Pharmacology notes

Apr 16th, 2015
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Wednesday, November 23, 2011TUBERCULOSIS TREATMENTActive TB will kill 2/3 people affected if its untreatedTreated TB has a mortality rate of <5%The standard "short" course Tx for TB is isoniazid, rifampicin, pyrazinamide and ethambutol for 2 months then isoniazid and rifampin alone for a further 4 monthsThe patient is considered cured at 6 months (although there is still a relapse rate of 2-3%)For latent TB, the standard Tx is 6-9 months of isoniazid alone.// After 2 weeks, sputum +ve (sterile/dead MTB), after 2 months, sputum -ve (96% are cured at this time)First line tuberculosis drugsThese drugs includeEthambutol (EMB/E)Isoniazid (INH/H)Pyrazinamide (PZA/Z)Rifampicin (RMP/ R)Streptomycin (STM/S)// In pleural effusion and Potts dse, its pointless to take sputum test!! There is closed and open pulmonary TB with the latter being smear +ve and the former being -ve.Second line tuberculosis drugsThere are six classes of 2nd line drugs (SLDs) used 4 Tx of TBA drug may be classified as 2nd line instead of 1st line for one or 2 possible reasonsIt may be less effective than the 1st line drugs (e.g p-aminosalicylic acid)It may have toxic side effects (e.g cycloserine)It may be unavailable in many developing countries (e.g fluoroquinolones)Second line drugs includeAminoglycosides e.g amikacin (AMK), kanamycin (KM)Polypeptides e.g capreomycin, viomycin, enviomycinFluoroquinolone e.g ciprofloxacin (CIP), levofloxacin, moxifloxacin (MXF)Thioamides e.g eth

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