RNTCP And DOTS

• To improve patient compliance and prevent emergence of Drug resistant tuberculosis and Multi-Drug Resistant Tuberculosis.
• The thrice weekly regimen is followed
• Intensive Phase: H _600mg+R _600mg+Z _2000mg+ E _1600mg + Pyridoxine _10mg For 2 Months
• Continuation Phase: H _600mg+R _600mg+ Pyridoxine _10mg For 4 Months

• Resistance to both Isoniazid and Rifampicin with or without resistance to other anti-tubercular agents.
• Treatment
  
• Specially designed or individualized regimen
• 5-6 drugs to which the patient has not been exposed to previously
• Daily and Directly observed for at least 24 months.

• Designed to treat MDR- TB using second line drugs.
• Recommended in areas where DOTS is well established.

• Same categorisation
• Only difference is that Rifabutin is preferred to Rifampicin

• Isoniazid,Rifampicin and Ethambutol are safe.

• Use of anti tubercular drugs to prevent active infection
• Isoniazid is the most ideal agent as it is orally effective , cheap and less toxic.
• Indications:
• Newborn of mother with active tuberculosis
• Chidren with positive tuberculin test
• Patients with positive tuberculin test with additional risk factors

• Relative contraindication
• Indications under cover of ATT
• To prevent pleural/peritoneal/pericardial fibrosis
• To treat hypersensitivity reactions to Anti-Tubercular Agents
• In the eye, larynx, genito urinary tracts to prevent scarring
• Prednisone is the preferred agent.

Category: Pharmacology Notes