Stuedy and evaluation of adverse effect on Anti-Tuberculosis drugs

Views:
 
Category: Education
     
 

Presentation Description

No description available.

Comments

Presentation Transcript

slide 1:

Sattanathan K et al / Int. J. of Allied Med. Sci. and Clin. Research Vol-51 2017 121-126 121 IJAMSCR |Volume 5 | Issue 1 | Jan - Mar - 2017 www.ijamscr.com Research article Medical research Stuedy and evaluation of adverse effect on Anti-Tuberculosis drugs Sattanathan K Venu.V Mathew George Pushpagiri College of Pharmacy Medicity Tiruvalla. Corresponding Author: Sattanathan K Email id: sattanathan.mkgmail.com ABSTRACT A bacterium called Mycobacterium Tuberculosis causes TB. There are a variety of TB strains and some are resistant to medication. Tuberculosis is usually preventable and curable under the right conditions. The study was conducted in Tiruvalla and conducts the patient counseling on tuberculosis patient. It concluded that the patient counseling was effective to controlled the adverse effect of Anti-TB drugs and improve the health. Keywords: Adverse effect Tuberculosis INTRODUCTION TB is an airborne disease caused by the bacterium Mycobacterium tuberculosis M. tuberculosis 1 M. tuberculosis and seven very closely related mycobacterial species M. bovis M. africanum M. microti M. caprae M. pinnipedii M. canetti and M. mungi together comprise what is known as the M. tuberculosis complex.Most but not all of these species have been found to cause disease in humans 2 3. M. tuberculosis organisms are also called tubercle bacilli. Infection occurs when a person inhales droplet nuclei containing tubercle bacilli that reach the alveoli of the lungs. 4 5 These tubercle bacilli are ingested by alveolar macrophages the majority of these bacilli are destroyed or inhibited. A small number may multiply intracellular and are released when the macrophages die. If alive these bacilli may spread by way of lymphatic channels or through the bloodstream to more distant tissues and organs including areas of the body in which TB disease is most likely to develop: regional lymph nodes apex of the lung kidneys brain and bone 6-8 This process of dissemination primes the immune system for a systemic response. Pulmonary TB disease most commonly affects the lungs this is referred to as pulmonary TB. Patients with pulmonary TB usually have a cough and an abnormal chest radiograph and may be infectious. 9-12 Although the majority of TB cases are pulmonary TB can occur in almost any anatomical site or as disseminated disease. Extrapulmonary TB disease occurs in places other than the lungs including the larynx the lymph nodes the pleura the brain the kidneys or the bones and joints. In HIV-infected persons extrapulmonary TB disease is often accompanied by pulmonary TB. Persons with extrapulmonary TB disease usually are not infectious unless they have pulmonary disease in addition to Drug-resistant TB disease can develop in two different ways called primary and secondary resistance. 8-10 Primary resistance occurs in persons who are initially infected with resistant organisms. Secondary resistance or acquired resistance develops during TB therapy either because the patient was treated with an inadequate regimen did not take the prescribed ISSN:2347-6567 International Journal of Allied Medical Sciences and Clinical Research IJAMSCR

slide 2:

