Side effects of Latent Tuberculosis Infection treatment
LTBI treatment is composed of 3 main drugs: Isoniazid (INH), Rifampin, and Pyrazinamide. Some providers may choose to combine two of types of drugs to meet patient’s specific needs such as adherence, baseline liver enzyme level, and existence of other illness/diseases (Horsburgh, 2009). The below table lists the recommended LTBI medications in order of preference, side effects, drug interactions, contraindications, and monitoring (click on image),
In certain situations a patient might be taken off a certain medication therapy and put on a different therapy due to adverse side effects. The following are examples of such situations.
Isoniazid (INH): Isoniazid should be stop immediately if s/sx of liver toxicity occurs (Lehne, 2007). Health care provider must be notified immediately and liver function panel tests requested. Furthermore, INH may not be resumed if the serum liver enzyme aspartate aminotransferase (AST) is 3 to 5 times above upper limit of normal (Lehne, 2007).
Pyrazinamide: Pyrazinamide should be stopped if significant liver injury occurs. Furthermore, Rifampin and Pyrazinamide used for short-term therapy has been found to cause high incidences of hospitalizations and deaths from liver injury (Lehne, 2007). Hence Rifampin and Pyrazinamide co-usage should never be used in patient with acute liver disease or a history of Isoniazid-induced liver injury.
The more I delve into Tuberculosis, the more I feel as if I am in a quagmire. Tuberculosis disease screening protocols and diagnostics is different from that of latent Tuberculosis infection (LTBI). One of my cohorts told me, "When you are talking about TB, you have to specified which one you are talking about. Are you talking about TB disease, LTBI, or TB infection?" He is darn right. Not only do I have to specified which one I am talking about, I have to differentiate among the existing 3 or 4 classes of TB. A work in TB business is definitely cut out for me. Please, tell me that the end of the tunnel is near!
References
Horsburgh, C.R., (2009). Treatment of latent tuberculosis infection in HIV-seronegative adults. In B. Rose (Ed.),UpToDate. Available from http://www.uptodateonline.com/
Lehne, R. A. (2007). Antimycobacterial Agents: Drugs for Tuberculosis, Leprosy, and Mycobacterium avium Complex Infection. In K. Geen & L. Borstell (Eds.), Pharmacology for nursing care (pp. 1014-1028). St. Louis, Mo: Saunders Elsevier.
Pai, M., & Menzies, R., (2009). Diagnosis of latent tuberculosis infection in adults. In B. Rose (Ed.),UpToDate. Available from http://www.uptodateonline.com
posted by Nui at
12:24 AM
2 Comments:
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Infection with HSV-1 can happen from general
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HSV-2 is contracted through forms of sexual
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sore, the AAD reports that most people get
HSV-1 from an
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not have
sores.
having multiple sex partners
being female
having another sexually transmitted infection
(STI)
having a weakened immune system
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