Description of the medicine: Cycloserin (Cycloserinum)
Cycloserine is an antibiotic that is formed during the life of Streptomyces orchidaceus or other microorganisms; also obtained synthetically.
The chemical structure is D-4-amino-3-isoxazolidinone.
Synonyms: Ciclocarine, Ciclovalidin, Closin, Ciclocarine, Cyclomycin, Cycloserine, Farmiserina, Novoserin, Orientomycin, Oxamycin, Serociclina, Seromycin, Tebemicin, Tibicin, Tisomycin, etc.
White crystalline powder, slightly bitter in taste. Easily soluble in water.
The drug has a wide spectrum of antibacterial action: inhibits gram-positive and gram-negative bacteria. The most valuable property is its ability to inhibit the growth of mycobacterium tuberculosis. It is inferior in activity to streptomycin, tubazide and phtivazide, but it acts on tuberculosis mycobacteria resistant to these drugs and PASK.
Cycloserine is rapidly absorbed from the gastrointestinal tract, penetrates into the cerebrospinal fluid; therapeutic concentration is detected in the blood 4 to 8 hours after its administration.
Cycloserine is considered as a “reserve” anti-tuberculosis drug, that is, prescribed for patients with chronic forms of tuberculosis, in which the previously used main drugs ceased to have an effect. Cycloserine can also be combined with basic drugs to prevent the development of resistance of mycobacteria. It is also possible combined use of cycloserine with other drugs of the second row, ethionamide, pyrazinamide, etc.
Assign inside (immediately before meals): adults 0.25 g 3 times a day. The highest single dose for adults is 0.25 g, the daily dose is 1 g. Patients older than 60 years and weighing less than 50 kg take 0.25 g 2 times a day. The daily dose for children is from the calculation of 0.01 - 0.02 g / kg, but not more than 0.75 g per day, with a larger dose given only in the acute phase of the tuberculosis process or with insufficient effectiveness of lower doses.
In the treatment with cycloserine, side effects may occur due mainly to the toxic effect of the drug on the nervous system: headache, dizziness, insomnia (sometimes, on the contrary, drowsiness), anxiety, increased irritability, memory impairment, paresthesia, peripheral neuritis. More severe symptoms are sometimes possible: a sense of fear, psychosthenic conditions, hallucinatory phenomena, epileptiform seizures, loss of consciousness.
These phenomena usually disappear with a dose reduction or drug withdrawal. To prevent or reduce the toxic effect of cycloserine, you can prescribe during the treatment period glutamic acid 0.5 g 3-4 times a day (before meals); Intramuscular administration of the sodium salt of adenosine triphosphoric acid is also recommended - 1 ml of a 1% solution daily. The administration of pyridoxine is sometimes effective (intramuscularly 1 - 2 ml of a 5% solution per day). If necessary, you can take anticonvulsants and sedatives, antidepressants.