Drugs,and,Medicines,Used,Tuber health Drugs and Medicines to be Used in Tuberculosis
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Till about the first half of the century, the diagnostic verdict of tuberculosis was considered a death knell. It meant psychological depression, social isolation, and economic hardships for the family. The only treatment available was rest and a protein rich diet, and when possible, the patient was sent to a sanatorium for a change of environment. He would go to any comer of the country to consult the most qualified physicians, the crudest quacks, or priests with assumed healing powers, and was receptive to any available advice. Today, the prospects of a tuberculosis patient have changed entirely. It is no longer considered a dreaded disease but one which can be effectively controlled and cured by drugs. Tuberculosis, a tissue-destroying (necrotizing) infection, is caused by inhalation of the tubercle bacilli (mycobacterium tuberculosis). The lungs are most commonly affected, but it may spread to the kidneys, bowels, bones, lymph nodes, meninges, or any other part of the body. This infection may cause clinical disease either 1) shortly after inoculation*, sometimes called 'primary' tuberculosis; or 2) after months or decades of dormancy, which is erroneously referred to as 'reinfection' tuberculosis. Active tuberculosis is potentially fatal and may be transmitted to susceptible individuals. About one-third of the cases are discovered when the patient comes with a low grade fever; another one-third with unrelated complaints; and the remaining are those undergoing routine medical examination. In some cases of HIV infected persons, tuberculosis occurs in the rapidly progressive form. DiagnosisA tuberculosis patient may not be aware about his illness as the symptoms like fever, night sweating, cough, and headache appear slowly and are mild in nature. In the severe form, there may be breathlessness and palpitation on exertion, blood in the sputum (hemoptysis), pain in the chest or abdomen and weight loss. The diagnosis is made by a positive tuberculin skin test (Mantoux test), sputum examination for tubercle bacilli (acid fast bacilli), high ESR (blood test), and X-ray of the lungs which shows opacities or cavities (shadows) at the apex or elsewhere.Treatment The treatment of tuberculosis consists of preventive therapy and curative therapy.Preventive Therapy Preventive therapy of tuberculosis has two major goals: 1) to prevent infection in an individual with a negative tuberculin test but who has had intimate contact with an active case; 2) to an prevent active disease in an individual who is infected but does not have any symptoms (significant reaction to tuberculin test, but chest X-ray is negative). In children who come in contact with tuberculosis patients, tuberculin testing is essential. If the test is negative, BCG vaccination should be given. However, If the test is positive, a chest X-ray is essential. If this is abnormal, a diagnosis of primary tuberculosis is likely and conventional anti-tuberculosis treatment should be given. If the chest X-ray is normal, then chemoprophylaxis with isoniazid 5 to 10 mg/kg daily for 6 to 12 months is recommended. Patients receiving corticosteroids or immuno-suppressive treatment, or who develop diabetes or malignancy should be examined for an old 'inactive' tuberculosis lesion through an X-ray and sputum examination as it may become active in them. It may be wise to give a course of anti-tubercular drugs to make the patient 'safe' and avoid the disease from developing.Note: BCG vaccination has been used for several decades for conferring immunity against tuberculosis bacilli. However, controversy exists regarding its efficacy. In India, it has been shown to provide protection against tuberculosis only in about 30% patients. Article Tags: Chest X-ray
Drugs,and,Medicines,Used,Tuber