TREATMENT OF TUBERCULOSIS: Prevention: BCG vaccination: It does not prevent infection but limits multiplication and spread of following infection so prevents.

Slides:



Advertisements
Similar presentations
TUBERCULOSIS This is the prompt slide for the TB Therapy section.
Advertisements

TUBERCULOSIS Pulmonary TB.
Patient Initial Evaluation & Follow up. Pretreatment screening and evaluation: Initial evaluation serves to establish a baseline and may identify patients.
Tuberculosis and perinatal period Kai Kliiman Tartu University Lung Clinic Estonian NTP 15 September 2006 Tallinn.
Spinal Tuberculosis Abdullah Baghaffar. What Is Spinal Tuberculosis? Tuberculosis of the spine, also known as tuberculous spondylitis or Pott's Disease,
Respiratory System Drugs Antitubercular Drugs. Tuberculosis (TB) Caused by Mycobacterium tuberculosis Antitubercular drugs treat all forms of Mycobacterium.
Group II Treatment regimens, hospitalization. DOT provision, outcome definitions, management of adverse drug reactions.
7. Anti-TB regimen in special situations of liver disease, renal impairment, and pregnancy.
Pulmonary TB. BY PROF. AZZA ELMedany Dr. Ishfaq Bukhari.
Anti-tuberculous drugs. Mycobacteria Slow-growing bacillusDormant forms in macrophages.
Antimycobacterial drugs Tuberculosis Treatment of mycobacterial infections is complicated due: Limited information regarding antimycobacterial drug actions.
PULMONARY TUBERCULOSIS
Tuberculosis (TB) PHCL 442 Lab Discussion Jamilah Al-Saidan, M.Sc.
Clinical Pharmacy.  Tuberculosis is caused by M. tuberculosis, an aerobic, non–spore-forming bacillus that resists decolorization by acid alcohol after.
Tuberculosis Presented by Vivian Pham and Vivian Nguyen.
Treatment and Management. Stabilize the Patient Airway Breathing Circulation.
Plans for Diagnosis and Management of Acute Pyelonephritis.
TUBERCULOSIS Diagnosis & treatment
Current international guidelines recommend 6–9 months of isoniazid (INH) preventive chemotherapy to prevent the development of active tuberculosis in.
 Pulmonary Tuberculosis BY: MOHAMED HUSSEIN. Cause  Caused by Mycobacterium tuberculosis (M. tuberculosis)  Gram (+) rod (bacilli). Acid-fast  Pulmonary.
TB 101: TB Basics and Global Approaches. Objectives Review basic TB facts. Define common TB terms. Describe key global TB prevention and care strategies.
“Don’t tell me TB is under control!” Understanding TB
TUBERCULOSIS * Prevention * Treatment, and * Challenges.
THEME: PULMONARY TUBERCULOSIS ESSAY Kazakh National medical university named after S.D. Asfendiyarov Department of foreign languages Made by: Kalymzhan.
Side effects. Side effects: Isoniazid Rash, abnormal liver function, hepatitis, peripheral neuropathy and mild central nervous system (CNS) effects. Hepatitis.
ANTITUBERCULOUS DRUGS by Dr.Mohammed Abd-Almoneim
Unit 9 Diagnosis and Treatment of Paediatric TB: B Family Case Botswana National Tuberculosis Programme Manual Training for Medical Officers.
Pulmonary TB. BY PROF. AZZA EL- MEDANY Department of Pharmacology.
Elsevier Inc. items and derived items © 2010 by Saunders, an imprint of Elsevier Inc. Chapter 89 Antimycobacterial Agents: Drugs for Tuberculosis, Leprosy,
Tuberculosis Egan’s Chapter 22. Mosby items and derived items © 2009 by Mosby, Inc., an affiliate of Elsevier Inc. 2 Tuberculosis (TB) The incidence of.
Anri Uys (MSc Pharmacology, BPharm NWU) Medicines Information Centre, Division of Clinical Pharmacology University of Cape Town.
WORK UPS AND MANAGEMENT. Traditional and New Diagnostic Approaches DIAGNOSTICSAPPLICATIONS Traditional approaches - Symptom-based -TST -TB Culture --
Treatment of Tuberculosis: New Case Case Studies Module 7A2 – March 2010.
Adult Medical-Surgical Nursing Respiratory Module: Tuberculosis.
Treatment Bed rest doesn’t affect outcome Hospitalisation: – Ill, smear positive, highly infectious patients – Esp in multi-drug resistant TB Continuous.
