Tuberculosis is an infectious disease caused by the Mycobacterium tuberculosis bacteria which most commonly affects the lungs. It spreads through the air when people with active TB cough or sneeze. Common symptoms include cough, fever, night sweats and weight loss. Diagnosis involves chest x-ray and sputum culture. Treatment requires taking multiple antibiotic drugs daily for 6-9 months. Directly observed treatment short course chemotherapy (DOTS) involves health workers directly observing patients take their medications to ensure compliance. Tuberculosis remains a major global health issue and India has a high burden of cases.
tuberculosis lecture | pulmonary Tuberculosis
my self ritesh padghan
tuberculosis is infectious disease caused by mycobacterium tuberculosis in active and latent type of tuberculosis .
BRIEF DISCUSSION INCLUDE
:-LEARNING ABOUT
Introduction
Definition
Causative organism
Risk factor
Transmission
Clinical manifestation
Diagnostic evaluation
Medical management
In this lecture the pathophysiology and phathogenesis of tuberculosis has been discussed
HOPE YOU LIKE
#tuberculosis #respiratorysystem #chronicdiorder #TBkid #endTB #lunghealth # COVID19 #COMMUNIOTY #INFLUNZA #worldtbday # disease
tuberculosis lecture | pulmonary Tuberculosis
my self ritesh padghan
tuberculosis is infectious disease caused by mycobacterium tuberculosis in active and latent type of tuberculosis .
BRIEF DISCUSSION INCLUDE
:-LEARNING ABOUT
Introduction
Definition
Causative organism
Risk factor
Transmission
Clinical manifestation
Diagnostic evaluation
Medical management
In this lecture the pathophysiology and phathogenesis of tuberculosis has been discussed
HOPE YOU LIKE
#tuberculosis #respiratorysystem #chronicdiorder #TBkid #endTB #lunghealth # COVID19 #COMMUNIOTY #INFLUNZA #worldtbday # disease
Tuberculosis (TB) is an infectious disease usually caused by Mycobacterium tuberculosis (MTB) bacteria. Tuberculosis generally affects the lungs, but can also affect other parts of the body
Tuberculosis (TB) is an infectious disease usually caused by Mycobacterium tuberculosis (MTB) bacteria. Tuberculosis generally affects the lungs, but can also affect other parts of the body. Most infections show no symptoms, in which case it is known as latent tuberculosis.
TB is spread from person to person through the air. When people with lung TB cough, sneeze or spit, they propel the TB germs into the air. A person needs to inhale only a few of these germs to become infected.
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Presenting IIP MOUNT (September-October 2016) - Newsletter. This time it was full of festivities, photo tourism, in himalayas, contests, ngo students learning and such activities. IIP Foundation is working on fast pace and is committed to contribute in Empowering India. Enjoy it friends.
Tuberculosis (TB) is an infectious disease usually caused by Mycobacterium tuberculosis (MTB) bacteria. Tuberculosis generally affects the lungs, but can also affect other parts of the body
Tuberculosis (TB) is an infectious disease usually caused by Mycobacterium tuberculosis (MTB) bacteria. Tuberculosis generally affects the lungs, but can also affect other parts of the body. Most infections show no symptoms, in which case it is known as latent tuberculosis.
TB is spread from person to person through the air. When people with lung TB cough, sneeze or spit, they propel the TB germs into the air. A person needs to inhale only a few of these germs to become infected.
Visit...
Medishared.org
You can get..
--- Premium Layest Released Medical Books
--- MBBS & M.D Examination papers with Answer Keys
--- Important Exam Helping Documents
--- Detaile Explained MCQs
--- MCQs Online Testing
And Much more than your expectation from website.
Presenting IIP MOUNT (September-October 2016) - Newsletter. This time it was full of festivities, photo tourism, in himalayas, contests, ngo students learning and such activities. IIP Foundation is working on fast pace and is committed to contribute in Empowering India. Enjoy it friends.
Programa Formación Económica y Financiera para la Educación BásicaSaber Cuenta Banamex
Memorias del 3er. Encuentro de Educación Financiera / Programa Formación Económica y Financiera para la Educación Básica, por Fernando González, Subsecretario de Educación básica en la SEP
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Teaching with ALL Students in Mind: Collaborative Literacy Practices
Considering the shifts of the re-designed curriculum, including a focus on core competencies, examples of story necklaces in writing classrooms and a sequence guided by an essential question are presented.
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.
This ppt gives you idea about pathophysiology of tuberculosis and the pharmacology of drugs used to treat this infection. And it also give deep introduction of molecular interaction of mycobacteria with body i.e.. immune response by human to this mycobacteria.
it also gives you idea about treatment regimens and strategy for TB. discussed the different types of TB and mechanism of development of resistance by mycobacteria for anti-TB drugs.
