This document provides treatment guidelines for tuberculosis. It outlines the aims of TB treatment as curing the patient, preventing death from active or relapsed TB, decreasing transmission, and preventing drug resistance. It describes the initial and continuation phases of treatment for new and previously treated cases. It also defines different types of TB cases and provides recommended drug regimens and dosages depending on the category of TB patient. Isoniazid, rifampicin, pyrazinamide, and ethambutol are first-line oral drugs, while streptomycin and thioacetazone are also mentioned. BCG vaccination guidelines are also briefly covered.
The bacteria that cause tuberculosis (TB) can develop resistance to the antimicrobial drugs used to cure the disease. Multidrug-resistant TB (MDR-TB) is TB that does not respond to at least isoniazid and rifampicin, the 2 most powerful anti-TB drugs.
The 2 reasons why multidrug resistance continues to emerge and spread are mismanagement of TB treatment and person-to-person transmission. Most people with TB are cured by a strictly followed, 6-month drug regimen that is provided to patients with support and supervision. Inappropriate or incorrect use of antimicrobial drugs, or use of ineffective formulations of drugs (such as use of single drugs, poor quality medicines or bad storage conditions), and premature treatment interruption can cause drug resistance, which can then be transmitted, especially in crowded settings such as prisons and hospitals.
In some countries, it is becoming increasingly difficult to treat MDR-TB. Treatment options are limited and expensive, recommended medicines are not always available, and patients experience many adverse effects from the drugs. In some cases even more severe drug-resistant TB may develop. Extensively drug-resistant TB, XDR-TB, is a form of multidrug-resistant TB with additional resistance to more anti-TB drugs that therefore responds to even fewer available medicines. It has been reported in 117 countries worldwide.
Drug resistance can be detected using special laboratory tests which test the bacteria for sensitivity to the drugs or detect resistance patterns. These tests can be molecular in type (such as Xpert MTB/RIF) or else culture-based. Molecular techniques can provide results within hours and have been successfully implemented even in low resource settings.
New WHO recommendations aim to speed up detection and improve treatment outcomes for MDR-TB through use of a novel rapid diagnostic test and a shorter, cheaper treatment regimen. At less than US$ 1000 per patient, the new treatment regimen can be completed in 9–12 months. Not only is it less expensive than current regimens, but it is also expected to improve outcomes and potentially decrease deaths due to better adherence to treatment and reduced loss to follow-up.
Solutions to control drug-resistant TB are to:
cure the TB patient the first time around
provide access to diagnosis
ensure adequate infection control in facilities where patients are treated
ensure the appropriate use of recommended second-line drugs.
In 2015, an estimated 480 000 people worldwide developed MDR-TB, and an additional 100 000 people with rifampicin-resistant TB were also newly eligible for MDR-TB treatment. India, China, and the Russian Federation accounted for 45% of the 580 000 cases. It is estimated that about 9.5% of these cases were XDR-TB.
Acute kidney injury (AKI) is a potentially life-threatening
syndrome that occurs primarily in hospitalized patients
and frequently complicates the course of critically ill
patient.
Acute Kidney Injury is is (abrupt) reduction in kidney functions as evidence by changed in laboratory values; serum creatinine, blood urea nitrogen(BUN)and urine output
Definition
History
Chemistry
Properties
Classification & its Generation
Pharmacokinetics
Mechanism of action
Indication
Contraindication
Therapeutic use
Adverse effect
Resistance
Comparison with penicillin
Market preparation
Anti Tubercular Drugs - Mechanism of Action and Adverse effects Thomas Kurian
A brief outline of the mechanism of action and adverse effects of anti tubercular drugs
Only First line and second line drugs are dealt with.First line drugs may be useful for MBBS students and the rest is directed for postgraduate students.
Hope you find it useful.
The bacteria that cause tuberculosis (TB) can develop resistance to the antimicrobial drugs used to cure the disease. Multidrug-resistant TB (MDR-TB) is TB that does not respond to at least isoniazid and rifampicin, the 2 most powerful anti-TB drugs.
The 2 reasons why multidrug resistance continues to emerge and spread are mismanagement of TB treatment and person-to-person transmission. Most people with TB are cured by a strictly followed, 6-month drug regimen that is provided to patients with support and supervision. Inappropriate or incorrect use of antimicrobial drugs, or use of ineffective formulations of drugs (such as use of single drugs, poor quality medicines or bad storage conditions), and premature treatment interruption can cause drug resistance, which can then be transmitted, especially in crowded settings such as prisons and hospitals.