.. Tuberculosis is a chronic infectious and communicable granulomatous disease caused by the Mycobacterium tuberculosis. Tuberculosis most commonly affects.
Copyright (c) 2004 Elsevier Inc. All rights reserved. Antimycobacterial Agents: Drugs for Tuberculosis, Leprosy, and Mycobacterium avium Complex Infections.
Chemotherapy of Tuberculosis By Prof. Azza El-Medany.
Tuberculosis care and control in refugee and displaced population: An interagency field manual 2 nd edition © World Health Organization 2007 Edited by.
Extrapulmonary Site 2 :_____________________ TUBERCULOSIS TREATMENT CARD BOTSWANA NATIONAL TUBERCULOSIS PROGRAMME Date RegisteredIN ToOUT RegisteredIN.
TUBERCULOSIS   Pyrexia, fatigue, night sweats, weight
By: Kristen Sieck and Scott Senftner 3rd Period Health Class
Pulmonary TB. BY PROF.  AZZA ELMedany OBJECTIVES  At the end of lecture, the students should:  Discuss the etiology of tuberculosis  Discuss the.
Antitubercular Agents. Tuberculosis, “TB”Tuberculosis, “TB” Caused by Mycobacterium tuberculosisCaused by Mycobacterium tuberculosis Antitubercular agents.
LEARNING MODULE TITLE SUBTITLE. HISTORY OF PRESENT ILLNESS An 18 year-old woman with no past medical history and no known risks for TB presents with several.
PRIMARY PULMONARY TB Clinical Features: (in children) No symptoms or signs and passes unnoticed in the majority of cases  characterized by 1ry lesion.
TUBERCULOSIS. Tuberculosis is a chronic granulomatous disease and is one of the world’s most widespread and deadly illness. It is commonly called as Consumption.
Copyright © 2007, 2004, 2000, Mosby, Inc., an affiliate of Elsevier Inc. All Rights Reserved. Focus on Tuberculosis (Relates to Chapter 28, “Nursing Management:
Treatment Regimens for Pulmonary Tuberculosis Caused by Drug- Susceptible Organisms Initial PhaseContinuation Phase RegimenDrugs Interval and Doses (Minimal.
Depart. of Pulmonology R4 백승숙. 1. INTRODUCTION 2. BACKGROUND 3. DIAGNOSIS OF LATENT TB INFECTION 4. CHEMOPROPHYLAXIS 5. RISKS OF TUBERCULOSIS AND OF DRUG-INDUCED.
ANTI-TUBERCULOSIS DRUGS. TUBERCULOSIS Difficult to Treat Grow slowly Cell wall impermeable Inside macrophages Develop resistance Caseation & fibrosis.
Tuberculosis in Children: Treatment and Monitoring Module 10B - March 2010.
EPIDEMIOLOGY OF PULMONARY TUBERCULOSIS. LEARNIN G OBJECTIVES State the diagnostic criteria of pulmonary tuberculosis Describe trend & state reasons for.
Anti-TB Agents Dr. Jeff Hobden MIP. Mycobacterium tuberculosis TB is hard to kill with antibiotics TB is hard to kill with antibiotics Slow growth Slow.
Some Important Chest Diseaes
Antituberculous treatment.
Tuberculosis (TB) PHCL 442 Lab Discussion 4 Raniah Al-Jaizani M.Sc.
Tuberculosis Part 2.
ANTITUBERCULOUS DRUGS by Dr.Mohammed Abd-Almoneim
D.Ghada Saad Abdelmotaleb Professor of Pediatrics
Infant born with mother Tuberculosis
Treatment of TB Disease
. Antitubercular Drugs.
Treatment of Latent TB Infection (LTBI)
Epidemiology of pulmonary tuberculosis
بسم الله الرحمن الرحيم.
Respiratory System Drugs
Focus on Tuberculosis.
Tuberculosis in children BY MBBSPPT.COM
Tuberculosis Tuberculosis (TB) is a bacterial infection, treatable by anti-TB drugs. It is a global problem, with the incidence varying across the world.
Presentation transcript:

TREATMENT OF TUBERCULOSIS: Prevention: BCG vaccination: It does not prevent infection but limits multiplication and spread of following infection so prevents fulminating forms as miliary tuberculosis and tuberculous meningitis. ( In Egypt, it is compulsory given to infants in the first 30 days of life subcutaneously in the left deltoid region and a booster dose is given at school age). Chemoprophylaxis: It is the administration of isoniazide to prevent the development of TB in contacts or susceptible persons (AIDS and immunosuppressed patients) till the original case is considered noninfectious for a maximum of 1 yr.

