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Pyrazinamide is metabolized by the liver which should be used with caution by those with decreased liver function.
This drug is generally used in conjunction with other medications to treat TB.
Teach patients to protect the skin from sunlight and to avoid the use of alcohol.

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https://davisplus.fadavis.com/3976/meddeck/pdf/pyrazinamide.pdf

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Teach patient the risk factors for noncompliance with medication tx.

Teach patient that adequate fluid intake can help prevent kidney problems from medications as well as preventing other secondary complications.

Teach patients ways to prevent damage from direct sunlight exposure: sunscreen, protective clothing and accessories.

Inform patient that alcohol consumption can potentiate medication.

Inform the patient that lab tests will be performed to assess medication effectiveness.

Medication should be taken with food.

If a dosed is missed, take the missed dose as soon as possible unless it is almost time to take the next dose, then just skio the missed dose and resume your regular doasage schedule. NEVER double dose for a missed dose.

This medication is prescribed for active TB not for latent and is used in combination with other drugs.

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Pyrazinamide is used to treat tuberculosis and is used with other medications for treatment. If used alone, tuberculosis may become resistant to treatment. People taking pyrazinamide should be cautious with sun exposure because sensitivity is likely. You should not take pyrazinamide if you have active gout or liver disease. Also, patients who are pregnant or may become pregnant should talk with their doctor about potential risks before taking pyrazinamide.

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Pyrazinamide is used to treat tuberculosis and is used with other medications for treatment. If used alone, tuberculosis may become resistant to treatment. People taking pyrazinamide should be cautious with sun exposure because sensitivity is likely. You should not take pyrazinamide if you have active gout or liver disease. Also, patients who are pregnant or may become pregnant should talk with their doctor about potential risks before taking pyrazinamide.

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https://www.drugs.com/cdi/pyrazinamide.html

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Pyrazinamide: learn about side effects, dosage, special precautions, and more on MedlinePlus

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Is not inactivated by the acidic environment of macrophages and can effectively kill organisms residing within them.

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Is not inactivated by the acidic environment of macrophages and can effectively kill organisms residing within them.

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Nursing interventions
Ask whether the pt has ever had gout- this drug increases uric acid formation and will male gout worse.

Teach the pt to drink at least 8 ounces of water when taking this tablet and to increase fluid intake- this will help prevent uric acid from precipitating and causing gout or kidney problems.

Teach pt to wear protective clothing, a hat and sunscreen when when going outdoors- this drug causes photosensitivity and increases risk for sunburn.

Teach to avoid alcoholic beverages- this drug can cause liver damage. This effectis potentiated by alcohol.

Teach to report darkening of urine, a yellow appearance to the skin or whites of the eyes and increased tendency to bruise or bleed- this may be a sign of liver toxicity or failure.

Teach pt that strict adherence to the prescribed drug regimen is crucial for suppressing the disease.

Teach pt that fatigue will diminish as the treatment progresses.

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https://reference.medscape.com/drug/pyrazinamide-342678

Teach the patient to be consistent with th medicine and finish it. The medicine works best when constant levels are in the body.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: liver disease, kidney disease, diabetes, gout, high uric acid level in the blood, alcohol use.

Pyrazinamide may cause live bacterial vaccines (such as typhoid vaccine) not to work as well. Therefore, do not have any immunizations/vaccinations while using this medication without the consent of your doctor

Avoid use with rifampin. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Additive hepatotoxicity.

Hepatotoxicity ☠️

Patient may experience muscle pain. Have patient report immediately to prescriber signs of liver problems (dark urine, fatigue, lack of appetite, nausea, abdominal pain, light-colored stools, vomiting, or jaundice), joint pain, or joint edema (HCAHPS).

Periodic liver function tests, serum uric acid, sputum culture, chest x-ray 2-3 months into treatment and at completion 💉

Educate patient about signs of a significant reaction (eg, wheezing; chest tightness; fever; itching; bad cough; blue skin color; seizures; or swelling of face, lips, tongue, or throat)

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Some Precautions/contraindications are liver and renal impairment, DM, gout.
Hepatotoxic. Other side effects are anorexia, diarrhea, NV, dysuria, itching, rash, anemia, thrombocytopenia, hyperuricemia.
Use with rifampin may cause life-threatening hepatotoxicity. Decreases effectiveness of antigout agents and cyclosporine.
Liver function tests needed q2-4 wks
Monitor Uric acid levels
Take med as directed, don’t skip doses or double missed doses
Use sunscreen
Notify provider if symptoms do not improve within 2-3 was.