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- Pharmacology For Rifampicin + Isoniazid + Vit B6
Rifampicin + Isoniazid + Vit B6 Pharmacology
Rifampicin + Isoniazid + Vit B6
About Rifampicin + Isoniazid + Vit B6N/AMechanism of Action of Rifampicin + Isoniazid + Vit B6N/APharmacokinets of Rifampicin + Isoniazid + Vit B6N/AOnset of Action for Rifampicin + Isoniazid + Vit B6N/ADuration of Action for Rifampicin + Isoniazid + Vit B6N/AHalf Life of Rifampicin + Isoniazid + Vit B6N/ASide Effects of Rifampicin + Isoniazid + Vit B6N/AContra-indications of Rifampicin + Isoniazid + Vit B6N/ASpecial Precautions while taking Rifampicin + Isoniazid + Vit B6N/APregnancy Related InformationN/AOld Age Related InformationN/ABreast Feeding Related InformationN/AChildren Related InformationN/AIndications for Rifampicin + Isoniazid + Vit B6N/AInteractions for Rifampicin + Isoniazid + Vit B6N/ATypical Dosage for Rifampicin + Isoniazid + Vit B6N/ASchedule of Rifampicin + Isoniazid + Vit B6N/AStorage Requirements for Rifampicin + Isoniazid + Vit B6N/AEffects of Missed Dosage of Rifampicin + Isoniazid + Vit B6N/AEffects of Overdose of Rifampicin + Isoniazid + Vit B6N/ARifampicin
About RifampicinRifamycin derivative, Antituberculosis antibiotic.Mechanism of Action of RifampicinRifampicin is primarily bactericidal and has some bacteriostatic properties also. It acts by inhibiting DNA dependent RNA polymerase and thus stopping the expression of bacterial genes.M.tuberculosis requires DNA dependent RNA polymerase enzyme for the synthesis of RNA and protein. Without this enzyme bacteria cannot reproduce and they die.
Pharmacokinets of RifampicinAbsorption: Well absorbed orally, Distribution: Widely distributed, Metabolism: Metabolized in liver in to active desacetyl Rifampicin Excretion: Excreted mainly in bile & some extend in urineOnset of Action for RifampicinN/ADuration of Action for Rifampicin24 hoursHalf Life of Rifampicin2 - 5 hourSide Effects of Rifampicin1. Nausea
2. Vomiting
3. Epigastric distress
4. Anorexia
5. Pseudo membranous colitis
6. Acute renal failure
7. Hepato toxicity
8. Eosinophilia
9. Thrombocytopenia
10. Urticaria
11. Rash
12. Pruritis
13. Purpura
14. Shock
15. Headache
16. Drowsiness
17. Visual disturbance
18. Thrombophlebitis
19. Menstrual problems
Contra-indications of Rifampicin1.Hypersensitivity to the drug
2.Hepatic impairment
3.Jaundice
4.Biliary obstruction
5.Porphyria
6.As I.M. or S.C. injection
Special Precautions while taking RifampicinRenal impairment:
Use with caution
Hepatic impairment:
Use with caution
Other precautions:
1.Use with caution in alcoholics
2.Use with caution in malnourished individuals
3.Stop the drug use in Purpura & Thrombocytopenia
Pregnancy Related InformationUse with cautionOld Age Related InformationUse with cautionBreast Feeding Related InformationUse with cautionChildren Related InformationAbove 5 years: May be used
Neonates: Contraindicated
Indications for Rifampicin1. Leprosy
2. Tuberculosis
3. Prophylaxis of meningococcal carriers
4. Prophylaxis of H. influenzae
Interactions for RifampicinRifampicin by inducing the hepatic microsomal enzymes may reduce the efficacy of the following drugs: Acetaminophen, oral anticoagulants, barbiturates, benzodiazepines, chloramphenicol, clofibrate. Oral contraceptives, corticosteroids, cyclosporine, digitoxin, disopyramide, beta blockers oestrogens, hydantoins, mexiletine, quinidine, sulfones, sulphonylureas, theophylline, verapamil.
Halothane: Hepatotoxicity and hepatic encephalopathy.
Isoniazid: Higher incidence of hepatotoxicity than with either agent alone.
Ketoconazole: Treatment failure of either ketoconazole or rifampicin.
Food: Interferes with absorption of rifampicin, therefore it should be taken on empty stomach.