Objective :
Describe the morphology and structure of mycobacterial tuberculosis ?
What are the tests required for mycobacterial infection :
Mantoux skin test
Sputum examination using Ziehl-Neelsen staining
Sputum culture using lowenstein-jensen media
Discuss the clinical features and transmission of mycobacterial tuberculosis.
What are the pathological changes in mycobacterium tuberculosis?
How to control mycobacterial infection in the environment and vaccine available?
done by : asem shadid , college of medicine .
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
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Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
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Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
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- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
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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
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
2. WHAT IS TUBERCULOSIS
• Tuberculosis = Tubercule + Osis
• Tubercule : A small nodular lesion in the lungs
or the other tissues.
• Osis : A process or condition
• Tuberculosis is a condition which causes a
small nodular lesions in the lungs or other
tissues, an infectious disease caused by
Mycobacterim Bacteria.
2
3. HISTORY
• The bacillus causing tuberculosis, Mycobaterium
tuberculosis, was identified and described on 24
March 1882 by Robert Koch.
• Koch announced a glycerin extract of the tubercle
bacilli as a "remedy" for tuberculosis in 1890, calling
it "tuberculin". While it was not effective, it was later
successfully adapted as a screening test for the
presence of pre-symptomatic tuberculosis.
3
4. • Tuberculosis is a chronic granulomatous
disease caused by Mycobacterium
tuberculosis.
• In developing countries, it is a major public
health problem. India has the highest number
of TB cases in the world accounting for 20% of
the global burden. About 5000 people
develop disease everyday and about
37,00,000 people die in India every year due
to Tuberculosis.
4
5. SIGNS AND SYMPTOMS
• Tuberculosis generally affects the lungs, but
can also affect other parts of the body. It is
spread through the air when people who have
an active TB infection cough, sneeze, or
otherwise transmit respiratory fluids through
the air.
• The classic symptoms of active TB infection
are a chronic cough with blood-tinged
sputum, fever, night sweats, and weight loss.
5
6. • Tuberculosis may infect any part of the body, but
most commonly occurs in the lungs (known as
pulmonary tuberculosis).Extrapulmonary TB
occurs when tuberculosis develops outside of the
lungs, although extrapulmonary TB may coexist
with pulmonary TB, as well. Most infections don’t
have symptoms known as Latent TB.
• General signs and symptoms include fever, chills,
night sweats, loss of appetite, weight loss, and
fatigue. Significant nail clubbing may also occur.
6
7. PULMONARY TUBERCULOSIS
• If a tuberculosis infection does become active, it most
commonly involves the lungs. Symptoms may include
chest pain and a prolonged cough producing sputum.
About 25% of people may not have any symptoms.
Occasionally, people may cough up blood in small
amounts, and in very rare cases, the infection may
erode into the pulmonary artery, resulting in massive
bleeding. Tuberculosis may become a chronic illness
and cause extensive scarring in the upper lobes of the
lungs. The upper lung lobes are more frequently
affected by tuberculosis than the lower ones.The
reason for this difference is not entirely clear. It may be
due to either better air flow, or to poor lymph drainage
within the upper lungs 7
9. EXTRA PULMONARY TUBERCULOSIS
• In 15–20% of active cases, the infection spreads
outside the lungs, causing other kinds of TB. These are
collectively denoted as "extrapulmonary tuberculosis".
Extrapulmonary TB occurs more commonly in
immunosuppressed persons and young children. In
those with HIV, this occurs in more than 50% of cases.
Notable extrapulmonary infection sites include the
pleura, the central nervous system (meningitis), the
lymphatic system (scrofula of the neck), the
genitourinary system (urogenital tuberculosis), and the
bones and joints, among others. Sometimes, bursting
of a tubercular abscess through skin results in
tuberculous ulcer. A potentially more serious,
widespread form of TB is called "disseminated" TB,
commonly known as miliary tuberculosis.
9
11. CAUSES
• The main cause of TB is Mycobacterium
tuberculosis, a small, aerobic, nonmotile bacillus.
• It divides every 16 to 20 hours.
• Mycobacteria have an outer membrane lipid
bilayer. If a Gram stain is performed, MTB either
stains very weakly "Gram-positive" or does not
retain dye as a result of the high lipid and mycolic
acid content of its cell wall. MTB can withstand
weak disinfectants and survive in a dry state for
weeks. In nature, the bacterium can grow only
within the cells of a host organism, but MTB can
be cultured in the laboratory. 11
14. MECHANISM
• TRANSMISSION
• When people with active pulmonary TB cough, sneeze,
speak, sing, or spit, they expel infectious aerosol
droplets. Each one of these droplets may transmit the
disease, since the infectious dose of tuberculosis is
very small (the inhalation of fewer than 10 bacteria
cause infection).
