Drugs and Medicines to be Used in Tuberculosis

>headache appear slowly and are mild in nature. In the
There are about 8.8 million cases of tuberculosissevere form, there may be breathlessness and
worldwide, more than 40% of these cases are inpalpitation on exertion, blood in the sputum
South East Asia; India has 53.3% of South East Asian(hemoptysis), pain in the chest or abdomen and
burden. Globally, one person is infected with tubercleweight loss. The diagnosis is made by a positive
bacilli every second. Till about the first half of thetuberculin skin test (Mantoux test), sputum
century, the diagnostic verdict of tuberculosis wasexamination for tubercle bacilli (acid fast bacilli), high
considered a death knell. It meant psychologicalESR (blood test), and X-ray of the lungs which
depression, social isolation, and economic hardshipsshows opacities or cavities (shadows) at the apex or
for the family. The only treatment available was restelsewhere.Treatment The treatment of tuberculosis
and a protein rich diet, and when possible, the patientconsists of preventive therapy and curative
was sent to a sanatorium for a change oftherapy.Preventive Therapy Preventive therapy of
environment. He would go to any comer of thetuberculosis has two major goals: 1) to prevent
country to consult the most qualified physicians, theinfection in an individual with a negative tuberculin test
crudest quacks, or priests with assumed healingbut who has had intimate contact with an active
powers, and was receptive to any available advice.case; 2) to an prevent active disease in an individual
Today, the prospects of a tuberculosis patient havewho is infected but does not have any symptoms
changed entirely. It is no longer considered a dreaded(significant reaction to tuberculin test, but chest X-ray
disease but one which can be effectively controlledis negative). In children who come in contact with
and cured by drugs. Tuberculosis, a tissue-destroyingtuberculosis patients, tuberculin testing is essential. If
(necrotizing) infection, is caused by inhalation of thethe test is negative, BCG vaccination should be given.
tubercle bacilli (mycobacterium tuberculosis). The lungsHowever, If the test is positive, a chest X-ray is
are most commonly affected, but it may spread toessential. If this is abnormal, a diagnosis of primary
the kidneys, bowels, bones, lymph nodes, meninges,tuberculosis is likely and conventional anti-tuberculosis
or any other part of the body. This infection maytreatment should be given. If the chest X-ray is
cause clinical disease either 1) shortly afternormal, then chemoprophylaxis with isoniazid 5 to 10
inoculation*, sometimes called 'primary' tuberculosis; ormg/kg daily for 6 to 12 months is recommended.
2) after months or decades of dormancy, which isPatients receiving corticosteroids or
erroneously referred to as 'reinfection' tuberculosis.immuno-suppressive treatment, or who develop
Active tuberculosis is potentially fatal and may bediabetes or malignancy should be examined for an old
transmitted to susceptible individuals. About one-third'inactive' tuberculosis lesion through an X-ray and
of the cases are discovered when the patient comessputum examination as it may become active in
with a low grade fever; another one-third withthem. It may be wise to give a course of
unrelated complaints; and the remaining are thoseanti-tubercular drugs to make the patient 'safe' and
undergoing routine medical examination. In someavoid the disease from developing.Note: BCG
cases of HIV infected persons, tuberculosis occurs invaccination has been used for several decades for
the rapidly progressive form. DiagnosisA tuberculosisconferring immunity against tuberculosis bacilli.
patient may not be aware about his illness as theHowever, controversy exists regarding its efficacy.
symptoms like fever, night sweating, cough, and