H Mono Resistance Flashcards
Hmono/poly regimen
6 or 9 lfx rez
When do u extend
Extensive disease Uncontrolled comorbidity Eptb Smear at end of 4th month positive Or when regimen is modified
When do u call treatment failed
Positive at end of 5th month
Longer- 8th month
Shorter 6th month
Culture
Smear
3rd month - if positive one more sample
Month 6/9
Smear- from 3month monthly till end
Max till when u can extend
12 months in extensive diesease
Qtc classification
Mild-450-480
Moderate- 481- 500
Severe- >500 on two sepearte ecg
Life threatening- >500 plus life threatening consequences
Mangament of qtc prolongation
1- correct electrolytes , ecg
2- hold all , correct electrolyte., and restart
3- hold , ecg next day if <500 -reintroduce
4- stop offending drug
Reintroducing qtc prolonging drugs
Normal elec+ <470 on 2 days -bdq
If still normal , add fq
Cfz- ecg daily
Dlm- ecg daily for one week
Order of reintroduction in rash
H,z,eto , e, fq
Reintroduction in hepatitis
R
Z
Ast /alt every 3 days
Reintroduction in shorter and longer regimen
Shorter- bdq, h,z, eto
Longer- bdq, z ,eto, pas
Ast every 3 days before adding next
If <2 - continue all and monitor 2nd weekly
How do u manage myelosupression
Lzd
Stop
Start at 300
How do u manage Hypothyroid
Drugs causing
Eto , pas
Continue with supplements
Arthralgia
Drugs
Z, fq, bdq
Paracetamol/nsiads
Gout- allopurinol
Peripheral neuropathy
Common -lzd- dose reduction,tryptomer
Pyridoxine doesnt help in lzd
Decrease dose of cs, stop hh