In some countries, it is becoming increasingly difficult to treat MDR-TB. Treatment options are limited and expensive, recommended medicines are not always available, and patients experience many adverse effects from the drugs. In some cases even more severe drug-resistant TB may develop. Extensively drug-resistant TB, XDR-TB, is a form of multidrug-resistant TB with additional resistance to more anti-TB drugs that therefore responds to even fewer available medicines. It has been reported in 117 countries worldwide.
Drug resistance can be detected using special laboratory tests which test the bacteria for sensitivity to the drugs or detect resistance patterns. These tests can be molecular in type (such as Xpert MTB/RIF) or else culture-based. Molecular techniques can provide results within hours and have been successfully implemented even in low resource settings.
New WHO recommendations aim to speed up detection and improve treatment outcomes for MDR-TB through use of a novel rapid diagnostic test and a shorter, cheaper treatment regimen. At less than US$ 1000 per patient, the new treatment regimen can be completed in 9–12 months. Not only is it less expensive than current regimens, but it is also expected to improve outcomes and potentially decrease deaths due to better adherence to treatment and reduced loss to follow-up.
Solutions to control drug-resistant TB are to:
cure the TB patient the first time around
provide access to diagnosis
ensure adequate infection control in facilities where patients are treated
ensure the appropriate use of recommended second-line drugs.
In 2015, an estimated 480 000 people worldwide developed MDR-TB, and an additional 100 000 people with rifampicin-resistant TB were also newly eligible for MDR-TB treatment. India, China, and the Russian Federation accounted for 45% of the 580 000 cases. It is estimated that about 9.5% of these cases were XDR-TB.
Acute kidney injury (AKI) is a potentially life-threatening
syndrome that occurs primarily in hospitalized patients
and frequently complicates the course of critically ill
patient.
Acute Kidney Injury is is (abrupt) reduction in kidney functions as evidence by changed in laboratory values; serum creatinine, blood urea nitrogen(BUN)and urine output
Definition
History
Chemistry
Properties
Classification & its Generation
Pharmacokinetics
Mechanism of action
Indication
Contraindication
Therapeutic use
Adverse effect
Resistance
Comparison with penicillin
Market preparation
Anti Tubercular Drugs - Mechanism of Action and Adverse effects Thomas Kurian
A brief outline of the mechanism of action and adverse effects of anti tubercular drugs
Only First line and second line drugs are dealt with.First line drugs may be useful for MBBS students and the rest is directed for postgraduate students.
Hope you find it useful.
Tuberculosis and basic of att. Tuberculosis and basic of att. Tuberculosis and basic of att. Tuberculosis and basic of att. Tuberculosis and basic of att. Tuberculosis and basic of att. Tuberculosis and basic of att. Tuberculosis and basic of att. Tuberculosis and basic of att. Tuberculosis and basic of att. Tuberculosis and basic of att. Tuberculosis and basic of att. Tuberculosis and basic of att. Tuberculosis and basic of att. Tuberculosis and basic of att. Tuberculosis and basic of att. Tuberculosis and basic of att. Tuberculosis and basic of att. Tuberculosis and basic of att. Tuberculosis and basic of att. Tuberculosis and basic of att. Tuberculosis and basic of att. Tuberculosis and basic of att. Tuberculosis and basic of att. Tuberculosis and basic of att. Tuberculosis and basic of att. Tuberculosis and basic of att. Tuberculosis and basic of att. Tuberculosis and basic of att. Tuberculosis and basic of att. Tuberculosis and basic of att. Tuberculosis and basic of att. Tuberculosis and basic of att. Tuberculosis and basic of att. Tuberculosis and basic of att. Tuberculosis and basic of att. Tuberculosis and basic of att. Tuberculosis and basic of att. Tuberculosis and basic of att. Tuberculosis and basic of att. Tuberculosis and basic of att. Tuberculosis and basic of att. Tuberculosis and basic of att. Tuberculosis and basic of att. Tuberculosis and basic of att. Tuberculosis and basic of att. Tuberculosis and basic of att. Tuberculosis and basic of