General Principles of Treatment: Rest is not important except in a very severe illness  in bed till symptoms subside or hospitalization in active cases with complications and in cases not controlled at home. Isolation of patients who are excreting tubercle bacilli. Surgical treatment is now rarely required except in cases of empyema or lymph node abscess. (Pulmonary resection is indicated in severely destructed lung or lobe with recurrent hemoptysis or infection and in cases of tuberculoma or lung cavity. Artificial pneumothorax, pneumoperitoneum or phrenic crush is rarely used now).

Any associated disease should be treated properly e.g. D.M. Good diet, adequate but not excessive, is important to regain weight. Because of frequent development of resistance to antibiotics, no single drug should be given alone. Combined chemotherapy lessens the dose and side effects of each drug. Test for sensitivity of the organism to each drug  if resistance to one of them it should be replaced.

Because of the phenomenon of bacterial persisters and to prevent relapse, treatment should be continued for at least 9 months with continuous follow up of the patient after cessation of treatment for 5 years. Follow up include examination of the patient for renewal of symptoms and signs, estimation of ESR, tuberculin test and x-ray chest. Modern drug treatment regimens consist of an initial phase of therapy followed by a maintenance phase of therapy.

Chemotherapy: *First line drugs: used in the initial and maintenance chemotherapy unless drug resistance is known. Rifampicin: 60 kg  600 mg per day. In children mg/kg. It is taken in a single daily dose before breakfast. Side effects are: yellow discoloration of urine, hepatotoxicity and gastrointestinal tract upsets. Isoniazide: In adults 300 mg daily. In children 10 mg/kg. Side effects are peripheral neuritis (interfere with vitamin B6 metabolism, so pyridoxine must be given) and hepatotoxicity.

Ethambutol: 25 mg/kg for 2 months then 15 mg/kg per day. Side effects are retrobulbar neuritis and diminution of field of vision so not given to children. Pyrazinamide: 50 kg  2 g. per day. In children 40 mg/kg. It is given for the initial 2 months only. The main side effects are arthralgia (it can cause acute attack of gout due to precipitation of uric acid) and hepatotoxicity. Streptomycin: 50 kg  1 g. (750 mg > 40 years). In children 20 mg/kg. It is given intramuscularly for the initial 2 months only. The main side effects are ototoxicity and vestibular disturbances.

Standard 6 months short course chemotherapy: Initial phase: 2 Ms of rifampicin, INH, streptomycin & pyrazinamide. Continuation phase of rifampicin & INH for 4 Ms Standard 9 months chemotherapy: - Initial phase: 2 Ms of rifampicin, INH, ethambutol and streptomycin or pyrazinamide. - Continuation phase of rifampicin & INH daily for 7 Ms. For non compliant patients & in poor countries: Initial phase: 2 Ms of rifampicin, INH, ethambutol and streptomycin or pyrazinamide. Continuation phase of rifampicin and isoniazide twice or thrice weekly for 9 Ms.

N.B.: -Treatment response should be assessed by repeated sputum examination and culture for acid-fast bacilli, repeated x-rays & estimation of the sedimentation rate. -Provided that the baseline measurements of visual acuity, uric acid and liver function tests are normal and the patient did not report any new symptom, routine monitoring of blood tests is not usually required.

*Reserve drugs: These drugs are used in the treatment or re-treatment of patients with known or suspected drug resistance. They are: Para-aminosalicylic acid (PAS): 10 gm daily. Side effects are gastrointestinal tract upsets and cutaneous reactions. Thiacetazone: 150 mg daily. Side effects are gastrointestinal tract upsets. Ethionamode and Proethionamide: 50 kg  1 g. per day. Side effects are gastrointestinal tract upsets. Cycloserine: mg daily. Side effects are confusion, slurred speech and convulsions. Kanamycine: like streptomycin.

*Recent drugs: Amikacin and quinolones. *Corticosteroids may be indicated in: Tuberculosis of the serous membranes as pleural and pericardial effusion and ascites to decrease exudation and fibrosis. Very ill patients. Tuberculous meningitis. To control drug hypersensitivity reactions.