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ANTI TUBERCULAR DRUGS
PRESENTED BY
ABHAY RAJPOOT
DEFINITION
It is infectious disease caused by Mycobacterium tuberculosis and
characterized by the formation of tubercles (round nodules) or
granulomas in lungs.
It may be transmitted to other body parts such as meningitis, bones,
kidneys, lymph nodes.
Latent TB - the bacteria
remain in the body in an
inactive state. They cause
no symptoms and are not
contagious, but they can
become active.
Active TB - the bacteria
do cause symptoms and
can be transmitted to
others.
ANTI
TUBERCULAR
DRUGS
FIRST LINE DRUGS
 Isoniazid (H)
 Rifampicin(R)
 Pyrazinamide(Z)
 Ethambutol(E)
 Streptomycin(S)
Directly
Observation
Treatment
Shortcourse
 Why? Many patient don’t take medicine
regularly ,even if excellent health
education provided.
 Who? All patient…impossible to
predict which patient will take
medicine(1/3 not adherent).
 What? Observer watches and helps
patient swallow tablets.
 Where? Anywhere (home, clinic, work,
school etc).
 Who does it? HCW, community
workers , teacher.
 Direct observation ensure treatment for
entire course with the right drugs, in the
right dose, at the right intervals.
SECOND LINE
DRUGS
 Thioacetazone
 PASA
 Ethionamide
 Cycloserine
 Kanamycin
 Capreomycin
 Amikacin
NEWER
DRUGS
Ciprofloxacin
Ofloxacin
Clarithromycin
Azithromycin
Rifabutin
`
Category Type of patient Regimen Duration in
months
Test at month
Category I
COLOR OF
BOX: RED
New sputum
smear positive
New sputum
smear negative
New extra
pulmonary
New others
2(HRZE)3
4(HR)3
6 2
Category II
COLOR OF
BOX:BLUE
Sputum positive
relapse
Sputum positive
failure
After default
2(HRZES)3
1(HRZE)3
5(HRE)3
8 3
Category III
COLOR OF
BOX:GREEN
Sputum negative,
Extra pulmonary
not seriously ill
2(HRZ)3
4(HR)3
6
Adverse reactions to anti-T.B
drugsDrugs Adverse effects
•Isoniazid Peripheral neuropathy
Hepatitis
•Rifampicin Vomiting, abdominal pain
hepatitis
•Pyrazinamide Joint pain, hepatitis
•Ethambutol Optic neuritis
•Streptomycin Renal damage
Auditory & vestibular nerve
damage
OTHER
MANAGEMENT
STRATEGIES
Nutritional therapy
Lifestyle modification
Cough hygiene
Regular follow up
Prevention of complications
ROLE OF NURSE
 NURSES ARE THE BACKBONE OF TB CONTROL
 NURSES EXIST GLOBALLY AND SHARE COMMON IDEAS AND
VALUES
KEY
ACTIVITIES
OF NURSES
PATIENT CARE
HEALTH EDUCATION
TREATMENT OBSERVATION
SPUTUM COLLECTION
MANAGEMENT/ COORDINATION
CONTACT TRACING/ SCREENING
RESEARCH
TEACHING
NURSES AND
CASE
DETECTION:
• First point to call in
primary care services
• Health education
• Holding patient from
presentation to
registration
• Reporting and
recording
70% CASE
DETECTION-
Nurses and
treatment
success
85 % treatment success
• Patient care
• Health education
• Treatment monitoring
• Reporting and recording
Challenges
Lack of nursing
guidelines
Lack of research
evidence
Lack of an
international voice
Large variety of
circumstances
PREVENTION
 Wash your hands after sneezing, coughing or holding your hands near
your mouth or nose.
 Cover your mouth with a tissue when you cough, sneeze or laugh.
Discard used tissues in a plastic bag, then seal and throw it away.
 Do not attend work or school.
 Avoid close contact with others.
 Sleep in a room away from other family members.
 Ventilate your room regularly. TB spreads in small closed spaces. Put a
fan in your window to blow out air that may contain bacteria
 Vaccination (BCG)
RESEARCH STUDY
Aspirin could be the new target for treating drug-resistant
tuberculosis, as tuberculosis bacterium was found to hijack
platelets from the blood clotting system to weaken body's
immune system, according to the research led by the Centenary
Institute in Sydney
SUMMARY
CONCLUSION
Urine testing of people with HIV for tuberculosis can save lives and be
cost-effective, stated findings from an international team of
investigators published in The Lancet Global Health and could
influence international guidelines on TB testing. Screening all
hospitalized patients with HIV for tuberculosis (TB) using urine tests
would improve life expectancy and be cost-effective in Malawi and
South Africa
Anti tuberculor drugs
Anti tuberculor drugs

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Anti tuberculor drugs

  • 2. DEFINITION It is infectious disease caused by Mycobacterium tuberculosis and characterized by the formation of tubercles (round nodules) or granulomas in lungs. It may be transmitted to other body parts such as meningitis, bones, kidneys, lymph nodes.
