• It is a relative to nicotinamide. • It is is a prodrug (converted to pyrazinioic acid , the active form of the drug). • In its active form it is thought to prevent the production of mycolic acids by inhibiting the enzyme fatty acid synthetase IZ • Pyrazinamide is inactive at neutral pH but tuberculostatic at acid pH. It is effective against the intracellular organisms in macrophages. • Bactericidal It is well absorbed and diffuse to all body fluids including CSF.
It is metabolized in the liver and is excreted by the kidney.
Therapeutic uses:
used in combination with ISONIAZID and Rifampin in the initial intensive course or when resistance is suspected.
Adverse effects:
- Hepatotoxicity:Tell your patients to report any signs of hepatitis (dark urineZ , abdominal pain, loss of appetite) when they are on pyrazinamide.
- Hyperureacemia
- Artheralgia and GIT upset