Medication Description: Cycloserine (Cycloserinum)
Cycloserine - an antibiotic that is formed in the process of vital activity of Streptomyces orchidaceus or other microorganisms; also obtained by synthetic means.
The chemical structure is a 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 taste. Easily soluble in water.
The drug has a wide range of antibacterial action: inhibits gram-positive and gram-negative bacteria. The most valuable property is its ability to delay the growth of mycobacterium tuberculosis. By activity, it is inferior to streptomycin, tubaside and ftivazidu, but acts on Mycobacterium tuberculosis, resistant to these drugs and PASK.
Cycloserine is rapidly absorbed from the gastrointestinal tract, enters the cerebrospinal fluid; therapeutic concentration is found in the blood after 4 to 8 hours after taking it.
Cycloserine is considered as a “reserve” anti-tuberculosis drug, that is, it is prescribed to patients with chronic forms of tuberculosis, in which the previously used basic drugs have ceased to have an effect. Cycloserine can also be combined with basic drugs to prevent the development of mycobacterial resistance. It is also possible the combined use of cycloserine with other drugs of the II series, ethionamide, pyrazinamide, etc.
Assign inside (just before meals): adults to 0.25 g 3 times a day. The highest single dose for adults is 0.25 g, the daily dose is 1 g. Patients over 60 years old and with a body weight of less than 50 kg take 0.25 g 2 times a day. The daily dose for children is at the rate of 0.01–0.02 g / kg, but not more than 0.75 g per day, and a higher dose is given only in the acute phase of the tuberculosis process or with insufficient efficacy of smaller doses.
When treating cycloserine, there may be side effects caused mainly by the toxic effect of the drug on the nervous system: headache, dizziness, insomnia (sometimes, on the contrary, drowsiness), anxiety, irritability, memory impairment, paresthesia, peripheral neuritis. Sometimes more severe symptoms are possible: anxiety, psycho-stenotic states, hallucinatory phenomena, epileptiform seizures, loss of consciousness.
These phenomena usually go away with a dose reduction or drug withdrawal. It is possible to prevent or reduce the toxic effect of cycloserine, prescribing glutamic acid 0.5 g 3-4 times a day (before meals) during the treatment period; It is also recommended that intramuscular administration of adenosine triphosphate sodium is 1 ml of 1% solution daily. Sometimes, administration of pyridoxine is effective (intramuscularly 1 - 2 ml of 5% solution per day). If necessary, you can take anticonvulsants and sedatives, antidepressants.