RIPE

RIPE as in rifampicin, isoniazid, pyrazinamide, and ethambutol are drugs (first line) for tuberculosis.

Isoniazid, toxicity-- hepatotoxicity, bone marrow suppression. It reacts with pyridoxal to form complex that is easily excreted out the urine. As pyridoxal is important for the nutrition of nerve, low in pyridoxal after excretion cause peripheral neuritis, and convulsion, especially in malnourished people.

Rifampicin toxicity -- pseudomonas coliitis, CNS disturbancces (thus causing dizziness, confusion), liver damage, nausea, rashes. Give orange tinge to saliva. Also induces liver enzymes -- thus more degradation of for pts on warfarin, glucocorticoids, oral antidiabetics, i.e. less effective for these drugs to work.

Pyrazinamide toxicity -- hepatotoxicity. inhibits renal excretion of uric acid -- thus causing hyperuricaemia.

Ethambutol toxicity -- optic neuritis (blurred vision, green/red color blindness), GIT disturbances, headache, giddiness (huh? XD).

SECOND LINE ANTI TB
PAS (para-aminosalicylic acid)
toxicity -- epigastric pain, hypersensitivity reactions (fever, joint pains, rashes.)

Ciprofloxacin For NON - TB induced TB (atypical TB)
Ofloxacin for Mycobacterium tuberculosis induced. TB.