Tuberculosis: drug side-effects and mechanism of action

Tuberculosis: drug side-effects and mechanism of action

• mechanism of action: inhibits bacterial DNA dependent RNA polymerase preventing transcription of DNA into mRNA
  Rifampicin - inhibits bacterial DNA dependent RNA polymerase preventing transcription of DNA into mRNA
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  Importance: 48
• potent liver enzyme inducer
• hepatitis
  Rifampicin may cause hepatotoxicity
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  Importance: 20
  , orange secretions
  Rifampicin may cause orange tears and urine
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  Importance: 33
• flu-like symptoms

• mechanism of action: inhibits mycolic acid synthesis
  inhibits mycolic acid synthesis
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• peripheral neuropathy
  Isoniazid causes peripheral neuropathy
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  Importance: 61
  : prevent with pyridoxine (Vitamin B6)
  prevent with pyridoxine (Vitamin B6)
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• hepatitis
  Isoniazid may cause hepatotoxicity
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  Importance: 47
  , agranulocytosis
• liver enzyme inhibitor

• mechanism of action:
  Pyrazinamide - converted by pyrazinamidase into pyrazinoic acid which in turn inhibits fatty acid synthase (FAS) I --> disrupts bacterial fatty acid synthesis
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  Importance: 27
  • converted by pyrazinamidase into pyrazinoic acid which in turn inhibits fatty acid synthase (FAS) I
  • this disrupts fatty acid production needed for bacterial growth
• hyperuricaemia causing gout
  Pyrazinamide may cause gout
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  Importance: 31
• arthralgia, myalgia
• hepatitis
  Pyrazinamide may cause hepatotoxicity
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  Importance: 14

• mechanism of action: inhibits the enzyme arabinosyl transferase which polymerizes arabinose into arabinan
  Ethambutol - inhibits the enzyme arabinosyl transferase which polymerizes arabinose into arabinan
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  Importance: 23
• optic neuritis
  Optic neuritis is common in patients taking ethambutol
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  Importance: 63
  : check visual acuity before and during treatment
  check visual acuity before and during treatment
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• dose needs adjusting in patients with renal impairment