Rationale for multi-drug therapy in tuberculosis If a single drug is given for the treatment of tuberculosis, there is increased chance of development of resistance to the drug. The incidence of resistant strain in an individual will be about 1 in 10^6 to 10^8.
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What is the role of combination therapy in the treatment of tuberculosis?
Combination therapy also appears to be more effective than single-drug therapy. Many drugs potentiate (or inhibit) the actions of other drugs; however, this is not the rationale for using multiple drugs to treat tuberculosis. Treatment with multiple drugs does not reduce adverse effects and may expose the client to more adverse effects.
Why is it important to finish treatment for tuberculosis (TB)?
It is very important that people who have TB disease are treated, finish the medicine, and take the drugs exactly as prescribed. If they stop taking the drugs too soon, they can become sick again; if they do not take the drugs correctly, the TB bacteria that are still alive may become resistant to those drugs.
What drugs are used to treat tuberculosis (TB)?
There are 10 drugs currently approved by the U.S. Food and Drug Administration (FDA) for treating TB. Of the approved drugs, the first-line anti-TB agents that form the core of treatment regimens are: isoniazid (INH) rifampin (RIF) ethambutol (EMB) pyrazinamide (PZA) TB Regimens for Drug-Susceptible TB.
What is multidrug-resistant tuberculosis and how do we control it?
What is multidrug-resistant tuberculosis and how do we control it? The bacteria that cause tuberculosis (TB) can develop resistance to the antimicrobial drugs used to cure the disease.
What is the rationale for multiple drugs used for the treatment of tuberculosis?
When two or more drugs to which in vitro susceptibility has been demonstrated are given together, each helps prevent the emergence of tubercle bacilli resistant to the others. The standard of care for initiating treatment of TB disease is four-drug therapy.
Which of these drugs is used to treat cases of tuberculosis?
The most common treatment for active TB is isoniazid INH in combination with three other drugs—rifampin, pyrazinamide and ethambutol. You may begin to feel better only a few weeks after starting to take the drugs but treating TB takes much longer than other bacterial infections.
What pharmacologic therapies and dosing strategies are available for the treatment of active pulmonary tuberculosis?
Dosing recommendations for capreomycin, streptomycin, kanamycin, and amikacin are the same. These agents are administered 5–7 days each week at a dose of 15 mg/kg/day (maximum 1 g/day) for the first 2–4 months of therapy in patients with normal renal function.
What method monitors the effectiveness of the treatment regimen for TB?
The use of sputum smear microscopy and culture rather than sputum smear microscopy alone is recommended for the monitoring of patients with multidrug-resistant TB (MDR-TB) during treatment (conditional recommendation/very low quality evidence) (2).
What is multidrug-resistant tuberculosis?
Multidrug-resistant TB (MDR TB) is caused by TB bacteria that are resistant to at least isoniazid and rifampin, the two most potent TB drugs. These drugs are used to treat all persons with TB disease. TB experts should be consulted in the treatment of MDR TB. Pre-Extensively Drug-resistant TB (pre-XDR TB)
Why is tuberculosis so drug-resistant?
Drug resistance in TB remains a man-made phenomenon. It emerges as a result of spontaneous gene mutations in M. tuberculosis that render the bacteria resistant to the most commonly used anti-TB drugs. Among the reasons for this, the non-compliance with the treatment regimens is signaled as the first cause.
Why is proper antibiotic therapy especially important for patients with tuberculosis?
A long treatment is required because antibiotics work only when the bacteria are actively dividing, and the bacteria that cause TB can rest without growing for long periods. This treatment is necessary to keep the latent TB infection from developing into active disease.
When is a patient diagnosed as having multi drug resistant MDR-TB?
FASTPlaque-Response is a phage amplification-based test, and has been developed for direct use on sputum specimens. Drug resistance is diagnosed when M tuberculosis is detected in samples that contain the drug (ie, RIF).
What are the nursing management of tuberculosis?
First-line agents for the treatment of tuberculosis are isoniazid (INH), rifampin (RIF), ethambutol (EMB), and pyrazinamide. Active TB. For most adults with active TB, the recommended dosing includes the administration of all four drugs daily for 2 months, followed by 4 months of INH and RIF. Latent TB.
For what purpose is tuberculosis treatment monitored?
All patients should be monitored to assess their response to therapy (Standard 10 of the ISTC (1)). Regular monitoring of patients also facilitates treatment completion and allows the identification and management of adverse drug reactions.
How do you know if MDR TB treatment is working?
Physical Signs That TB Treatment Is WorkingA reduction in symptoms, such as less coughing.Overall improvement in the way one feels.Weight gain.Increased appetite.Improvement in strength and stamina.
How can TB treatment adherence be improved?
Several interventions were found effective in improving medication adherence and outcomes of active TB patients, i.e. DOT by trained community members, SMS combined with TB education, a reinforced counselling method, monthly TB voucher, drug box reminder and a combination drug box reminder and text messaging.
