DundeeChest 3.0

Posts Tagged ‘Ethambutol’

Amy, regular DC3.0 user asks:

Hi,
Do we need to know the side effects of the TB drugs…at this stage?
thanks!

It is important to know the drugs routinely used to treat TB, and their side effects.

Rifampicin – Causes orange colouration of tears, urine, and other secretions.
Isoniazid – Can cause a peripheral neuropathy. Co-prescription of pyridoxine reduces this risk.
Ethambutol – Can cause optic atrophy. All patients should have their colour vision checked prior to commencing ethambutol, and advised to seek medical attention if their colour vision begins to deteriorate.
Pyrazinamide – All the anti-TB drugs can cause gastrointestinal upset, but pyrazinamide is the most likely to give significant symptoms.

Rifampicin, Isoniazid and ethambutol can all affect liver function – we accept a 5 fold increase in ALT as being acceptable when on treatment; as long as the patient remains asymptomatic. For further side effects, refer to the BNF (www.bnf.org)

Remember that the standard regimen for proven MTB in Ninewells is Rifampicin, Isoniazid, Pyrazinamide and Ethambutol for 2 months, stepping down to Rifampicin and Isoniazid for a further 4 months if clinical and radiological improvement is seen at 2 month review.

Drug resistance is uncommon in the indigenous population of Scotland, however multi drug resistance is increasingly common in the immigrant population. We have seen only 1 case of extended spectrum drug resistant TB in Scotland thus far.

The commonest cause of treatment failure in Scotland is poor concordance with medication.