1. The document discusses the management of tuberculosis, including the history, statistics, principles of treatment, protocols, side effects of drugs, and the Revised National Tuberculosis Control Programme in India. 2. It covers topics like tuberculosis and diabetes, tuberculosis and HIV co-infection, multi-drug resistant tuberculosis, and paradoxical reactions seen with antituberculosis treatment and antiretroviral therapy. 3. Guidelines are provided for treatment of different categories of tuberculosis patients, management of drug interactions and adverse effects, and regimens for multi-drug resistant cases.

1. Management of Tuberculosis Dr. Uttam Kumar Dasgupta MBBS (Cal) MD (Cal, Chest)

14. Contd… PPI / Antiemetics Eto, Pto, PAS R Gastritis Thyroxine PAS, Eto, Pto Hypothyroidsm Change to Cm AG Clr Hearing loss Management Drugs responsible Adverse effects

15. Contd… Stop E Optic neuritis NSAID Dose / Stop Z Arthralgia Replace Cm AG Electrolyte disturbances (K, Mg ) Use Cm Give bi / tri wkly. AG Renal toxicity Management Drugs responsible Adverse effects

17. Setup

22. Sputum Categorization 100 - NEG Nil 200 No / 200 Scanty 1 – 9 AFB / 100 OIF 100 1+ POS 10 – 99 AFB / 100 OIF 50 2+ POS 1 – 10 AFB / OIF 20 3+ POS >10 AFB / OIF No. of fields Grading Results If slide has

32. Overlapping adverse event profile - ZDV CTMX Valganciclovir Bone marrow dysplasia RBT, R Pancytopenia - d4T, ddl & ddc - - H & E Peripheral neuropathy + in pts. With chr. Viral hepatitis NVP, all PI CTMX - ZRH, RBT Hepatitis - Ddl - - E, RBT Ocular Effects + Pancreatitis or Intra – abd. Adenitis ZDV, r, IDV - Do - Other opp infections - Do - Nausea Vomiting - NVP, EVP, ABC CTMX Folliculitis ZRH, RBT Skin Rash IRS ARV drugs Medication other than ARV HIV ATT Possible Causes Adverse Effects

40. Doses 10 – 12 g. 10 g. 8 g. 150 m/K PAS 750-1000 mg. 750 mg. 500 mg. 15-20m/K Cs 750-1000 mg. 750 mg. 500 mg. 15-20m/K Eto / Pto 400 mg. 400 mg. 400 mg. 7.5–10m/k Mfx / Gfx 750-1000 mg. 750 mg. 750 mg. 7.5–10m/k Lfx 800-1000 mg. 800 mg. 800 mg. 15–20m/k Ofx - - - 15–20m/k AG > 70 Kg. 51-70 Kg. 33–50 Kg. < 33 Kg. Drugs

52. Management of latent TB – Indications of Tt. Silicosis / DN / malignancy Chr. immunosupression Lab personnel Prior TB (fiibrosis) Residents & employees of high risk setup. Recent contact No risk persons Immigration HIV +ve 15 mm. induration 10 mm. induration 5 mm. induration

63. Thank You!