att. Tuberculosis and basic of att. Tuberculosis and basic of att. Tuberculosis and basic of att. Tuberculosis and basic of att. Tuberculosis and basic of att. Tuberculosis and basic of att. Tuberculosis and basic of att. Tuberculosis and basic of att. Tuberculosis and basic of att. Tuberculosis and basic of att. Tuberculosis and basic of att. Tuberculosis and basic of att. Tuberculosis and basic of att. Tuberculosis and basic of att. Tuberculosis and basic of att. Tuberculosis and basic of att. Tuberculosis and basic of att. Tuberculosis and basic of att. Tuberculosis and basic of att. Tuberculosis and basic of att. Tuberculosis and basic of att. Tuberculosis and basic of att. Tuberculosis and basic of att. Tuberculosis and basic of att. Tuberculosis and basic of att. Tuberculosis and basic of att. Tuberculosis and basic of att. Tuberculosis and basic of att. Tuberculosis and basic of att. Tuberculosis and basic of att. Tuberculosis and basic of att. Tuberculosis and basic of att. Tuberculosis and basic of att. Tuberculosis and basic of att. Tuberculosis and basic of att. Tuberculosis and basic of att. Tuberculosis and basic of att. Tuberculosis and basic of att. Tuberculosis and basic of att. Tuberculosis and basic of att. Tuberculosis and basic of att. Tuberculosis and basic of att. Tuberculosis and basic of att. Tuberculosis and basic of att. Tuberculosis and basic of att. Tuberculosis and basic of att. Tuberculosis and basic of att. Tuberculosis and basic of att. Tuberculosis and basic o
Pharmacotherapy Of Tuberculosis infection.pptxdrsriram2001
Tuberculosis (TB) is a contagious infectious disease caused by the bacterium Mycobacterium tuberculosis. It primarily affects the lungs but can also affect other parts of the body, such as the brain, kidneys, or spine. Here's a four-step explanation of tuberculosis:
Cause and Transmission: Tuberculosis is caused by the bacterium Mycobacterium tuberculosis. When an infected person with active TB coughs, sneezes, or talks, they release droplets containing the bacteria into the air. Another person can become infected by inhaling these droplets. TB is primarily transmitted through the air, making close and prolonged contact with an infected individual the main risk factor for transmission.
Symptoms: TB can manifest differently depending on whether it's active or latent. Latent TB infection occurs when the bacteria are present in the body but are not causing symptoms or spreading to others. Active TB disease occurs when the bacteria are actively multiplying and causing symptoms. Common symptoms of active TB include a persistent cough, chest pain, coughing up blood, fatigue, weight loss, fever, and night sweats.
Diagnosis: Diagnosis of TB involves several steps. Firstly, a medical history and physical examination are conducted to assess symptoms and risk factors. Following this, diagnostic tests such as the tuberculin skin test (TST) or interferon-gamma release assays (IGRAs) are used to determine if a person has been infected with TB bacteria. If these tests are positive, further tests such as chest X-rays, sputum tests, or cultures may be performed to confirm active TB disease and determine the most effective treatment.
Treatment and Prevention: Treatment for TB usually involves a combination of antibiotics taken for several months. Commonly used antibiotics include isoniazid, rifampin, ethambutol, and pyrazinamide. It's essential to complete the full course of treatment to prevent the development of drug-resistant strains of TB. Additionally, preventive measures such as vaccination with the Bacillus Calmette-Guérin (BCG) vaccine, good ventilation in living and working spaces, and early identification and treatment of active cases can help control the spread of TB.
DRUG RESISTANT TUBERCULOSIS,DIAGNOSIS AND TREATMENTDr.Lalit Kumar
VERY USEFUL PRESENTATION TO LEARN THE BASICS OF MDR/XDR-TB AS WELL AS THEIR MANAGEMENT.MOST OF THE CONTENT ARE BASED ON THE RNTCP GUIDELINES AND WHO 2013 UPDATE....
Pulmonary tuberculosis
The bacterium Mycobacterium tuberculosis causes tuberculosis (TB), a contagious, airborne infection that destroys body tissue. Pulmonary TB occurs when M. tuberculosis primarily attacks the lungs. However, it can spread from there to other organs.
New treatment regimen is mentioned here.
