TUBERCULOSIS

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TUBERCULOSIS
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What is tuberculosis?
Tuberculosis is a disease caused by an infection
with the bacteria Mycobacterium tuberculosis.
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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.

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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.

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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.

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ISONIAZIDAdverse Reactions

• Hepatitis
• Peripheral neuropathy
• Lupus

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ISONIAZIDMonitoring

• Liver function tests
• Clinical signs of hepatic toxicity
• Numbness/tingling of extremities

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ISONIAZIDDrug Interactions

• Alcohol
• Phenytoin
• Disulfiram
• Aluminum Salts
• Carbamazepine
• Benzodiazepines
• Anticoagulants
• Ketoconazole

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RIFAMPINAdverse Reactions

• Hepatitis
• Orange discoloration of secretions
• Drug interactions
• Immunologic mediated illness

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RIFAMPINMonitoring

• Liver function tests
• Clinical signs of hepatic toxicity
• CBC, platelets, serum creatinine, bilirubin
• Bleeding abnormalities

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RIFAMPINDrug Interactions

• Warfarin
• Digoxin
• Beta-blockers
• Ketoconazole
• Verapamil
• Quinidine
• Methadone
• Phenytoin.

• Corticosteroids
• Oral Contraceptives
• Dapsone
• Theophylline
• Sulfonylureas
• Cyclosporine
• Protease Inhibitors

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ETHAMBUTOLAdverse Reactions

• Gout
• Rash
• Peripheral neuritis
• Optic neuritis

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ETHAMBUTOLMonitoring

• Visual acuity
• Uric acid levels

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ETHAMBUTOLDrug Interaction

• Aluminum salts

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PYRAZINAMIDEAdverse Reactions

• Hepatitis
• Gout

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PYRAZINAMIDEMonitoring

• Liver function tests
• Clinical signs of hepatic
• toxicity
• Uric acid levels

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STREPTOMYCINAdverse Reactions

• Auditory
• Vestibular
• Nephrotoxicity
• Hypersensitivity

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STREPTOMYCINMonitoring

• Signs of Ototoxicity
• Vertigo
• Ataxia
• Hearing Loss

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STREPTOMYCINDrug Interactions

• Loop diuretics
• Neuromuscular blockers