TB Drugs (RIPE Regimen) on the NCLEX
Rifampin, isoniazid, pyrazinamide, ethambutol: side effects, B6 with INH, red-orange urine.
TB treatment uses 4 drugs initially (RIPE). NCLEX tests side effects of each and the B6 supplementation with isoniazid.
RIPE regimen
Rifampin, Isoniazid (INH), Pyrazinamide, Ethambutol. 2 months intensive phase, then 4 months continuation with INH + rifampin.
Rifampin
Red-orange tears, urine, sweat. Stains contact lenses. Hepatotoxic. Many CYP interactions (reduces OCP, warfarin effect).
Isoniazid (INH)
Peripheral neuropathy, give B6 (pyridoxine) to prevent. Hepatotoxic. Drug-induced lupus rare.
Pyrazinamide
Hepatotoxic. Hyperuricemia (gout).
Ethambutol
Optic neuritis, color vision changes, decreased acuity. Monitor visual acuity.
Frequently asked
Why B6 with INH?
INH depletes B6 → peripheral neuropathy. Pyridoxine prevents.
Red urine, counsel patient?
Expected with rifampin. Not dangerous. Will resolve when drug stops.
Quick check
Loading a question…
How ready are you right now?
10 real NCLEX questions, free, in your browser. See how close you are to ready and which subjects are costing you.
Try 10 questions free