263778731218 Abortion Clinic /Pills In Harare ,sisternakatoto
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- Video recording of this lecture in English language: https://youtu.be/kqbnxVAZs-0
- Video recording of this lecture in Arabic language: https://youtu.be/SINlygW1Mpc
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Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
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Adv. biopharm. APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMSAkankshaAshtankar
MIP 201T & MPH 202T
ADVANCED BIOPHARMACEUTICS & PHARMACOKINETICS : UNIT 5
APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMS By - AKANKSHA ASHTANKAR
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
2. AIMS OF TREATMENT –
1. To cure the patient of TB
2. To prevent death from active TB
3. To prevent death from relapse of TB
4. To decrease transmission of TB to others
5. To prevent development of acquired drug
resistance
4. 1.Tuberculosis suspect-
Any person who presents with symptoms or
signs suggestive of TB
2.Definite case of TB-
Patient with M.TB complex identified from a
clinical specimen, either by culture or by a newer
method such as molecular line probe assay
One or more initial sputum smear examinations
positive for AFB is also considered to be a
‘definite’ case
5. 3. Case of TB-
A definite case of TB or one in which a health
worker has diagnosed TB and has decided to treat
the patient with a full course of TB treatment
Cases of TB also classified according to the-
a. anatomical site of the disease
b. bacteriological results
c. history of previous treatment
d. HIV status of the patient
6. 4. Smear negative PTB cases-
Smear negative PTB cases should either:
A. Sputum smear negative but culture positive for
M. tuberculosis
OR
B. meet the following diagnostic criteria :
decision by a clinician to treat with a full course
of anti TB therapy; and
7. radiographic abnormalities consistent with active
pulmonary TB and either:
-laboratory or strong clinical evidence of HIV
infection
or:
- if HIV negative and no improvement in response
to a course of broad spectrum antibiotics
8. A. FIRST LINE DRUGS:-
Isoniazid (H)
Rifampicin (R)
Pyrazinamide (Z)
Streptomycin (S)
Ethambutol (E)
9. B. SECOND LINE DRUGS:-
Para-amino salicylic Acid
Ethionamide
Cycloserine
Kanamycin / Amikacin / Capreomycin
Macrolides
Fluroquinolones
Second line ATT are used in the
treatment of MDRTB
15. INH and Rifampicin-
Most powerful bactericidal drugs
active against all population of TB bacilli
16. Rifampicin -
most potent sterilizing drug
Pyrazinamide -
bactericidal- active only in acidic environment
Streptomycin -
Bactericidal- against rapidly multiplying bacilli
19. 1. NEW CASE-
A patient who has never had treatment for TB
OR
Who has taken ATT <1 month
2. REPALSE-
A patient previously treated for TB declared
cured / treatment completed
Subsequently diagnosed with bacteriologically positive
(smear or culture) tuberculosis
20. 3. TREATMENT FAILURE-
A patient who while on treatment, remained or
became again smear positive five months or later after
commencing treatment
OR
Initially smear negative before starting treatment and
became smear positive after the second month of
treatment
21. 4. DEFAULTER-
A patient who returns to treatment, positive
bacteriogically, following interruption of
treatment for 2 months or more
5. OTHERS-
All cases that do not fit the above difinitions.
Chronic Case A patient who is sputum
positive at the end of a retreatment regimen
22. 6. TRANSFER IN-
A patient who has been transferred from another
TB register to continue treatment
23. Recommended treatment regimens are similar
irrespective of site of the disease
A patient with both pulmonary and extra
pulmonary TB
Classified as a case of PTB
25. TBTB
CATEGORYCATEGORY
TB PATIENTSTB PATIENTS TB TREATMENTTB TREATMENT
REGIMENSREGIMENS
InitialInitial
PhasePhase
ContinuationContinuation
PhasePhase
II
• New Smear +ve PTSNew Smear +ve PTS
• New smear –ve PTSNew smear –ve PTS
with extensivewith extensive
parenchymalparenchymal
involvementinvolvement
• Severe concomitantSevere concomitant
HIV diseaseHIV disease
• Severe forms ofSevere forms of
extra pulmonary TBextra pulmonary TB
2 EHRZ2 EHRZ 4 HR or 6 HE4 HR or 6 HE
27. IVIV
Chronic CasesChronic Cases
MDR TBMDR TB
( Still sputum-positive( Still sputum-positive
after a supervised re-after a supervised re-
treatment regimen ie.treatment regimen ie.
Cat-II)Cat-II)
Patient referred toPatient referred to
higher centre forhigher centre for
further managementfurther management
29. PERSONS FOR WHOM RECOMMENDED ??
Determined by Tuberculin test
I Persons with HIV infection / Close contacts of
infectious cases
≥ 5mm - positive
II At risk persons
≥ 10 mm - positive
III Persons not in a high risk category / not exposed to
high risk environment
Cut off limit ≥ 15mm – positive
30. 1. Persons with HIV infection or risk factors for HIV infection
2. Close contacts of persons with newly diagnosed
infectious tuberculosis
3. Recent tuberculin skin test converters
≥ 10mm within a 2year period, age < 35years
≥ 15mm within a 2year period, age > 35 years
4. Persons with medical conditions-reported to have risk of
tuberculosis.
i. Diabetes mellitus
ii. Prolonged therapy with steroids.
iii. Immunosuppressive therapy.
31. iv. Hematological / reticulo endothelial disease
Leukemia, Hodgkin’s disease
v. End stage renal disease
vi. I.V drug abusers.
5. Foreign-borne persons from high prevalence countries
- Latin America, Asia, Africa.
32. Given in single dose
Adults - 300mg/day
Children - 10- 15mg /kbw/day
(Dose should not exceed 300mg/day)
Total duration – 12 months (minimum = 6
months)