Side effects of anti-TB Drugs

Side effects of anti-TB Drugs

•         Most TB patients complete treatment with out any significant drug side effects

•         Clinical monitoring important during treatment. Laboratory monitoring not necessary.

•         Monitoring involves teaching patients how to recognize symptoms of common side effects and by health workers asking specifically about these symptoms during follow-up visits.

Side effects

Drug	Common side effects	Rare side effects
Isoniazid	·         Peripheral neuropathy ·         Hepatitis	Convulsion, pellagra, joint pains, skin reaction
Rifampicin	·         Anorexia, nausea, vomiting, abdominal pains ·         Hepatitis ·         Reduce effectiveness of contraceptive pills	Acute renal failure, shock, thrompocytopenia, skin rash, ‘flu syndrome,
Pyrazinamide	·         Joint pains ·         Hepatitis	Gastrointestinal symptoms, skin rash, sideroblastic anemia.
Streptomycin	·         Auditory and vestibular damage ·         Renal damage	Skin rash
Ethambutol	·         Optic neuritis	Skin rash, joint pains, peripheral neuropathy

Symptom based approach for the management of drug side effects  -  Minor symptoms

Side effects	Drug probably responsible	Management (cont. anti-TB drugs)
Anorexia, nausea, abdominal pain	rifampicin	Give tablets last thing in the night
Joint pains	pyrazinamide	aspirin
Burning sensation of the feet	isoniazid	Pyridoxine 100mg daily
Orange/red urine	rifampicin	reassurance

Major symptoms

Side effects	Drug probably responsible	Management (cont. anti-TB drugs)
deafness	streptomycin	Stop strep and substitute with ethambutol
dizziness	streptomycin	Stop strep and substitute with ethambutol
jaundice	Most anti-TB drugs	Stop all drugs until jaundice resolves
visual impairment	ethambutol	Stop ethambutol
Shock and purpura	rifampicin	Stop rifampicin
Vomiting and confusion (Pre-icteric Hepatitis)	Most anti-TB drugs	Stop anti-TB, urgent LFT

Reference :           http://independent.academia.edu

Hepatitis more infectious than HIV

DC | Kaniza Garari | 28th Jul 2013

Hyderabad: Since four per cent of the Indian population is suffering from Hepatitis B or severe inflammation of the liver, gastroenterologists have been urging the Central government to make it a part of their vaccination programme, a demand that is repeatedly being made for the last 20 years.

On World Hepatitis Day, observed on July 28, experts reiterate that they have been predicting a huge problem with this disease. Almost 10 per cent Indians are carriers of Hepatitis B.

So, once in a lifetime, a person is likely to suffer from it. Out of 100 who are infected, 95 who develop it will get cured, but 5 will accelerate to a chronic level and allow it to spread. The complexity in tackling Hepatitis lies in the existence of different types of viruses.

While Hepatitis A and E are food-borne and water-borne, Hepatitis B and C spread via infected body fluids like blood, sexual contact, childbirth, contaminated medical equipment, piercing of the ear, body tattooing, acupuncture and dialysis units. Shaving and even bruises during hair cuts can facilitate  transmission.

Vaccination for Hepatitis B is available as it is found to be the most debilitating. Admittedly, vaccination can prevent it. If the virus is already transmitted, the vaccine will help fight it. The vaccine does not allow the disease to accelerate to a chronic level. This is the main reason why doctors want it to become a part of the government programme. There is currently no vaccine for Hepatitis C.

Earlier, the cost of the vaccine was a deterrent. It was imported,  but now with Indian companies manufacturing it,  doctors are at their wits’ end trying to figure out the reluctance of the government. The cost of the vaccine in the open market ranges from Rs 175 to Rs 476 per vaccine. Whenever health camps are organised, the vaccine is available in bulk for less than Rs 100.

Given this scenario, health experts feel that the government can buy the vaccine in bulk and then administer it to children. Recent studies have shown that in Hyderabad 70 per cent of the chronic liver ailment cases are Hepatitis B, while 30 per cent are of Hepatitis C.

Alcoholics are considered  a high-risk group along with middle-aged and senior citizens as they are exposed to dental treatments and surgical intervention, which can transmit Hepatitis B and C. Awareness about the disease is very low. Even those who have a sound knowledge of the ailment are, surprisingly,  unwilling to opt for vaccination.

Dr Nagarjuna Yarlagadda, senior gastroenterologist with KIMS hospital, explained, “The hepatitis B virus is highly infectious. About 50-100 times more infectious than HIV. If the virus is chronic, it may cause liver cirrhosis or liver cancer after 40 years. In some cases, as short a time as five years is enough for the disease to surface.”

Safe blood transfer needed

Health workers in government hospitals as well as private clinics should always employ safe methods for blood transfusion or while collecting blood from blood donors in view of the rising incidence of people contracting life threatening Hepatitis B and C viruses, experts have suggested.

People get infected with such deadly viruses owing to the blood donated by professional blood donors, experts said adding, blood donors contract the infection via transfusion injections and can then infect others. According to them, the prevalence of the Hepatitis B and C viruses among professional donors is as high as 14 per cent.

“In multiple blood transfusions, hepatitis virus was found to be prevalent among 28 per cent cases, as per random studies conducted in the country,” Dr Chandra Sekhar Reddy, a gastroenterologist at Yashoda Hospital said.

“The high prevalence of the hepatitis virus shows that there is a strong need to follow stricter methods while collecting blood and also during transfusion,” he said. According to him, apart from better technologies, a data-base of donors must be maintained so that professional donors can be tracked and the havoc they create can be prevented.

Source : http://www.deccanchronicle.com/130728, http://www.indianexpress.com/news