It contains cause,symptoms &treatment.

1. 1

2. Contains:-
Introduction
Causative agent
Mode of transmission
Signs &symptoms
Chemotherapy of Tuberculosis
Prevention
Bibliography
2

3. Introduction:-
 Tuberculosis is a communicable disease.
 Tuberculosis is a specific infectious disease
primarily affected the lungs.
 It is a chronic disease.
 Tuberculosis is most acute in problem developing
countries such as India.
3

4. According to the side of infection tuberculosis
may be classified in to two groups:-
1. Pulmonary tuberculosis
2. External tuberculosis
1.Pulmonary tuberculosis:
Disease primarily affecting the lungs.
2.External tuberculosis:
It can affect intestine, meninges, bones, joint,
lymph gland, skin& other tissues of the body then is
called external tuberculosis .
4

5. Causative agent:-
 Tuberculosis is caused by Mycrobecterium
tuberculosis.
 It is a acid fast bacillus.
 Three types of tubercle bacilli are responsible for
the disease of man.
 These include-
-Human type
-Bovine type
-Atypical type or anonymous
mycrobactirium . 5

6. Mode of transmission:-
 Tuberculosis is mainly transmitted by
-droplet infection
-droplet nuclei
 Tubercle bacilli from a infected person are excreted
as droplet during coughing, sneezing or speaking.
 When inhaled the droplet may reach the respiratory
bronchiole &establish an infection.
 Tuberculosis is not spread by the formites used by
the patient . 6

7. Signs & symptoms:-
 A mild fever& malaise may develop after 4weeks of
inoculation.
 The ear lies symptoms may be-
-Fever(around 40 0c)
-General malaise
-Irritability
-Depression
-Excessive fatigue towers evening
-Profuse sweating during sleeping
-Weight loss is common& more rapid late in the cause
of disease. 7

8. Sign& symptoms:-
 Headache in the evening.
 Coughing is frequent &may often be confused with
smoker’s cough.
 Sputum is usually odourless, green or yellow in
colour.
 It may be stained with blood &usually occurs in the
morning or walking.
 In some cases,pulmonary tuberculosis onset may be
sudden with fever, productive cough or pleuritic pain.
 In cheldren,below 3 years of age massive
haematogenous dissemination is most likely occur. 8

9. Chemotherapy of Tuberculosis:
 Presently 17drugs are being used for the treatment .
 The drugs are divided under two groups as follows-
1.First line drugs.
2.Second line drugs.
1.First line drugs:-
Thy have a high efficacy &low toxicity.
Drugs are - a.Isoniazid(H)
b.Refampacin (R)
c.Pyrazinamide (Z)
d.Ethambutol (E)
e.Steptomycin (S)
9

10. 2.Second line drugs:
 They have a low efficacy, but high toxicity .
 Drugs are useful only in selective patients.
 Drugs are-
a.Thiacetazone
b.Kenamycin
c.Amicacin
d.Capreomycin
e.Ciprofloxacin
f.Ofloxacin
g.Azithromycin
h.Clarithromycin 10

11. Treatment of T B:
According to the duration of time in
infection treatment of T B divided in to four
category.
These are –
a.Category-I
b.Category-II
c.Category-III
d.Category-IV
11

12. Category-I
 Includes new untreated smear positive case or
 New smear negative or severe extra pulmonary T B.
 Initial phase:-Four drugs
H R Z+E or S
are given daily or thrice weekly for 2months.
-It can be extended for 1month in case smear has not
become negative.
 Continuation phase:-Two drugs-H R
are given daily/thrice weekly for 4months.
-In case of meningitis or spinal diseases it can be
extended for 6-7mpnths. 12

13. Categogy:II
 Smear positive, treatment failure, relapse or interrupted
treatment.
 Patient have resistant bacilli or increase risk of developing
drug resistant.
 Initial phase:-All 5first line drugs are given daily for
2months,followed by 4drugs-
H R Z E for next 4month.
-If at the end of 3rd month sputum is still positive the 4 drugs
are continued for another month.
 Continuation phase:-
 Three drugs-H R E are given for 5months either daily or
thrice weekly.
13

14. Category:-III
 New smear negative pulmonary T B
 Or severe extra pulmonary tuberculosis are
include.
Initial phase:-
 Three drugs H R E are given for two months.
Continuation phase:-
 Two drugs H R are given thrice weekly for four
months.
 Or, H E daily for six months. 14

15. Category: IV
 The patients have remained or smear positive
after completing category-II.
 These are multidrug resistant case.
 Treatment depend on drug use earlier & presence
of associate disease e.g.-diabetes, AIDS,
leukemia etc.
 H resistance case R E Z are given for 2years.
 H+R resistance case Z E+S/Etm+Cipro are use.
15

16. DOTS Chemotherapy:-
DOTS means Direct Observed Treatment
Short course Chemotherapy.
16

17. Prevention of tuberculosis:-
 Prevention of TB government adopted National
Tuberculosis Programme (NTP) & District
Tuberculosis Programme (DTP).
 Prevention is done by-
 BCG Vaccination
 Improving good social condition, including
Satisfactory housing & an adequate diet.
 Reduction of the human infection by-
 Detection &isolation of maximum number of case.
 Chemoprophylaxis. 17

18. Bibliography:-
 “Common Diseases-Manifestations & Pathophysiology”
in A Test book of Hospital & Clinical Pharmacy, by
Dr.P.C.Dandiya&Dr.Mukul Mathur, 4th edition (6th reprint)
2012,Page no.-149-150.
 “Anti tubercular drugs” in Pharmacology & Therapeutics
by R.S.Satoskar, Nirmala N.Rege &S.D.Bhandakar,12th
Edition 2011,Page no.-738-755.
 “Communicable Diseases” in Health Education &
community Pharmacy by P.C.Dandiya, Z.Y.K.Zafer &
Alifa Zafer, 6th edition 2011, Page no.-217-221. 18

19. 19