Which First Line Anti TB Drug is prohibited for a woman during pregnancy?

Appeared in: MP CHO-2018

Explanation

Streptomycin is an aminoglycoside antibiotic used in treating tuberculosis.
It is contraindicated in pregnancy because it crosses the placental barrier.
The primary risk to the fetus is ototoxicity, which is irreversible damage to the 8th cranial nerve (auditory nerve), potentially causing congenital deafness.

Option B: Isoniazid is considered safe for use during pregnancy and is a cornerstone of TB treatment.
Option C: Ethambutol is generally considered safe for use during pregnancy.
Option D: Pyrazinamide is considered safe to use during pregnancy according to WHO and Indian RNTCP guidelines.

Clinical Relevance

Nursing practice connection: Use the key finding related to Pharmacology - Anti-Tuberculosis Drugs in Pregnancy to guide bedside assessment, documentation, and the next nursing action.
Treating tuberculosis in a pregnant woman is crucial as untreated TB poses a greater risk to the mother and fetus than the treatment itself.
Nurses must ensure that Streptomycin is not administered and that any regimen is prescribed in consultation with a specialist. Patient education on adherence and side effects is vital.
Pyridoxine (Vitamin B6) supplementation is a standard nursing intervention for all pregnant women on Isoniazid to prevent neurological side effects.

How to Approach the Question

First, identify the core of the question: it asks for a contraindicated anti-TB drug during pregnancy.
This is a factual recall question from pharmacology. Access your knowledge about the safety profiles of common medications in special populations.
Recall the first-line anti-TB drugs: Isoniazid (H), Rifampicin (R), Pyrazinamide (Z), Ethambutol (E), and Streptomycin (S).
Systematically review the options provided against their known teratogenic effects.
Remember that aminoglycosides (like Streptomycin) are generally associated with ototoxicity and nephrotoxicity, and this risk extends to the fetus.
Select Streptomycin as the drug known to cause fetal harm (ototoxicity), making it prohibited in pregnancy.

Concept Tested & Keywords

QDYSY5yIiPVcN8Jlouh0WW

E6 Parks TextBook of Preventive & Social Medicine part 1 — Subpart B (pp 202-403 of 604) p. 41-43

E6 Pharmacology Nurses Shanbhag 3e p. 312-314

Practise the full MP CHO-2018

Attempt every question from this paper in a timed mock, then review the full solution for each one.