• People with prolonged, frequent, or close contact with
people with TB are at particularly high risk of becoming
infected. A person with active but untreated
tuberculosis may infect other people. Transmission
occur from only people with active TB – those with
latent infection are not thought to be contagious.
14
15. • The probability of transmission from one person to
another depends upon several factors, including the
number of infectious droplets expelled by the carrier,
the effectiveness of ventilation, the duration of
exposure, the virulence of the MTB strain, the level of
immunity in the uninfected person etc. The person-to-
person spread can be circumvented by effectively
segregating those with active TB and putting them on
anti-TB drug regimens. After about two weeks of
effective treatment, subjects with nonresistant active
infections generally do not remain contagious to
others. For a newly infected person it typically takes
three to four weeks to become infectious enough to
transmit the disease to others.
15
17. PATHOGENESIS
• TB infection begins when the mycobacteria reach the
pulmonary alveoli, where they invade and replicate
within endosomes of alveolar macrophages.
Macrophages identify the bacterium as foreign and
attempt to eliminate it by phagocytosis. During this
process, the bacterium is enveloped by the
macrophage and stored temporarily in a membrane-
bound vesicle called a phagosome. The phagosome
then combines with a lysosome to create a
phagolysosome. In the phagolysosome, the cell
attempts to use reactive oxygen species and acid to kill
the bacterium. However, MTB has a thick, waxy
mycolic acid capsule that protects it from these toxic
substances. MTB is able to reproduce inside the
macrophage and will eventually kill the immune cell.
17
19. • The primary site of infection in the lungs, known as the
"Ghon focus", is generally located in either the upper
part of the lower lobe, or the lower part of the upper
lobe. Tuberculosis of the lungs may also occur via
infection from the blood stream. This is known as a
Simon focus and is typically found in the top of the
lung. This hematogenous transmission can also spread
infection to more distant sites, such as peripheral
lymph nodes, the kidneys, the brain, and the bones. All
parts of the body can be affected by the disease,
though for unknown reasons it rarely affects the heart,
skeletal muscles, pancreas, or thyroid.
19
20. • Tuberculosis is classified as one of the granulomatous
inflammatory diseases. Macrophages, T lymphocytes, B
lymphocytes, and fibroblasts aggregate to form
granulomas, with lymphocytes surrounding the infected
macrophages. When other macrophages attack the
infected macrophage, they fuse together to form a giant
multinucleated cell in the alveolar lumen. The granuloma
may prevent dissemination of the mycobacteria and
provide a local environment for interaction of cells of the
immune system. However, more recent evidence suggests
that the bacteria use the granulomas to avoid destruction
by the host's immune system. Macrophages and dendritic
cells in the granulomas are unable to present antigen to
lymphocytes; thus the immune response is suppressed.
Bacteria inside the granuloma can become dormant,
resulting in latent infection. Another feature of the
granulomas is the development of abnormal cell death in
the center of tubercles. To the naked eye, this has the
texture of soft, white cheese and is termed caseous
necrosis.
20
21. Tuberculosis with massive caseous necrosis, lung : Cut surface
shows multiple minute granulomas and a large area of confluent
granuloma with massive caseous necrosis (yellowish semiliquid
substances].
21
22. • If TB bacteria gain entry to the blood stream
from an area of damaged tissue, they can
spread throughout the body and set up many
foci of infection, all appearing as tiny, white
tubercles in the tissues. This severe form of TB
disease, most common in young children and
those with HIV, is called miliary tuberculosis.
• Treatment with appropriate antibiotics kills
bacteria and allows healing to take place.
22
23. DIAGNOSIS
• ACTIVE TUBERCULOSIS
• A diagnosis of TB should, however, be
considered in those with signs of lung disease
or constitutional symptoms lasting longer than
two weeks. A chest X-ray and multiple sputum
cultures for acid-fast bacilli are typically part
of the initial evaluation. Interferon-γ release
assays and tuberculin skin tests are of little
use in the developing world.
23
25. • A definitive diagnosis of TB is made by identifying
MTB in a clinical sample (e.g., sputum, pus, or a
tissue biopsy). However, the difficult culture
process for this slow-growing organism can take
two to six weeks for blood or sputum culture.
Thus, treatment is often begun before cultures
are confirmed.
