Conditions Affecting the treatment of tuberculosis

Conditions Affecting the treatment of tuberculosis

No matter what month of pregnancy Pregnancy diagnosis of tuberculosis treatment should start edilince. Etyonamid and injectable drugs (streptomycin, and kanamycin kapreomisin) fetüs'e can be toxic.

Kidney failure possible, nephrotoxic side effects in patients with kidney disease with streptomycin, kanamycin, kapreomisin, ethambutol, and cycloserine kullanümamaldır. Patient with drug-resistant bacilli or other toxic drugs, a situation that if you have written above, by controlling renal function may be nephrotoxic drugs.

SGOT and SGPT are reviewed prior to the treatment of liver disease. Much impressed by the selection of mild disorder drug. SGOT or SGPT increases 3-4 times hepatotkosik drugs (isoniazid, rifampin, pyrazinamide) are the side effects of treatment programs to be evaluated. The first 1-2 weeks of treatment and 3-4 weeks later SGOT, SGPT examined.

Tuberculosis morbidity and mortality is higher in patients with diabetes mellitus. There are some features with the cases of diabetes and tuberculosis. Therefore, all cases of chronic tuberculosis and diabetes cases investigated do not respond well to treatment, fasting blood sugar yetinmemeli being a normal, glucose tolerance test also assessed whether diabetes.
Tuberculosis - the normal daily calories is sugar patient, ie, diabetes, glycemic diet and oral antidiabetic drugs or insulin to be controlled. Blood sugar should be checked frequently during the treatment period. Tüberkolüz drug therapy is successful, many times the need for oral antidiabetic drugs and insulin is reduced. This observation is a good index showing that effective treatment of tuberculosis. If the tuberculosis drug therapy is not effective in controlling blood sugar can not be easy. Oral antidiabetic drugs and insulin must be increased. Sugar-tuberculosis patients, the start of treatment in the morning and afternoon blood sugar is checked twice a day or night, and if necessary, antidiabetic drugs, eg insulin twice a day are complying with these findings. Antituberculosis drugs in patients with diabetes-tuberculosis will continue for 12 months or longer if necessary.

Prenvantif drug therapy

Risk of TB than in those with isoniazid and rifampin used in conjunction with preventive purpose. In adults, a daily dose of isoniazid and rifampin 300 mg daily dose is 600 mg. These drugs are given one or two installments if necessary. Treatment duration is one year. Preventive drug therapy of primary tuberculosis meningitis, bone or kidney, such as extrapulmonary tuberculosis, 85% are effective in preventing complications yonlarını. Koch's bacillus in adults with the theme of preventive treatment with 80% effective.

Surgical Treatment

Tuberculosis infection is treated with drugs. Cases, surgical treatment is not responding to drug treatment. The main indications for surgical treatment:
1. 3-6 months after initiation of drug treatment, even Koch bacilli in sputum-positive cases have to be open and Intracavernous or kavernlerin. The first is used when isoniazid, rifampin, streptomycin, pyrazinamide and ethambutol-resistant bacilli, such as drugs, have 2 or more indications for surgery reinforces.
2. Sputum cultures remain positive despite the necessary medical treatment and lost the functional nature of a lung lobe or an entire regional bron-şektazi, causing changes in secondary atelectasis or obstructive inflammation of bronchial stenosis and caseous nodules require extensive surgery pathological finding the remains. Intracavernous absence does not preclude surgical intervention. Lesions of specific and non-specific treatment, improve, inter-mitan infections or recurrent or persistent bronchial and parenchymal he-moptizilere involves the surgical intervention, even when applied to negative bacilli.
3. Medical treatment of tuberculosis bronkoplöral fistula is not close.
4. Empyema unresponsive to medical treatment.
5. Open-healed (open-negative bacilli) Intracavernous. This topic is controversial. The standard treatment is fully implemented, the control is good and the possibilities of reactivation tuberculosis in the absence of disease or socio-eco-nomic conditions that require the best surgical intervention in cases not be left open Intracavernous-negative bacilli.
6. Diameter of nodular or cavitary lesions 1.5-3.0 part there has not been as definitive etiology, these lesions is surgical intervention.

Are two main types of surgical intervention in pulmonary tuberculosis:

1. Lobectomy and 2 Pneumonectomy

Recurrent pneumothorax, empyema did not respond to medical treatment in cases of pleural thickening and lung function affecting the intensive and extensive decortication (resection of parietal pleura) is applied.
A serious disease, respiratory failure, bilateral and diffuse lung disease, severe systemic disease, for example, serious kidney, liver, and surgical intervention in patients with blood disease kontredikedir. Generally, surgical intervention during pregnancy is not applicable. On tuberculosis drug therapy is necessary until the end. However, this treatment does not result in a desired surgical procedure can be applied.

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