Side effects of anti-TB Drugs

Side effects of anti-TB Drugs

•         Most TB patients complete treatment with out any significant drug side effects

•         Clinical monitoring important during treatment. Laboratory monitoring not necessary.

•         Monitoring involves teaching patients how to recognize symptoms of common side effects and by health workers asking specifically about these symptoms during follow-up visits.

Side effects

Drug	Common side effects	Rare side effects
Isoniazid	·         Peripheral neuropathy ·         Hepatitis	Convulsion, pellagra, joint pains, skin reaction
Rifampicin	·         Anorexia, nausea, vomiting, abdominal pains ·         Hepatitis ·         Reduce effectiveness of contraceptive pills	Acute renal failure, shock, thrompocytopenia, skin rash, ‘flu syndrome,
Pyrazinamide	·         Joint pains ·         Hepatitis	Gastrointestinal symptoms, skin rash, sideroblastic anemia.
Streptomycin	·         Auditory and vestibular damage ·         Renal damage	Skin rash
Ethambutol	·         Optic neuritis	Skin rash, joint pains, peripheral neuropathy

Symptom based approach for the management of drug side effects  -  Minor symptoms

Side effects	Drug probably responsible	Management (cont. anti-TB drugs)
Anorexia, nausea, abdominal pain	rifampicin	Give tablets last thing in the night
Joint pains	pyrazinamide	aspirin
Burning sensation of the feet	isoniazid	Pyridoxine 100mg daily
Orange/red urine	rifampicin	reassurance

Major symptoms

Side effects	Drug probably responsible	Management (cont. anti-TB drugs)
deafness	streptomycin	Stop strep and substitute with ethambutol
dizziness	streptomycin	Stop strep and substitute with ethambutol
jaundice	Most anti-TB drugs	Stop all drugs until jaundice resolves
visual impairment	ethambutol	Stop ethambutol
Shock and purpura	rifampicin	Stop rifampicin
Vomiting and confusion (Pre-icteric Hepatitis)	Most anti-TB drugs	Stop anti-TB, urgent LFT

Reference :           http://independent.academia.edu