Tuberculosis First & Second Line Drugs Cheat Sheet

Some Facts of First-line or second-line medications
First-line medications provide the most effective antituberculosis activity.Second-line medications are used in combination with first-line medications but are more toxic.
Current infecting organisms are proving resistant to standard first-line medications; the resistant organisms develop because individuals with the disease fail to complete the course of treatment, so surviving bacteria adapt to the medication and become resistant. Multidrug therapies are instituted because of the resistant organisms.


First & Second Line Drugs Cheat Sheet
Drug Names
Adverse Effects
First-Line Agents
Hypersensitivity reactions,
Peripheral neuritis, Neurotoxicity, Hepatotoxicity, Nausea and vomiting,Dry
mouth, Dizziness, Hyperglycemia, Vision changes,
Hypersensitivity reaction
,Heartburn, nausea, vomiting, diarrhea, Red-orange–colored body secretions,
Vision changes, Hepatotoxicity and hepatitis, Increased uric acid levels,
Blood dyscrasias, Colitis,
Hypersensitivity reactions
,Anorexia, nausea, vomiting, Dizziness, Malaise, Mental confusion, Joint
pain, Dermatitis, Optic neuritis, Peripheral neuritis, Thrombocytopenia,
Increased uric acid levels, Anaphylactoid reaction,
Increases liver function tests
and uric acid levels, Arthralgia, myalgia, Photosensitivity, Hepatotoxicity,
Rash, Gastrointestinal
disturbances, Neutropenia, Red-orange–colored body secretions, Uveitis,
Myositis, Arthralgia, Hepatitis, Chest pain with dyspnea, Flulike syndrome,
Second-Line Agents
■ Amikacin (Amikin)
■ Capreomycin sulfate
■ Ciprofloxacin (Cipro)
■ Cycloserine (Seromycin)
■ Ethionamide (Trecator)
■ Kanamycin (Kantrex)
■ Levofloxacin (Levaquin)
■ Moxifloxacin (Avelox)
■ p-Aminosalicylic acid (Paser)
■ Streptomycin


Second-Line Agents Drugs Side Effects

Capreomycin sulfate (Capastat Sulfate)

Side/adverse effects

  • Nephrotoxicity
  • Ototoxicity
  • Neuromuscular blockade



Side/adverse effects

  • Hypersensitivity
  • Pain and irritation at the injection site
  • Nephrotoxicity is indicated by increased blood urea nitrogen and serum creatinine levels.
  • Ototoxicity is indicated by tinnitus, dizziness, ringing or roaring in the ears, and reduced hearing.
  • Neurotoxicity is indicated by headache, dizziness, lethargy, tremors, and visual disturbances.
  • Superinfections


Ethionamide (Trecator)

Side/adverse effects

  • Anorexia, nausea, vomiting
  • Metallic taste in the mouth
  • Orthostatic hypotension
  • Jaundice
  • Mental changes
  • Peripheral neuritis
  • Rash


Aminosalicylic acid (Paser)

Side/adverse effects

  • Hypersensitivity
  • Bitter taste in the mouth
  • Gastrointestinal tract irritation
  • Exfoliative dermatitis
  • Blood dyscrasias
  • Crystalluria
  • Changes in thyroid function


Cycloserine (Seromycin)


Side/adverse effects

  • Hypersensitivity
  • CNS reactions
  • Neurotoxicity
  • Seizures
  • Heart failure
  • Headache
  • Vertigo

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