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