Lab tests: Inhibits standard assays for serum folate and vitamin B12 (riboflavin). Transient abnormalities in liver function tests, reduced excretion of contrast media used for visualization of gall bladder.
Typical Dosage for RifampicinAdults: 0.45gm to 0.6gm single dose
Children: 10 to 20 mg/kg/day
Leprosy: 600mg orally once monthly
Pulmonary tuberculosis:
Adults: 600mg/day orally or I.V. as a single dose
Children: 10 to 20 mg/kg/day orally or I.V.as a single dose
Meningococcal infections:
600mg 12 hourly for two days
Children (1 to 2 years): 10 mg/kg
Children (below 1 year): 5mg/kg for two days
Schedule of RifampicinHStorage Requirements for RifampicinStore in a cool dry place.Protect from heat and light.Keep out of the reach of children.Effects of Missed Dosage of RifampicinTake the missed dose as soon as noticed and if it is the time for next dose then skip the missed dose. Continue the regular schedule. Do not double the dose.Effects of Overdose of RifampicinTreatment includes Gastric lavage, administration of activated charcoal, forced diuresis & bile drainage etc.Isoniazid
About IsoniazidHydrazine derivative, Antitubercular Agent.Mechanism of Action of IsoniazidIsoniazid is a bactericidal drug. I t inhibits the mycolic acid synthesis which is essential for the cell wall formation. It also inhibits DNA, RNA and protein synthesis and cell metabolism. As the results of these bacterial death occurs.Pharmacokinets of IsoniazidAbsorption: It is rapidly absorbed after oral administration.Distribution: It is very widely distributed in the body.Metabolism: It undergoes metabolism in the liver.Excretion:It is mainly excreted through urine and small amount excreted through bile, breast milk, sputum and saliva.Onset of Action for Isoniazid1 - 2 daysDuration of Action for Isoniazid1 dayHalf Life of Isoniazid1 - 4 hourSide Effects of Isoniazid1. Nausea
2 .Vomiting
3. Gastric upset
4. Peripheral neuritis
5. Optic neuritis
6. Atrophy
7. Paresthesia
8. Allergy
9. Fever
10.Rash
11.Malaise
12.Lymph adenopathy
13.JaundiceContra-indications of Isoniazid1. Hypersensitivity to Isoniazide
2. Drug induced hepatic diseaseSpecial Precautions while taking Isoniazid1.Renal impairment
2.Hepatic impairment
3.Alcoholism
4.EpilepsyPregnancy Related InformationContraindicatedOld Age Related InformationUse with cautionBreast Feeding Related InformationUse with caution
Children Related InformationMay be used
NEONATES: may be used
Indications for Isoniazid1.Tuberculosis (pulmonary &extra pulmonary)Interactions for IsoniazidAlcohol: Regular ingestion of alcohol is associated with higher incidence of INH-related hepatitis.
Aluminium Salts: Oral absorption of INH reduced leading to decreased serum levels.
Oral anticoagulants: Efficacy of oral anticoagulants increased.
Benzodiazepines: Activity of benzodiazepines that undergo oxidative metabolism is possibly increased.
Carbamazepine: Isoniazid hepatotoxicity & carbamazepine toxicity may occur from concurrent use.
Cycloserine: Increased cycloserine related CNS side effects, especially dizziness.
Disulfiram: Acute behavioural and co-ordination changes.
Enflurane: High output renal failure may occur.
Halothane: Hepatotoxicity and hepatic encephalopathy.
Hydantoins: Serum hydantoin levels increased leading to enhanced pharmacological and toxic effects.
Ketoconazole: Serum concentrations of ketoconazole decreased possibly leading to resistance to antifungal treatment.
Rifampicin: Higher incidence of hepatotoxicity than with either agent alone.
Food: Interaction with tyramine-containing foods since INH has MAOI activity.
Exaggerated response (headache, palpitation, sweating, hypotension, flushing, itching) to foods containing histamine (tuna, sauerkraut juice, yeast extract).
Typical Dosage for IsoniazidAdult: 200 - 300 mg once daily for 6 months to 24 months depending on the severity of infection
Children:5 - 10 mg / kg body weight / day for 6 months to 24 months depending on the severity of infection.
