TUBERCULOSIS. What is tuberculosis?. Tuberculosis is a disease caused by an infection with the bacteria Mycobacterium tuberculosis. What are the symptoms?. Typical signs of tuberculosis are:
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What is tuberculosis? Tuberculosis is a disease caused by an infection with the bacteria Mycobacterium tuberculosis.
What are the symptoms? • Typical signs of tuberculosis are: • Chronic or persistent cough and sputum production. If the disease is at an advanced stage the sputum will contain blood. • Fatigue. • Lack of appetite. • Weight loss. • Fever. • Night sweats.
How is tuberculosis treated? • Today, treatment involves three or four different kinds of antibiotics given in combination over 6 to 12 months. • Multiple medicines are necessary to prevent the emergence of resistance, which would lead to treatment failure. • The main cause of treatment failure is non-compliance with what is perceived as a demanding and prolonged programme of therapy.
TB TREATMENT PLAN • For positive culture do susceptibilities and report results to Health Department • begin taking four medications — isoniazid, rifampicin , ethambutol pyrazinamide and streptomycin . • The standard "short" course treatment for tuberculosis (TB), is: • isoniazid, rifampicin, pyrazinamide, and ethambutol for two months, • Then isoniazid and rifampicin alone for a further four months. • This regimen may change if tests later show some of these drugs to be ineffective.
ISONIAZIDAdverse Reactions • Hepatitis • Peripheral neuropathy • Lupus
ISONIAZIDMonitoring • Liver function tests • Clinical signs of hepatic toxicity • Numbness/tingling of extremities
ISONIAZIDDrug Interactions • Alcohol • Phenytoin • Disulfiram • Aluminum Salts • Carbamazepine • Benzodiazepines • Anticoagulants • Ketoconazole
RIFAMPINAdverse Reactions • Hepatitis • Orange discoloration of secretions • Drug interactions • Immunologic mediated illness
RIFAMPINMonitoring • Liver function tests • Clinical signs of hepatic toxicity • CBC, platelets, serum creatinine, bilirubin • Bleeding abnormalities
RIFAMPINDrug Interactions • Warfarin • Digoxin • Beta-blockers • Ketoconazole • Verapamil • Quinidine • Methadone • Phenytoin. • Corticosteroids • Oral Contraceptives • Dapsone • Theophylline • Sulfonylureas • Cyclosporine • Protease Inhibitors
ETHAMBUTOLAdverse Reactions • Gout • Rash • Peripheral neuritis • Optic neuritis
ETHAMBUTOLMonitoring • Visual acuity • Uric acid levels
ETHAMBUTOLDrug Interaction Aluminum salts
PYRAZINAMIDEAdverse Reactions • Hepatitis • Gout
PYRAZINAMIDEMonitoring • Liver function tests • Clinical signs of hepatic toxicity • Uric acid levels
STREPTOMYCINAdverse Reactions • Auditory • Vestibular • Nephrotoxicity • Hypersensitivity
STREPTOMYCINMonitoring Signs of Ototoxicity • Vertigo • Ataxia • Hearing Loss
STREPTOMYCINDrug Interactions • Loop diuretics • Neuromuscular blockers