Management of Tuberculosis According to National Guidelines

Adverse Effects of Anti-Tuberculosis Medications and Management

Tuberculosis (TB) remains a significant global health concern, necessitating effective treatment strategies. National guidelines provide structured approaches to managing TB, including the use of first-line and second-line anti-TB medications. However, these medications can lead to various adverse effects, requiring careful monitoring and management.

Common Adverse Effects of Anti-Tuberculosis Medications

• Isoniazid (INH): Hepatotoxicity, peripheral neuropathy
• Rifampicin (RIF): Hepatotoxicity, gastrointestinal disturbances, red-orange discoloration of bodily fluids
• Pyrazinamide (PZA): Hepatotoxicity, hyperuricemia leading to gout
• Ethambutol (EMB): Optic neuritis, visual disturbances
• Streptomycin (SM): Ototoxicity, nephrotoxicity

Management of Adverse Effects

Hepatotoxicity

Regular liver function tests (LFTs) should be conducted. If hepatotoxicity occurs, discontinuation of the offending drug and substitution with non-hepatotoxic alternatives may be necessary.

Peripheral Neuropathy

Vitamin B6 (Pyridoxine) supplementation is recommended to prevent and manage neuropathy caused by Isoniazid.

Optic Neuritis

Patients on Ethambutol should undergo regular ophthalmologic evaluations. If visual disturbances occur, discontinuation of Ethambutol is advised.

Hyperuricemia and Gout

Pyrazinamide-induced hyperuricemia can be managed with uricosuric agents or NSAIDs.

Ototoxicity and Nephrotoxicity

Patients on Streptomycin should undergo audiometric and renal function assessments periodically. Dose adjustments or discontinuation may be required.

Conclusion

Effective TB management requires adherence to national guidelines while vigilantly monitoring and addressing adverse effects of anti-TB medications. Early detection and appropriate intervention can enhance treatment outcomes and patient safety.