Schedule of IsoniazidHStorage Requirements for IsoniazidThe drug should be stored at room temperature .Keep away from heat, light and moisture. The vial should be kept at 2 - 8 degree Celsius.Effects of Missed Dosage of IsoniazidTake the missed dose as soon as noticed and if it is the time for next dose then skip the missed dose.Continue the regular schedule.Do not double the dose.Effects of Overdose of IsoniazidGive supportive measures and treatment. Control seizure by giving Diazepam. Then Pyridoxine is administered followed by gastric lavage. Acidosis can be treated with sodium bicarbonate by parenteral administration. Forced diuresis and dialysis can be done if necessary.Vit B6
About Vit B6Physiological functions: It is involved as a coenzyme (Pyridoxal phosphate) in metabolism of tryptophan, in several metabolic transformations of amino acids including transamination, decarboxylation & racemization.
Deficiency symptoms: Peripheral neuritis, seizures, stomatitis, glossitis, anaemia, seborrhea like lesions.Mechanism of Action of Vit B6Vitamin B6 is a collective term for Pyridoxine, Pyridoxal, Pyridoxamine and their phosphorylated derivatives such as Pyridoxine phosphate, Pyridoxal phosphate and Pyridoxamine derivatives respectively. Vitamin B6 is essential for the metabolism of amino acid, glycogen and fatty acids, for nerve functions, for the formation of red blood cells and also helps the skin healthy. Vitamin B6 is also used for the synthesis of nucleic acid, Haemoglobin, Sphingomyelin, other Sphingolipids, Serotonin, Dopamine, Noradrenaline and GABA.Pharmacokinets of Vit B6Absorption: Vitamin B6 is readily absorbed after oral administration.
Distribution: It is mainly distributed in the body in protein bound form. It is stored primarily in the liver and to a lesser extent muscle and brain.
Metabolism: It is metabolised in the liver
Onset of Action for Vit B6N/ADuration of Action for Vit B6N/AHalf Life of Vit B615-20 daysSide Effects of Vit B61. Neuropathy
2. Unstable gait
3. Drowsiness
4. Perioral numbness
5. Paresthesia
6. Numbness of feet
7. Somnolence
8. Sensory neuropathy
9. Ataxia
Contra-indications of Vit B61. Hypersensitivity to Vitamin B6Special Precautions while taking Vit B6N/APregnancy Related InformationMay be usedOld Age Related InformationMay be usedBreast Feeding Related InformationUse with cautionChildren Related InformationUse with caution
NEONATES: Contraindicated
Indications for Vit B61. Vitamin B6 deficiency including inadequate diet and drug induced causes
2. Neuropathy
3. Premenstrual syndrome
4. Hyperoxaluria type 1
5. Metabolic disorder
6. Isoniazid poisoning
Interactions for Vit B6Cycloserine, Hydralazine, Isoniazide, Oral contraceptive, Penicillamine: Increase Pyridoxine requirement.
Levodopa: Pyridoxine reverses the therapeutic effect of Levodopa.
Phenobarbital, Phenytoin: Pyridoxine decreases serum level of these anticonvulsants.
Typical Dosage for Vit B6Adult: 10 - 20 mg / day
Dietary deficiency: 2.5 -10 mg / day for effective therapeutic response is obtained.
Maintenance dose: 2 - 5 mg / day for several weeks.
Drug induced deficiency: 100 - 200 mg / day for 3 weeks.
Maintenance dose: 25 - 100 mg / day
Neuropathy: 50 - 200 mg /day
Premenstrual syndrome: 40 - 500 mg / day
Hyperoxaluria type 1: 25 - 300 mg / day
Metabolic disorder: 100-500 mg /day.
Isoniazid poisoning: Initial dose: 1 - 4 g as IV administration, then 1 g IM every 30 minute until Pyridoxine dose is equal to the Isoniazid dose has been given.
Schedule of Vit B6N/AStorage Requirements for Vit B6Store it at 15 - 30 degree C. Protect from moisture and heat.Effects of Missed Dosage of Vit B6Take the missed dose as soon as noticed and if it is the time for next dose then skip the missed dose. Continue the regular schedule. Do not double the dose.Effects of Overdose of Vit B6Give supportive measures and symptomatic treatment. The signs of Pyridoxine overdose can be resolved by discontinuation (withdrawal) of Pyridoxine.Home Delivery for Rifampicin + Isoniazid + Vit B6 in Your City
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