Question

Ms. Y is a migrant worker who has been in the United States for 8 months. She has been doing odd jobs, one of which has been cleaning chicken houses. While she is waiting for official citizenship papers, she has been unable to obtain permanent housing. She went to the health department when she could not stop coughing. She has lost 10 pounds in the last month and just does not feel well. While at the Health Department they diagnosed Ms. Y with Tuberculosis.

The Nurse Practitioner has given Ms. Y two prescriptions for medication. One medication is Isoniazid and the other is Rifampin. She asks the LPN to educate the client on both of these medications.

1. What would be included in the teaching for Isoniazid?

2. What would be included in the teaching for Rifampin?

3. The NP also asks the LPN to explain Direct Observation Therapy to the client. What will you explain that DOT is?

Answer 1

ISONIAZID

# It is a first-line therapy of tuberculosis, which inhibits the mycobacterial cell synthesis. It can cause visual disturbances, drug-induced hepatitis, and peripheral neuropathy. Therefore patient should notify the doctor. Always take medication regularly, never miss any dose or double dose without prescription. Avoid alcohol intake, it may increase hepatic toxicity. Do ophthalmic examinations regularly.

RIFAMPIN

# It is also a first-line drug which inhibits RNA synthesis of mycobacterium. It cause red discolouration of tears,urine and saliva. Should be taken in empty stomach,never miss the dose,avoid driving as it cause drowsiness. Use other non hormonal contraceptioves as it decrease effectiveness of oral contraceptives.

DOTS

# It is best curative and preventive method to stop spread of TB in community where HCP ensures proper intake of doses in front of them at right interval without missing any dose and thus prevent drug resistant.