Antituberculosis drugs: drug interactions, adverse effects, and use in special situations. Part 2: second line drugs.

Marcos Abdo Arbex, Marília de Castro Lima Varella, Hélio Ribeiro de Siqueira, Fernando Augusto Fiúza de Mello

Clinical Medicine Section of Department of Internal Medicine, Federal University of São Paulo/Paulista School of Medicine, São Paulo, Brazil. arbexma@techs.com.br

Jornal brasileiro de pneumologia : publicaça̋o oficial da Sociedade Brasileira de Pneumologia e Tisilogia 2010 Sep-Oct

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The main objectives of tuberculosis therapy are to cure the patients and to minimize the possibility of transmission of the bacillus to healthy subjects. Adverse effects of antituberculosis drugs or drug interactions (among antituberculosis drugs or between antituberculosis drugs and other drugs) can make it necessary to modify or discontinue treatment. We describe the general mechanism of action, absorption, metabolization, and excretion of the drugs used to treat multidrug resistant tuberculosis (aminoglycosides, fluoroquinolones, cycloserine/terizidone, ethionamide, capreomycin, and para-aminosalicylic acid). We describe adverse drug reactions and interactions (with other drugs, food, and antacids), as well as the most appropriate approach to special situations, such as pregnancy, breastfeeding, liver failure, and kidney failure.

Citation

Marcos Abdo Arbex, Marília de Castro Lima Varella, Hélio Ribeiro de Siqueira, Fernando Augusto Fiúza de Mello. Antituberculosis drugs: drug interactions, adverse effects, and use in special situations. Part 2: second line drugs. Jornal brasileiro de pneumologia : publicaça̋o oficial da Sociedade Brasileira de Pneumologia e Tisilogia. 2010 Sep-Oct;36(5):641-56