Generic Name: Isoniazid

Brand Name: Nydrazid

Drug Classification: Antitubercular agent

Mode of Action: Isoniazid inhibits the synthesis of mycolic acids in the cell wall of
Mycobacterium tuberculosis, disrupting its cell wall integrity and leading to bacterial death.

Ordered Dose: Depends on the patients condition.

Suggested Dose: 5 mg/kg to 10 mg/kg orally once daily.

Indication: Treatment of active tuberculosis and prophylaxis for latent tuberculosis infection.

Contraindication: Hypersensitivity to isoniazid, severe liver disease, acute liver disease, history
of isoniazid-associated hepatic injury.

Side Effects:

● Peripheral neuropathy
● Hepatitis
● Gastrointestinal upset
● Rash

Adverse Effects:

● Hepatotoxicity
● Optic neuritis
● Lupus-like syndrome

Drug Interactions:

● Rifampin: Increased risk of hepatotoxicity.

● Phenytoin: Decreased phenytoin levels.
● Acetaminophen: Increased risk of hepatotoxicity.

Nursing Management

1. Monitor for adverse effects.

● Rationale: Isoniazid can cause a variety of adverse effects, including hepatotoxicity,
neuropathy, and seizures. Monitoring for these effects is essential to ensure patient
safety.
2. Educate patients about the importance of adherence to therapy.
● Rationale: Isoniazid is most effective when taken as prescribed for the full course of
treatment. Nonadherence can lead to treatment failure and the development of
drug-resistant tuberculosis.

3. Provide patients with information about lifestyle modifications that can reduce the risk of
adverse effects.
● Rationale: Certain lifestyle modifications, such as avoiding alcohol and limiting caffeine
intake, can help to reduce the risk of adverse effects associated with isoniazid.

4. Monitor liver function tests.

● Rationale: Isoniazid can cause hepatotoxicity, so it is important to monitor liver function
tests regularly. This will help to identify any potential problems early on and allow for
prompt intervention.

5. Assess for signs and symptoms of neuropathy.

● Rationale: Isoniazid can cause neuropathy, which can manifest as numbness, tingling, or
burning in the hands and feet. Assessing for these symptoms regularly will allow for early
detection and intervention.

6. Monitor for seizures.

● Rationale: Isoniazid can cause seizures, especially in patients with a history of seizures
or epilepsy. It is important to monitor patients for signs of seizures, such as sudden loss
of consciousness or convulsions.

7. Teach patients about the importance of tuberculosis infection control measures.

● Rationale: Patients with tuberculosis are contagious, so it is important to teach them
about infection control measures to prevent the spread of the disease. This includes
covering their mouth and nose when coughing, sneezing, or laughing, and avoiding
close contact with others.

8. Provide patients with support and resources to help them cope with the challenges of
tuberculosis treatment.
● Rationale: Tuberculosis treatment can be challenging, both physically and emotionally. It
is important to provide patients with support and resources to help them cope with the
challenges of treatment. This may include counseling, support groups, or financial
assistance.

9. Monitor for signs and symptoms of drug-resistant tuberculosis.

● Rationale: Nonadherence to therapy can lead to the development of drug-resistant
tuberculosis, which is more difficult to treat. It is important to monitor patients for signs
and symptoms of drug-resistant tuberculosis, such as persistent cough, fever, or weight
loss.
10. Encourage patients to report any concerns or side effects promptly.
● Rationale: Open communication between patients and healthcare providers is essential
for the safe and effective use of isoniazid. Encourage patients to report any concerns or
side effects promptly so that they can be addressed appropriately.

Reference:

(isoniazid) dosing, indications, interactions, adverse effects, and more. (n.d.).

https://reference.medscape.com/drug/isoniazid-342564

Isoniazid oral: Uses, side effects, interactions, pictures, warnings & dosing - WebMD.
(n.d.). https://www.webmd.com/drugs/2/drug-8665/isoniazid-oral/details

Isoniazid: Uses, interactions, mechanism of action | DrugBank Online. (n.d.). DrugBank.

https://go.drugbank.com/drugs/DB00951