Tuberculosis

Reportable, communicable, inflammatory disease that can occur in any part of the body; most frequent site - pulmonary.

Classification of TB:

1. Class 0: no exposure, no infection.
2. Class 1: exposure, no infection.
3. Class 2: infection; no disease (+PPD reaction but no clinical evidence of active TB)
4. Class 3: disease; clinically active.
5. Class 4: disease; not clinically active.
6. Class 5: suspected disease, diagnosis pending.

Pathophysiology:

Client Education Guide: PTB

1. TB is infectious; it may be cured or arrested by medications.
2. TB is transmitted by droplet infection.
3. Cover nose and mouth when coughing, sneezing, or laughing.
4. Wash hands after any contact with the body substances, masks or soiled tissues.
5. Wear mask when advised.
6. Take medications regularly, as prescribed.

Primary Anti-TB drugs
1. Isoniazid (INH)

• may be used at any age and among pregnant women.
• side effects: peripheral neuritis, hepatotoxicity.
• administer vitamin b6 (pyridoxine) to prevent peripheral neuritis.
• monitor ALT (SGPT), AST (SGOT)
• used as prophylaxis for 6 months to 1 year.

2. Streptomycin

• side effects: ototoxicity, nephrotoxicity

3. Rifampicin

• side effects: red orange color of body secretions, hepatotoxicity, nausea and vomiting, thrombocytopenia.

4. Ethambutol

• side effects: optic neuritis, skin rash
• opthalmologic examination at regular basis.
  

Note:

1. Evaluate effectiveness of anti-TB drugs by sputum culture for acid fast bacilli.
2. Anti-TB drugs must be taken in combination to avoid bacterial resistance.
3. Drugs must be taken on empty stomach for maximum absorption.