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Assessment
• Chronic cough (sometimes with yellow mucoid sputum), dyspnea, frank
hemoptysis, rales or crackles.
• Anorexia, malaise, weight loss, afternoon low-grade fever, pallor, pain,
fatigue, night sweats.
Diagnostic tests
• Chest x-ray- indicates presence and extent of disease
process but cannot differentiate active from inactive form.
• Skin test (PPD) positive; area of induration 10mm or more
in diameter after 48 hours.
• Sputum positive for Acid-Fast Bacillus(AFB)- three samples
in diagnostic for disease
• Culture positive- most definitive diagnosis is made
• WBC and ESR increased
Medications
Primary Anti-TB Drugs
• Isoniazid (INH) – May be used at any age and among pregnant women.
Side effects: peripheral neuritis, hepatotoxicity
Administer Vitamin B6 (pyridoxine) to prevent peripheral
neuritis
Monitor ALT (SGPT), AST (SGOT)
Used as prophylaxis for 6 months to 1 year
• Streptomycin
Side effects: ototoxicity, nephrotoxicity
• Rifampicin
Side effects: red orange color to body secretions, hepatotoxicity,
nausea and vomiting, thrombocytopenia
• Pyrazinamide
Side effects: increased uric acid in the blood (Hyperuricemia)
• Ethambutol
Side effects: optic neuritis, skin rash
Ophthalmologic examination at regular basis
NOTE: Evaluate effectiveness of anti- TB drugs by sputum culture for acid-
fast bacilli.
Anti- TB drugs must be taken in combination to avoid bacterial
resistance.
Drugs to be taken on empty stomach for maximum absorption.
PULMONARY
TUBERCULOSIS