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04/19/11
TB MANAGEMENT
Aims of treatment ,[object Object],[object Object],[object Object],[object Object],[object Object]
Treatment of TB ,[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object]
Patient Monitoring ,[object Object],[object Object],[object Object],[object Object],[object Object]
Category I Category II Category III New case Chronic case Relapse Sputum neg Treatment failure Treatment after interruption Refer to physician/chest Sputum positive, MO CAN treat
[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object]
Daily dosage Biweekly dosage mg/kg max mg/kg max Isoniazid H 5-8 300 15-20 1200 Rifampicin R 10-15 600 15-20 600 Streptomycin S 15-20 1000 15-20 1000 Ethambutol E 15-25 1200 50 2000 Pyrazinamide Z 20-40 1500 50 3000
 
2SHRZ/2EHRZ 4SHR 2  4HR 2 Continue Rx  Continue Rx Completion of 6 mo Rx Follow up Baseline Ix:FBC,LFT,RP,HIV,RBSSpt AFBs DS, AFB culture Spt AFB DS, spt culture if smear positive,CXR Spt AFB DS, CXR Spt AFB DS, CXR Spt AFB, CXR 1. 0 mo (0 w) 2. 2 mo (8w) 3. 2 mo (8w) 4. 2m (8w) 5. 6mo(24w)
04/19/11 STRATEGY OF TREATMENT
WHAT IS MULTI DRUG RESISTANT TB? MDR TB IS A SPECIFIC FORM OF DRUG RESISTANT TB DUE TO A BACILLUS RESISTANT TO ATLEAST ISONIAZID AND RIFAMPICIN, THE TWO MOST POWERFUL ANTI TB DRUGS.
 
MDR TB is a man made disease! The best treatment for MDR-TB is prevention by good management
Problems in MDR-TB management ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Contributing factor leading to MDR-TB Defaulters: leads to resistance so please ensure your patients do not default Doctor: inadequate dosage and drugs lead to resistance so please ensure the drug dosage is correct
NOTIFICATION!!!!!
[object Object],[object Object],[object Object],[object Object],[object Object]
 

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Cme tb 2

  • 3.
  • 4.
  • 5.
  • 6.
  • 7. Category I Category II Category III New case Chronic case Relapse Sputum neg Treatment failure Treatment after interruption Refer to physician/chest Sputum positive, MO CAN treat
  • 8.
  • 9.
  • 10.
  • 11. Daily dosage Biweekly dosage mg/kg max mg/kg max Isoniazid H 5-8 300 15-20 1200 Rifampicin R 10-15 600 15-20 600 Streptomycin S 15-20 1000 15-20 1000 Ethambutol E 15-25 1200 50 2000 Pyrazinamide Z 20-40 1500 50 3000
  • 12.  
  • 13. 2SHRZ/2EHRZ 4SHR 2 4HR 2 Continue Rx Continue Rx Completion of 6 mo Rx Follow up Baseline Ix:FBC,LFT,RP,HIV,RBSSpt AFBs DS, AFB culture Spt AFB DS, spt culture if smear positive,CXR Spt AFB DS, CXR Spt AFB DS, CXR Spt AFB, CXR 1. 0 mo (0 w) 2. 2 mo (8w) 3. 2 mo (8w) 4. 2m (8w) 5. 6mo(24w)
  • 14. 04/19/11 STRATEGY OF TREATMENT
  • 15. WHAT IS MULTI DRUG RESISTANT TB? MDR TB IS A SPECIFIC FORM OF DRUG RESISTANT TB DUE TO A BACILLUS RESISTANT TO ATLEAST ISONIAZID AND RIFAMPICIN, THE TWO MOST POWERFUL ANTI TB DRUGS.
  • 16.  
  • 17. MDR TB is a man made disease! The best treatment for MDR-TB is prevention by good management
  • 18.
  • 19. Contributing factor leading to MDR-TB Defaulters: leads to resistance so please ensure your patients do not default Doctor: inadequate dosage and drugs lead to resistance so please ensure the drug dosage is correct
  • 21.
  • 22.