TB drugs are more types, the effect of each drug on tubercle bacilli not the same, there are drugs that inhibit bacteria, can sterilize the drug, with effects on the tubercle bacilli when they are in cells, have effects on the tubercle bacilli both inside and outside the cell ...
Currently TB drugs is divided into 2 types: essential drugs and secondary drugs.
- 6 essential drugs is isoniazid, rifampicin, ethambutol, pyrazinamide, streptomycin and thiacetazon.
- 7 TB drugs is minor ethionamid, prothionamid, PAS, cycloserin, kanamycin and capreomycin.
The use of these drugs together, depending on how it is possible disease severity, initial treatment or has treated many times, new employees or employees relapse etc. ..
Generally tuberculosis treatment must coordinate at least 3 TB drugs.
Not to quit smoking while taking TB drugs!
a. Streptomycin
As Waksman antibiotic first isolated in 1944 from the fungus Actinomyces griseus, dungdiet work by inhibiting bacterial protein synthesis by tubercle bacilli. Drugs work best well with tubercle bacilli outside the cells (the progression to acute tuberculosis).
Streptomycin is not absorbed through the intestinal tract should be administered intramuscularly. After injection easily diffuse within the body's tissues. Streptomycin concentrations in water are low cerebrospinal meningitis Nung when higher drug concentrations. Because it can be used in the treatment of tuberculosis meningitis. It also crosses the placenta so it may affect the fetus. Drugs excreted almost entirely by the kidneys to elderly, impaired renal function when used to reduce the dose.
Streptomycin has two types of dihydrostreptomycin (now little used because many events) and sulfatstreptomycin.
Drug powder mixed with distilled water (preferably freshly prepared immediately before use) enough 5 ml for 1 g (if using distilled water at high concentrations will cause the injection hardware).
When the injection needle once to avoid the possibility of HIV / AIDS. Injections all once, not divided doses per day.
- Adults under 40 years of age: Under 50 kg: 0.75 g
Above 50 kg: 1 g
- From age 40-60: 0.75 g
- Over 60 years: 0.50 g
Children's daily dose of 10 mg / kg (less than 0.75 g)
When injected every other day dose of 20 mg / kg (less than 0.75 g).
b. Isoniazid
1912 are summarized in Prague (Czech Republic) and put in 40 years after treatment.
Drugs that kill bacteria by destroying crashing membrane of tubercle bacilli. No cross-resistance to other drugs.
Drugs are often administered orally. Some cases may be administered intravenously or by injection into the cerebrospinal country.
After injection or pill to reach high levels in all tissues of the body, in the cerebrospinal fluid of water, breast milk.
In the body of the drug in the liver acetyl acetyl isoniazid does not work with TB bacilli (an inactive form of the drug).
Rate translates into an inactive form but change according to peoples no significance in treating universal.
Those of drug metabolism as slow as complications of pruritus, rash, numbness in hands and feet due to peripheral neuritis.
The average dose of 5 mg kg-being for both children and adults, the maximum daily dose is 300 mg orally once fasting. Using intermittent dose (maintenance stage) 12-15 mg for both children and adults.
c. Rifampicin
As of macrocyclic antibiotic isolated from the fungus Streptomyces.
As strong bactericidal drugs, sterilization.
It inhibits the ability of synthetic nucleic acid bacillus tuberculosis, tubercle bacilli destroy the slow reproduction of bean residue, the tubercle bacillus "exists", "sleep", "lying" often relapse .
Rifampicin also works with Hansen bacilli and some Gram (+), Gram (-).
No phenomenon of cross-resistance with other TB drugs.
After drug was highly effective concentrations in all body tissues and cerebrospinal national average.
Daily Dose: From 50 kg or more is 600 mg.
Less than 50 kg is 450 mg
(Weakness elderly people lower dosage)
Children 10 mg / kg body condition
Dose intervals during the maintenance stage: as above.
When dosing, urine, possibly sweat, tears and red. Oral Medications (capsules, tablets, syrups) or intravenously. Body rifampicin combined with isoniazid tablets 300/150 mg or 150/100 mg.
Do not overdose rifampicin 12 mg / kg body weight when combined with isoniazid easy cause cholestatic jaundice.
d. Pyrazinamide
The drug is synthesized in 1950, for the treatment of tuberculosis in 1952.
1978 International Conference on Tuberculosis role of pyrazinamide in Belgium was featured.
As the only drug kills tubercle bacilli in acid environment, microbicides and sterilization sterilization of tubercle bacilli both in cells (macrophages ...) so desperately need in the short term and chemotherapy in TB meningitis.
Drugs as 500 mg tablets. The daily dose is 30 mg (25 - 35) mg / kg body weight for both adults and children. The maximum dose for adults is 2g/day.
Dosing interval is maintained between 50 mg (if used 3 times a week) and 70 mg (if used 2 times a week / kg body weight dose intervals up to 3.5 g / time or can sum of the following:
Adults: continuous daily dose: Below 50 kg: 1.5 g
Above 50 kg: 2.0 g
Dose interval (1 week 2 times):
Below 50 kg: 3.0 g
Above 50 kg: 3.5 g
(1 week 3 times):
Below 50 kg: 2.0 g
Above 50 kg: 2.5 g
e. Ethambutol
Synthesized in 1961. As bacteriostatic drugs. Mainly used for the prevention of drug resistance to the antimicrobial drugs (isoniazid, streptomycin and rifampicin). Often used in combination with medications to prevent drug resistance mutations.
Medicine as oral tablets (100 mg park, 200 mg, 400 mg ...) is kind of a combination with isoniazid in the park.
The daily dose for most children and adults in the first 2 months of 25 mg / kg body weight, then reduced to 15 mg / kg body weight. Dose 2 week time interval is 25 mg / kg, 3 times per week is 30 mg / kg.
Not recommended for children and people with renal impairment:
f. Thiacetazon (TB1)
As a bacteriostatic drug, is used more in Africa. Elsewhere, there are different opinions in use.
Often associated with drinking isoniazid tablets 300/150 mg or 100/50 mg isoniazid and thiacetazon.
Daily dose of 2.5 mg / kg body weight for both adults and children. The maximum dose is 150 mg daily. Do not use thiacetazon of intermittent therapy, not thiacetazon for the case of HIV / AIDS because it can cause more serious complications.
g. Ethionamid (Trecator)
Oral tablets, is used to treat tuberculosis since 1956.
Less than 50 kg for 750 mg day (250 mg morning and 500 mg at night just before going to bed to prevent nausea)
h. Prothionamid (Trevintix)
Oral tablets 125 mg, 250 mg. Used 1960 TB treatment. Dosage and Administration as for ethionamid.
i. Cycloserin
250 mg tablets. Used from tuberculosis in 1955. Oral dose of 250 mg 2 times / day increasing to 250 mg 3lan/ngay.
k. Viomycin
Injection, 1g vial. Used 1957 TB treatment.
l. Kanamycin
Injection, 1g vial. Used from 1957 to refugee workers.
m. Capreomycin
As a student audience of polypeptide. Produced in 1960. Injection, 1g vial.
n. P.A.S (para acid - amino acids - salicylic)
500 mg tablets. Drink 10-12 g split 2 times per day.
Note: When using the anti-TB drugs should be used as directed by a doctor and not voluntarily quit to avoid the risk of resistant TB thuoc.Neu you have questions about the treatment of TB drugs to the operator call health advisory 19008909 to receive the advice of experts.