Question

Tuberculosis management and care

6. i) What are the medicines recommended for the management of Multiple or Extended Spectrum -Drug resistant TB,

ii) Mention of one side effect each

Answer 1

Multi-drug-resistant tuberculosis (MDR-TB) is a form oftuberculosis (TB) infection caused by bacteria that are resistant to treatment with at least two of the most powerful first-line anti-TBmedications (drugs), isoniazid and rifampin.Extensively drug resistant tuberculosis (XDR-TB) is a form of TB caused by bacteria that are resistant to several of the most effective anti-TB drugs. XDR-TB strains arose after the mismanagement of individuals with MDR-TB.Those patients identified with MDR-TBwill be switched to the standardregimen: — 8 months of pyrazinamide, kanamycin, ofloxacin, protionamide, and cycloserine, followed by 12 months of ofloxacin, protionamide, and cycloserine. The regimen contains fourdrugs rarely used in the area and is also relatively inexpensive.The principles of treatment for MDR-TB and for XDR-TB are the same. Treatment requires extensive chemotherapy for up to two years. Second-line drugs are more toxic than the standard anti-TB regimen and can cause a range of serious side-effects including hepatitis, depression, hallucinations, and ddeafness.PPatientsare often hospitalized for long periods in isolation.

There are so many side effects for these drugs which are as follows:

Streptomycin,Kanamycin,Amikacin-Hearing loss,renal toxicity.

Ethambutol-optic neuritis.

Ethionamide,Delamanid-nausea,vomiting

Pyrazinamide,fluroquinolones-liver toxicity, psychosis,seizures