TUBERCULOSIS

Mohamed Amr 32297 Sherif Mohamed Hussein 32259 Ehab Ahmed Mohamed 29978

TB Transmission What is TB?

TB is a disease caused by infection with a bacteria called Mycobacterium tuberculosis which can invade various tissues and organs of the whole body. TB is spread through respiratory drops.

TB Infection and Disease

The lungs are the most common place for TB. This is known as pulmonary TB TB can infect the brain, kidneys, bones, and other areas.

TB Treatment
The response of TB to chemotherapy is slow and treatment must be administered for months to years. Usually, a drug-combination regimen is required ;otherwise microbial resistance develops rapidly.

Multidrug-resistant TB (MDR)
Multidrug-resistant TB is on the rise. MDR TB means that some TB bacteria have developed resistance, so that traditional antibiotics, like INH, no longer kill the bacteria. This is due to people not taking their medication properly; new strains of the bacteria evolve.

Treatment for Active TB

The CDC recommends that infections due to Mycobacterium tuberculosis be treated with several drugs in addition to INH: Rifampin, Streptomycin, and Pyrazinamide.

Anti-tuberculosis

Anti-tuberculosis drugs can be divided into two major categories: base on their efficacies and toxicities

First-line drugs: Isoniazid (INH), rifampin, pyrazinamide, ethambutol. Second-line drugs: streptomycin, paraaminosalicylic acid, kanamycin, amikacin, capreomycin, fluoroquinolone, ethionamide.

Isoniazid

the most widely used agent in the treatment and prophylaxis of TB

INH Mechanism of action: the

inhibition of synthesis of mycolic acid.

It is bactericidal and bacteriostatic. Given orally on empty stomach. Adverse effects: Allergic reaction, hepatotoxicity and Peripheral neuritis due to pyridoxine deficiency.

Rifampin

Broad spectrum antibiotics

Rifampin Mechanism of action: the inhibition

of synthesis of mRNA.

It is bactericidal. Rifampin is absorbed orally. Adverse effects: Induction of P450 hepatic microsomal enzyme and flu-like syndrome.

Pyrazinamide

It is a pyrazine analogue of nicotinamide

It is bactericidal and used in combination with INH and RFP. It is Quickly absorbed after orally administered. Adverse effects: Liver damage, urate retention may precipitate gouty attack.

Streptomycin

It is a the first antimicrobial drug used to treat TB.

It is bactericidal and used in combination with INH and RFP. replaced by kanamycin or amkiacin in case of bacterial resistance.

Other 2nd Anti-TB Drugs

Fluoroquinolone : Moxifloxacin and Levofloxacin for multidrug resistant TB. Macrolide : Azithromycin with HIV infected patient. Capreomycin : give parenterally and inhibit protein synthesis. Cycloserine : inhibition of cell wall synthesis.

Patient Education
Patient education is an essential component to prevent the spread of TB.
A surgical mask must be worn by a TB patient whenever they leave the isolation room.