxacin or gatifloxacin... 

M. leprae Dapsone -1- rifampin + clofazimine Minocycline moxifloxacin or gatifloxacin clarithromycin ethionamide... 

Antimycobacterials and related drugs Aminosalicylic acid (PAS), Capreomycin, Clofazimine, Cycloserine, Dapsone, Ethambutol, Ethionamide, Isoniazid, Methaniazide, Protionamide, Pyrazinamide, Rifabutin, Rifampicin (Rifampin), Rifamycin, Rihipentine, Rihiximin... 

Rifampin-, isoniazid-, streptomycin-, ethambutol-, and ethionamide-resistant strains have been found that are virtually untreacable with existing antibiotics cases have increased 28% since the 1980s. 

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