• Nucleic acid amplification tests and adenosine
deaminase testing may allow rapid diagnosis of
TB. These tests, however, are not routinely
recommended, as they rarely alter how a person
is treated. Blood tests to detect antibodies are
not specific or sensitive, so they are not
recommended.
25
26. LATENT TUBERCULOSIS
• The Mantoux tuberculin skin test is often used to
screen people at high risk for TB. Those who have been
previously immunized may have a false-positive test
result.The test may be falsely negative in those with
sarcoidosis, Hodgkin's lymphoma, malnutrition, or
most notably, in those who truly do have active
tuberculosis.Interferon gamma release assays (IGRAs),
on a blood sample, are recommended in those who are
positive to the Mantoux test. These are not affected by
immunization or most environmental mycobacteria, so
they generate fewer false-positive results. IGRAs may
increase sensitivity when used in addition to the skin
test, but may be less sensitive than the skin test when
used alone.
26
27. • A diagnosis of latent tuberculosis (LTB), also
called latent tuberculosis infection (LTBI)
means a patient is infected with
Mycobacterium tuberculosis, but the patient
does not have active tuberculosis. Active
tuberculosis can be contagious while latent
tuberculosis is not, and it is therefore not
possible to get TB from someone with latent
tuberculosis.
27
29. TREATMENT OF TUBERCULOSIS
• ANTITUBERCULAR DRUGS:
• Antitubercular drugs are medicines used to
treat tuberculosis.
• Antituberculosis drugs are available only with
a physician's prescription and come in tablet,
capsule, liquid and injectable forms. Some
commonly used antituberculosis drugs are
cycloserine, ethambutol, ethionamide,
isoniazid, pyrazinamide, rifampicin.
29
31. ISONIAZID (INH)
• Acts only on mycobacteria
• Interferes with mycolic acid synthesis (unique
to mycobacterial cell wall)
• Passes freely to mammalian cell wall
• Effective for intracellular organism
• Bacteriostatic – to resting organism
31
32. PHARMACOKINETICS
• Well absorbed from GIT
• Fatty food and aluminum-containing antacids
may reduce absorption
• CSF penetration: 20% of plasma concentration
with non-inflamed meninges
• Penetrate well into caseous material
• Excretion – urine
METABOLISM
• By acetylation – genetically determined
• Slow acetylation – better response - t ½ - 3h
• Fast acetylation – t ½ - 1h
32
33. RIFAMPICIN
• Inhibits bacterial DNA-dependent RNA
polymerase
• Bactericidal
• Gram positive and negative
• kill intracellular organism
• Resistance – chemical modification of DNA-
dependent RNA polymerase
33
34. PHARMACOKINETICS
• Well absorbed from GIT
• CSF penetration: 10-40% of plasma
concentration with non-inflamed meninges
• Elimination hepatic, renal
ADVERSE EFFECTS
• Rashes, hepatotoxicity, thrombocytopenia
• Mild elevation of liver enzymes - common
34
35. • Orange discoloration of urine, sweat, tears
• Potent CYP-P450 inducer- reduce the serum
level of drugs warfarin, oestrogen
35
36. ETHAMBUTOL
• Inhibits arabinosyl transferases involved in cell
wall biosynthesis.
• Bacteriostatic to MTB.
• Resistance develops rapidly if used alone.
PHARMACOKINETICS
• Well absorbed from GIT
• Bioavailability 80%
• CSF penetration poor
• Elimination renal
36
38. DRUG RESISTANCE
• Multi drug resistance (MDR)
– Resistant to at least isoniazid & rifampicin
• Extensive drug resistance (XDR)
– MDR strains also resistant to any fluoroquinolone
& at least one injectable second-line drugs
(amikacin, capreomycin, kanamycin)
38
39. Primary drug resistance
• Those exposed to resistance organism
Secondary drug resistance
• After initial drug sensitivity
• Due to non compliance
39
41. DIRECTLY OBSERVED TREATMENT SHORT COURSE
CHEMOTHERAPY
(DOTS)
• DOTS was launched in 1997 and by 2006 had
covered the entire country and is the fastest
expanding health program in India.
• It involves providing most effective medicine
and confirming that it is taken- a health
worker ensures that the drug is taken by the
patient in his presence in the intensive case.
41
42. • In the continuation phase, the patient
swallows the first tablet and the tablets are
issued for the rest of the week.
42
43. REFERECES
• Padmaja Udaykumar. Medical Pharmacology,
fourth editin; unit-56; Pg no: 444-451.
• K D Tripathi. Essential of Medical
Pharmacology, sixth edition; section 12- 55
unit, Pg no: 739-750.
• Internet Source.
43