ANTITUBERCULARS – INTRODUCTION
Antitubercular drugs are the antibiotics used in prevention and treatment of tuberculosis caused by the bacteria mycobacterium tuberculosis.
ANTITUBERCULARS – INDICATION
Antituberculosis drugs are medicines used to treat tuberculosis, an infectious disease that can affect the lungs and other organs.
ANTITUBERCULARS – INFORMATION
The common antitubercular drugs are Isoniazid, Rifampicin, ethambutol and Pyrizanamide. They are first line drugs used for treating tuberculosis.
In short course treatment of tuberculosis the Isoniazid, Rifampicin, pyrazinamide and ethambutol is given for 2 months followed by Isoniazid and Rifampicin alone for 4 months.
Isoniazid, pyrazinamide and rifampicin have hepatotoxic potential, and can lead to such reactions during antituberculosis chemotherapy. Most of the hepatotoxic reactions are dose-related; some are, however, caused by drug hypersensitivity. The immunogenetics of antituberculosis drug-induced hepatotoxicity, especially inclusive of acetylaor phenotype polymorphism, has been increasingly unravelled. Other principal clinical risk factors for hepatotoxicity are old age, malnutrition, alcoholism, HIV infection, as well as chronic hepatitis B and C infections. Drug-induced hepatic dysfunction usually occurs within the initial few weeks of the intensive phase of antituberculosis chemotherapy. Vigilant clinical (including patient education on symptoms of hepatitis) and biochemical monitoring are mandatory to improve the outcomes of patients with drug-induced hepatotoxicity during antituberculosis chemotherapy. Some fluoroquinolones like ofloxacin/levofloxacin may have a role in constituting non-hepatotoxic drug regimens for management of tuberculosis (TB) in the presence of hepatic dysfunction. Isoniazid administration is currently the standard therapy for latent TB infection. Rifamycins like rifampicin or rifapentine, alone or in combination with isoniazid, may also be considered as alternatives, pending accumulation of further clinical data. During treatment of latent TB infection, regular follow up is essential to ensure adherence to therapy and facilitate clinical monitoring for hepatic dysfunction. Monitoring of liver chemistry is also required for those patients at risk of drug-induced hepatotoxicity.
Adverse effects of antitubercular drugs
- Loss of appetite
- Joint pains
- Burning sensation in feet
- Skin rash
- Bitter taste
- Body pain
Some antituberculosis drugs also are used to treat or prevent other infections such as Mycobacterium avium complex (MAC), which causes disease throughout the bodies of people with AIDS or other diseases of the immune system.