TB side-effects

Question 1

What is the treatment regime for TB?

Answer 1

Give 4 (RIPE) for 2 months, and then 2 of them for 4 months (depending on Culture and Sensitivity)

• usually P and E stopped due to bigger side-effect profile) (RIP available as combinations Rifater)
• Pyrazinamide and Ethambutol (can bu substituted by Moxifloxacin) - 2 months
• Rifampicin and Isoniazid - 6 months (“Rifinan”)

Question 2

What are the main side-effects of Rifampacin?

Answer 2

1. Enyme inducer
2. Orange colouration of secretion

antibiotic that obstructs cell wall synthesis

Question 3

What are the main side-effects of Isoniazid?

Answer 3

Enzyme inhibitor

peripheral neuropathy

Therefore co-prescribed with: pyridoxine (B6) to prevent this

inhibition of mycolic acid synthesis (part of mycobacteria cell wall)

Question 4

What is the main side-effect of Pyrazinamide?

Answer 4

Gout
arthralgia
liver toxicity

antimicrobial drug

Question 5

What is the main side-effect of Ethambutol

Answer 5

Colour blindness (Ishihara test before starting)

antimycobacterial drug that inhibits arabinosyltransferase and thereby stops carbohydrate polymerization of the mycobacterial cell wall

Question 6

What test should be done before commencing TB treatments?

Answer 6

• HIV test
• Visual acuity testing
• Renal function
• Liver function