What are the symptoms of tuberculosis?
1. Tuberculosis typically produces anorexia and weight loss. Other signs and symptoms may include fatigue, low-grade fever, and night sweats. Increased appetite is not a symptom of tuberculosis; dyspnea on exertion and change in mental status are not common symptoms of tuberculosis.
What is a DOT in a tuberculosis clinic?
Remind the client that tuberculosis can be fatal if it is not treated promptly. 1. Directly observed therapy (DOT) can be implemented with clients who are not compliant with drug therapy. In DOT, a responsible person, who may be a family member or a health care provider, observes the client taking the medication.
Can you give antihypertensives in combination therapy?
Combination therapy may allow some medications (e.g., antihypertensives) to be given in reduced dosages; however, reduced dosages are not prescribed for antibiotics and antituberculosis drugs. The client with tuberculosis is to be discharged home with community health nursing follow-up.
Can you double the dose of Tyramine?
The client should not double the dose of the drug because of potential toxicity. The client taking the drug should avoid foods that are rich in tyramine, such as cheese and dairy products, or he may develop hypertension. A client who has been diagnosed with tuberculosis has been placed on drug therapy.
Can you use multiple drugs for tuberculosis?
Many drugs potentiate (or inhibit) the actions of other drugs; however, this is not the rationale for using multiple drugs to treat tuberculosis. Treatment with multiple drugs does not reduce adverse effects and may expose the client to more adverse effects.
Is increased appetite a symptom of tuberculosis?
Increased appetite is not a symptom of tuberculosis; dyspnea on exertion and change in mental status are not common symptoms of tuberculosis. The nurse should teach clients that the most common route of transmitting tubercle bacilli from person to person is through contaminated: 1. Dust particles. 2.
How to teach a client that tuberculosis is fatal?
Remind the client that tuberculosis can be fatal if it is not treated promptly. 1. Ask the client's spouse to supervise the daily administration of the medications. Directly observed therapy (DOT) can be implemented with clients who are not compliant with drug therapy.
Why are elderly people at higher risk for tuberculosis?
Elderly persons are believed to be at higher risk for contracting tuberculosis because of decreased immunocompetence. Other high-risk populations in the United States and Canada include the urban poor, clients with acquired immunodefciency syndrome, and minority groups. 62.
How are tuberculosis bacilli spread?
Tubercle bacilli are spread by airborne droplet nuclei. Droplet nuclei are the residue of evaporated droplets containing the bacilli, which remain suspended and are circulated in the air. Dust particles and water do not spread tubercle bacilli. Tuberculosis is not spread by eating utensils, dishes, or other fomites.
Why should a client not double the dose of tyramine?
The client should not double the dose of the drug because of potential toxicity. The client taking the drug should avoid oods that are rich in tyramine, such as cheese and dairy products, or he may develop hypertension. 69. A client who has been diagnosed with tuberculosis has been placed on drug therapy.
How do you know if you have TB?
1. Weight loss. Tuberculosis typically produces anorexia and weight loss. Other signs and symptoms may include fatigue, low-grade fever, and night sweats. Increased appetite is not a symptom of tuberculosis; dyspnea on exertion and change in mental status are not common symptoms of tuberculosis.
What are the symptoms of TB?
Other signs and symptoms may include fatigue, low-grade fever, and night sweats. Increased appetite is not a symptom of tuberculosis; dyspnea on exertion and change in mental status are not common symptoms of tuberculosis. Click again to see term 👆. Tap again to see term 👆.
Can you use multiple drugs for tuberculosis?
Many drugs potentiate (or inhibit) the actions of other drugs; however, this is not the rationale for using multiple drugs to treat tuberculosis. Treatment with multiple drugs does not reduce adverse effects and may expose the client to more adverse effects.
How long does it take to treat TB?
TB disease can be treated by taking several drugs for 6 to 9 months. There are 10 drugs currently approved by the U.S. Food and Drug Administration (FDA) for treating TB. Of the approved drugs, the first-line anti-TB agents that form the core of treatment regimens are: isoniazid (INH) rifampin (RIF)
What is it called when TB bacteria multiply?
When TB bacteria become active (multiplying in the body) and the immune system can’t stop the bacteria from growing, this is called TB disease. TB disease will make a person sick. People with TB disease may spread the bacteria to people with whom they spend many hours.
What is XDR TB?
Extensively drug-resistant TB (XDR TB) is a rare type of MDR TB that is resistant to isoniazid and rifampin, plus any fluoroquinolone and at least one of three injectable second-line drugs (i.e., amikacin, kanamycin, or capreomycin). Treating and curing drug-resistant TB is complicated.
Can TB be treated?
It is very important that people who have TB disease are treated, finish the medicine, and take the drugs exactly as prescribed. If they stop taking the drugs too soon, they can become sick again; if they do not take the drugs correctly, the TB bacteria that are still alive may become resistant to those drugs.