Pyrazinamide Alcohol

Parts of pyrazine-2arboxylic acid is heated in a reaction vessel provided with an intake for Inert gas. The reaction mixture is heated in a bath held at 220°C and nitrogen is introduced. The solid material melts and effervesces and sublimed pyrazinamide vapors are carried out of the reaction vessel in the nitrogen stream. They are introduced into a suitably cooled condenser, condensing in the form of a white sublimate. After the reaction is proceeding vigorously the bath temperature is raised to 255 C and then gradually and slowly allowed to drop to 190°C over a period of time sufficient to permit the reaction to go substantially to completion. The sublimed pyrazinamide, if desired, is further purified by recrystallization from water or alcohol. 

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). 

Hepatotoxicity can occur with several antituberculous drugs including ethionamide, isoniazid, pyrazinamide and rifampicin and high alcohol consumption/chronic alcoholism has been reported to increase the risk. However, one study in patients with active tuberculosis taking rifampicin and pyrazinamide, found that of the 14 patients who developed hepatotoxicity, only 5 of these reported alcohol use (not quantified), and alcohol was not found to be associated with an increased risk of hepatotoxicity. Similarly, another study found that alcohol consumption was not a risk factor for antimycobacterial-induced hepatotoxicity. ... 

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