Tuberculosis

  

Tuberculosis

Definition: - Tuberculosis is chonic specific communicable granulomotus inflammatory lesion caused by Mycobacterium tuberculosis.

Tuberculosis may occur in any part of the body. But lungs is the most common site.

The other common sites are

1. leng (most)
2. skeleton
3. Skin
4. Genito urinary tract
5. Meninges

There are 4 types of micro bacteria which are responsible for tuberculosis. They are

1.   Micobacterium tuberculosis

2.   Micobacterium Bovis

3.   Micobactrrum Laprae

4.   Atypical mycobacteria

Causes/Responds for tuberculosis: Factor/Etiology

1.   All age groups but child below 3 years are highly susceptible

2.   Diabetics

3.   Malnutrition

4.   Poor sanitation, housing state poor nutrition

5.   Alcohol, tobacco, addiction

6.   H.I.V infection

7.   Genetic host resistance may be lowered by genetic factors

8.   Occupational risk factors

Clinical feature/sign-symptom of tuberculosis:

1.   Cough is an early symptom

2.   Anorexia

3.   Loss of weight and night sweating

4.   Weakness

5.   Headache

6.   Dyspnea

7.   Hemoptysis

Classification of anti-tuberculosis drugs.

A. First line drugs:

1.   Isoniazid (INH)

2.   Ethambutol

3.   Streptomycin

4.   Rifampicin (rifampin)

5.   Pyrazinamide

B. Second line drugs:

1.   Thiacetazone

2.   Ciprofloxacin

3.   Clycloserine

4.   Para amino salicylic acid (PAS)

5.   Ethienomide

6.   Clofazimine

Ideal properties of anti-tuberculosis drugs:

1.   Should be bactericidal (tuberculocida)

2.   Should be have greatest level of therapeutic efficacy

3.   Acceptable degree to have toxicity

4.   No rapid development of drugs resistance

Category of tuberculosis:

1.   Pulmonary tuberculosis

2.   Extra pulmonary tuberculosis

3.   Lymphadenitis, pleural ,gastrointestinal tuberculosis

4.   Bone and joint tuberculosis

5.   Tuberculosis meningitis

Objectives/Aims/Rational of combined uses of anti-tuberculosis drugs:

1.   To avoid emergence of resistant organisms (single drugs resistant develops slowly)

Rifampicin + Isoniazid (INH) = Rimactazid

2.   To obtain better therapeutic efficacy

3.   To broaden the spectrum of anti -mycobacterial

4.   To reduce the toxicity of drug.

Standard treatment regimens by WHO:-

Essential Anti-tuberculosis drugs	Recommended dose (mg/kg body weight) daily
Isoniazid	5
Rifampicin	10
Pyrazinamide	20
Streptomycin	15
Ethambutol	15