পাইরেজিনামাইড এ আছে Pyrazinamide। পাইরেজিনামাইড এর কাজঃ
পাইরেজিনামাইড is indicated for the initial treatment of active tuberculosis in adults and children when combined with other antituberculous agents.
It is also indicated after treatment failure with other primary drugs in any form of active tuberculosis.
পাইরেজিনামাইড should only be used in conjunction with other effective antituberculous agents.
|Pyrazinamide Tablet 500 mg in bangla|
|চিকিৎসাগত শ্রেণিঃ||Anti-Tubercular Chemotherapeutics|
|উৎপাদনকারীঃ||Essential Drugs Company Ltd|
|সর্বশেষ সম্পাদনাঃ||2020-11-20 18:15:00|
পাইরেজিনামাইড may be bacteriostatic or bactericidal in action, depending on the concentration of the drug attained at the site of the infection and the susceptibility of the infecting organism. Its activity appears to partly depend on conversion of the drug to pyrazinoic acid (POA), which lowers the pH of the environment below that which is necessary for growth of Mycobacterium tuberculosis. Susceptible strains of M. tuberculosis produce pyrazinamidase, an enzyme that deaminates pyrazinamide to POA, and the in vitro susceptibility of a given strain of the organism appears to correspond to its pyrazinamidase activity.
পাইরেজিনামাইড এ আছে Pyrazinamide 500 mg। পাইরেজিনামাইড খাওয়ার নিয়ম নিম্নরূপঃ
15 to 30 mg/kg (up to 2 g) orally once a day in combination with three other antituberculous drugs for the initial 2 months of a 6-month or 9-month treatment regimen, until drug susceptibility tests are known. An alternate dosing regimen of 50 to 75 mg/kg (up to 3 g) orally twice a week may be used after 2 weeks of daily therapy to increase patient compliance.
Alternatively, the CDC, The American Thoracic Society, and the Infectious Diseases Society of America suggest the following dosing based on estimated lean body weight:
Twice weekly dosing:
Thrice weekly dosing:
A public health expert should be consulted prior to the use of the combination regimen with rifampin.
15 to 20 mg/kg, based on actual body weight (lean), orally once daily (maximum 2 g) for 2 months. Alternatively, a dosage of 50 mg/kg may be administered orally twice-weekly (maximum 4 g).
(Used as part of a multidrug regimen. Treatment regimens consist of an initial 2-month phase, followed by a continuation phase of 4 or 7 additional months. Frequency of dosing may differ depending on phase of therapy)
Infants, Children less than 40 kg and Adolescents 14 years and younger and less than 40 kg:Non-HIV patients:
General: Fever, porphyria and dysuria have rarely been reported. Gout.
Gastrointestinal: The principal adverse effect is a hepatic reaction. Hepatotoxicity appears to be dose related, and may appear at any time during therapy. GI disturbances including nausea, vomiting and anorexia have also been reported.
Hematologic and Lymphatic: Thrombocytopenia and sideroblastic anemia with erythroid hyperplasia, vacuolation of erythrocytes and increased serum iron concentration have occurred rarely with this drug. Adverse effects on blood clotting mechanisms have also been rarely reported.
Other: Mild arthralgia and myalgia have been reported frequently. Hypersensitivity reactions including rashes, urticaria, and pruritis have been reported. Fever, acne, photosensitivity, porphyria, dysuria and interstitial nephritis have been reported rarely.
পাইরেজিনামাইড is contraindicated in patients with severe hepatic disease and with acute gout.
Patients started on pyrazinamide should have baseline serum uric acid and liver function test results. Liver function should be monitored closely during therapy. Patients with preexisting liver disease or those at increased risk of drug related hepatitis should be monitored closely.
পাইরেজিনামাইড should be discontinued and not restarted if signs of hepatocellular damage or hyperuricemia with an acute gouty arthritis appear.
Polyarthralgias have been reported in patients. The pain may respond to aspirin or other nonsteroidal anti-inflammatory agents.
Caution should be used in patients with a history of diabetes mellitus, as management of the disease may be more difficult.
Primary resistance of Mycobacterium tuberculosis to pyrazinamide is not common. In cases with known or suspected drug resistance, in vitro susceptibility tests with recent cultures of Mycobacterium tuberculosis against pyrazinamide and the usual primary drugs should be conducted. There are few reliable in vitro tests for pyrazinamide resistance. A reference laboratory capable of performing these tests must be utilized.
Clinical experience has not identified differences in responses between elderly and younger patients. In general, dose selection for elderly patients should be cautious, usually starting at the low end of the dosing range, reflecting the greater frequency of decreased renal or hepatic function, and of concomitant disease or other drug therapy.
Antagonises the effect of uricosuric agents (e.g. probenecid, sulfinpyrazone). May reduce the contraceptive effect of oestrogens. May inactivate oral typhoid vaccine. May increase the serum concentration of ciclosporin. May enhance the hepatotoxic effect of rifampicin.
Pregnancy Category C. Animal reproduction studies have not been conducted with পাইরেজিনামাইড. It is also not known whether পাইরেজিনামাইড can cause fetal harm when administered to a pregnant woman or can affect reproduction capacity. পাইরেজিনামাইড should be given to a pregnant woman only if clearly needed.
Nursing Mothers: পাইরেজিনামাইড has been found in small amounts in breast milk. Therefore, it is advised that পাইরেজিনামাইড be used with caution in nursing mothers taking into account the risk-benefit of this therapy.
পাইরেজিনামাইড is contraindicated in persons:
Usage in Children: পাইরেজিনামাইড regimens employed in adults are probably equally effective in children. পাইরেজিনামাইড appears to be well tolerated in children.
Geriatric Use: Clinical studies of পাইরেজিনামাইড did not include sufficient numbers of patients aged 65 and over to determine whether they respond differently from younger patients. Other reported clinical experience has not identified differences in responses between the elderly and younger patients. In general, dose selection for an elderly patient should be cautious, usually starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic or renal function, and of concomitant disease or other drug therapy.It does not appear that patients with impaired renal function require a reduction in dose. It may be prudent to select doses at the low end of the dosing range, however.
Renal Dose Adjustments: The manufacturer recommends to start therapy at low end of dosage range and monitor patient closely.For the treatment of active tuberculosis, the CDC, ATS, and IDSA recommend against daily dosing. For patients with CrCl less than 30 mL/min or patients receiving hemodialysis the recommended dose is 25 to 35 mg/kg per dose three times per week.
Liver Dose Adjustments: Monitor patients closely.
Dose Adjustments: In general, dose selection for an elderly patient should be cautious, usually starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic or renal function, and of concomitant disease or other drug therapy.
If organism is susceptible to isoniazid and rifampin, pyrazinamide is continued for the first 2 months of a 6-month course of therapy (9-months if HIV positive). If primary drug resistance is shown, drug regimens should be adjusted as needed and continued for at least 6 months, or 3 months beyond culture conversion (9 months, or 6 months beyond culture conversion if HIV positive). If multiple-drug resistance is demonstrated, therapy should be continued for 12 to 24 months following culture conversion.
Overdosage experience is limited. In one case report of overdose, abnormal liver function tests developed. These spontaneously reverted to normal when the drug was stopped. Clinical monitoring and supportive therapy should be employed. পাইরেজিনামাইড is dialyzable.
Store between 15-30° C.
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