  • 3. Latent TB - the bacteria remain in the body in an inactive state. They cause no symptoms and are not contagious, but they can become active. Active TB - the bacteria do cause symptoms and can be transmitted to others.
  • 4. ANTI TUBERCULAR DRUGS FIRST LINE DRUGS  Isoniazid (H)  Rifampicin(R)  Pyrazinamide(Z)  Ethambutol(E)  Streptomycin(S)
  • 5. Directly Observation Treatment Shortcourse  Why? Many patient don’t take medicine regularly ,even if excellent health education provided.  Who? All patient…impossible to predict which patient will take medicine(1/3 not adherent).  What? Observer watches and helps patient swallow tablets.  Where? Anywhere (home, clinic, work, school etc).  Who does it? HCW, community workers , teacher.  Direct observation ensure treatment for entire course with the right drugs, in the right dose, at the right intervals.
  • 6.
  • 7. SECOND LINE DRUGS  Thioacetazone  PASA  Ethionamide  Cycloserine  Kanamycin  Capreomycin  Amikacin
  • 9.
  • 10. ` Category Type of patient Regimen Duration in months Test at month Category I COLOR OF BOX: RED New sputum smear positive New sputum smear negative New extra pulmonary New others 2(HRZE)3 4(HR)3 6 2 Category II COLOR OF BOX:BLUE Sputum positive relapse Sputum positive failure After default 2(HRZES)3 1(HRZE)3 5(HRE)3 8 3 Category III COLOR OF BOX:GREEN Sputum negative, Extra pulmonary not seriously ill 2(HRZ)3 4(HR)3 6
  • 11.
  • 12. Adverse reactions to anti-T.B drugsDrugs Adverse effects •Isoniazid Peripheral neuropathy Hepatitis •Rifampicin Vomiting, abdominal pain hepatitis •Pyrazinamide Joint pain, hepatitis •Ethambutol Optic neuritis •Streptomycin Renal damage Auditory & vestibular nerve damage
  • 13. OTHER MANAGEMENT STRATEGIES Nutritional therapy Lifestyle modification Cough hygiene Regular follow up Prevention of complications
  • 14. ROLE OF NURSE  NURSES ARE THE BACKBONE OF TB CONTROL  NURSES EXIST GLOBALLY AND SHARE COMMON IDEAS AND VALUES
  • 15. KEY ACTIVITIES OF NURSES PATIENT CARE HEALTH EDUCATION TREATMENT OBSERVATION SPUTUM COLLECTION MANAGEMENT/ COORDINATION CONTACT TRACING/ SCREENING RESEARCH TEACHING
  • 16. NURSES AND CASE DETECTION: • First point to call in primary care services • Health education • Holding patient from presentation to registration • Reporting and recording 70% CASE DETECTION-
  • 17. Nurses and treatment success 85 % treatment success • Patient care • Health education • Treatment monitoring • Reporting and recording
  • 18. Challenges Lack of nursing guidelines Lack of research evidence Lack of an international voice Large variety of circumstances
  • 19. PREVENTION  Wash your hands after sneezing, coughing or holding your hands near your mouth or nose.  Cover your mouth with a tissue when you cough, sneeze or laugh. Discard used tissues in a plastic bag, then seal and throw it away.  Do not attend work or school.  Avoid close contact with others.  Sleep in a room away from other family members.  Ventilate your room regularly. TB spreads in small closed spaces. Put a fan in your window to blow out air that may contain bacteria  Vaccination (BCG)
  • 20. RESEARCH STUDY Aspirin could be the new target for treating drug-resistant tuberculosis, as tuberculosis bacterium was found to hijack platelets from the blood clotting system to weaken body's immune system, according to the research led by the Centenary Institute in Sydney
  • 22. CONCLUSION Urine testing of people with HIV for tuberculosis can save lives and be cost-effective, stated findings from an international team of investigators published in The Lancet Global Health and could influence international guidelines on TB testing. Screening all hospitalized patients with HIV for tuberculosis (TB) using urine tests would improve life expectancy and be cost-effective in Malawi and South Africa