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In The Name of God. Common Adverse Reactions to Anti-TB Drugs. Caused by: Any drug. Adverse reaction: Allergic reactions Signs/symptoms: Skin rash. Caused by: Ethambutol. Adverse reaction: Eye damage (optic neuritis)

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caused by any drug
Caused by: Any drug
  • Adverse reaction: Allergic reactions
  • Signs/symptoms: Skin rash
caused by ethambutol

Caused by: Ethambutol

Adverse reaction: Eye damage (optic neuritis)

Signs/symptoms: Blurred or changed vision ; changed color vision .

caused by inh pza rif

Caused by: INH, PZA, RIF

Adverse reaction: Hepatitis

Signs/symptoms:

Abdominal pain,Abnormal LFTs,Dark urine

Lack of appetite,Nausea,Vomiting,Yellowish

skin or eyes.

caused by isoniazid

Caused by: Isoniazid

Adverse reaction: Nervous system damage

Signs/symptoms: Dizziness, Tingling/numbness around mouth

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Adverse reaction: Peripheral neuropathy
  • Signs/symptoms: Tingling/numbness in hands and feet
caused by pyrazinamide

Caused by: Pyrazinamide

Adverse reaction: Stomach upset

Signs/symptoms:

Vomiting , Lack of appetite

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Adverse reaction: Increased uric acid
  • Signs/symptoms: Abnormal UA level Joint aches , Gout (rare)
caused by rifampin

Caused by: Rifampin

Adverse reaction: GI upset

Signs/symptoms: Anorexia,nausea,vomiting,diarrhea

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Adverse reaction: Discoloration of body fluids
  • Signs/symptoms: Orange urine, sweat, or tears ,Stained soft contact lenses
slide19
Adverse reaction: Drug interactions
  • Signs/symptoms: Interferes with some medications: BC pills,Anticoagulants, Methadone,Anticonvulsants,Cardiac glycosides,Oral hypoglycemics,…
slide20
‏Hemolytic anemia,Thrombocytopenia, Eosinophilia,Leukopenia
  • Interstitial nephritis,Flushing,Edema
  • Pruritus,urticaria,pemphigoid reactions
  • Myalgia,weakness,osteomalacia
caused by streptomycin
Caused by: Streptomycin
  • Adverse reaction: Ear damage
  • Signs/symptoms: Balance problems Hearing loss, Ringing in the ears
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Adverse reaction: Kidney damage
  • Signs/symptoms: Abnormal kidney function test results
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Minor side effects, such as gastrointestinal intolerance, mild skin rash, pruritus or flushing are best managed by reassurance and symptomatic treatment and the patient should be encouraged to continue anti tuberculosis treatment.

Treatment with non steroidal anti inflammatory drugs (NSAID)provide symptomatic relief of pyrazinamide related arthralgia. Skin rashescan usually be managed bywithholding the causative drug and if it is really necessary to reintroduce the drug, the patient should undergo desensitization.

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Hepatitis:

Patients who develop jaundice or other signs of liver dysfunction during therapy should have treatment stopped immediately. Although many patients with drug-induced hepatotoxicity can be successfully rechallenged, this is best done in a where liver function can be carefully monitored.

indications for stoping the hepatotoxic anti tuberculosis drugs
Indications for stoping the hepatotoxic anti-tuberculosis drugs
  • 1- Clinical signs and/or symptoms of hepatitis
  • 2- Abnormal liver enzymes
  • 3- Unexplained raised serum bilirubin
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If the period without drugs is likely to be prolonged, and the patient requires treatment, at least two other drugs should be given until it is determined whether the offending drug can be resumed.

the development of the following conditons contraindicates further use of the drug

The development of the following conditons contraindicates further use of the drug

*Thrombocytopenia ,hemolysis, shock and/or

renal failure due to rifampicin.

*Visual impairment due to ethambutol.

*Eighth nerve damage from streptomycin.

*Steven-Johnson syndrome.