Sattanathan K et al / Int. J. of Allied Med. Sci. and Clin. Research Vol-51 2017 121-126 122 regimen appropriately or because of other conditions such as drug malabsorption or drug-drug interactions that led to low serum levels 12-15 AIMOBJECTIVE  The aim of the study was to evaluate the adverse effects of anti-tuberculosis drugs during treatment.  Types of Tuberculosis and its distribution. Plan of work The entire work was carried out for a period of 6 months. The proposed study was designed in three different phases to achieve the objective. Phase 1 for Literature survey Phase 2 for patient selection patient interview and data collection and phase 3 for evaluation of data and report submission. Study Criteria It consists of Inclusion criteria: Both male and female TB patients who have age above 10 years old. And Exclusion criteria: Age below 10 years old and Multi drug resistant tuberculosis patients. METHODOLOGY The patients selected from Tertiary care hospital Tiruvalla. Data is collected from interview the patients those who identified tuberculosis in a Direct observed therapy of short course DOTs Centre.  Data such as demographic details disease classification occupation type of patients past history of tuberculosis category of treatment and weight of the patients.  Patients were interviewed and evaluate life style family history literacy status associated diseases awareness about disease and symptoms of the patients at the time of admission. Using a Questionnaire  Collect the adverse effects of anti-tubercular drugs during the treatment. Statistical analysis Difference between categorical variables were compared and analyzed by using the Fischer’s Exact test and Paired t test a two sided P value 0.05 was considered as statically significant. RESULTS Figure 1: Based on classification of tuberculosis n60 It shows that out of 60 tuberculosis cases 75 had pulmonary tuberculosis And 25 had extra pulmonary tuberculosis. 0 20 40 60 80 100 120 Pulmonary Tuberculosis Extra pulmonary Tuberculosis Total No.of Patients Classification of TB Number of patients Percentage of patients

slide 3:

Sattanathan K et al / Int. J. of Allied Med. Sci. and Clin. Research Vol-51 2017 121-126 123 Figure2: Age wise distribution of pulmonary tuberculosis By Gender.n45 Figure 2 shows that highest percentage of both male and female Pulmonary Tuberculosis patients were found between the age group of 10-20 years. Figure 3: Age wise distribution of extra pulmonary tuberculosis by Gender. n15 Itshows that highest percentage of both and male Extra Pulmonary Tuberculosis patients were found between the age group of 10-20 years. Figure 4: Symptoms of pulmonary and extra pulmonary tuberculosis PTB : Pulmonary Tuberculosis ETB :Extrapulmonary Tuberculosis 0 20 40 60 80 100 Oct-20 21-30 31-40 41-50 TOTAL No.of Patiens Distribution of pulmonary tuberculosis Number of patients Male Number of patients Female Percentage of patients Male Percentage of patients Female 0 20 40 60 Oct-20 21-30 31-40 Total No.of Patients Distribution of extra pulmonary tuberculosis Number of patients Male Number of patients Female Percentage of patients Male Percentage of patients Female 0 10 20 30 40 50 60 70 PTB and EPTB Cough Chest pain Night sweats Tiredness Anorexia Shortness of breath Haemoptysis Fever Pain Diarrhoea of Patients in EPTB No. of patients in EPTB of patients In PTB No. of patients in PTB

slide 4:

Sattanathan K et al / Int. J. of Allied Med. Sci. and Clin. Research Vol-51 2017 121-126 124 It shows that Cough Chest pain Night sweats Tiredness Anorexia Shortness of breath HaemoptysisFever were the majour symptoms of TB. Figure5: n60 Treatment category of pulmonary and extra pulmonary tuberculosis. It shows that most of the patients were treated with category I drugs in PTB 55.93 and EPTB 57.14. Figure 6: Adverse Effect of Anti Tuberculosis Drugs before and after patient counseling. It shows that the patient counselling was effective to controlled the adverse effect of drugs and improve the health by measuring the body weight. DISCUSSION In the total of 60 tuberculosis cases 75 had pulmonary tuberculosis and 25 had extra pulmonary tuberculosis. It indicates that significantly higher proportion of pulmonary tuberculosis. The clinical manifestations of TB are 0 10 20 30 40 50 60 70 80 Isoniazid Rifampicin Pyrazinamide Ethambutol Isoniazid Rifampicin Pyrazinamide Ethambutol Streptomycin Category I Category II Pulmonary TB No. of Pulmonary TB of patients Extra pulmonary TB No.of patients TB Extra pulmonary TB of patients 0 10 20 30 40 50 60 56.25 - 57.8 - 54.35 - 55.64 - 8 17.78 3 6.66 3 20 1 6.67 No: NO: NO: NO: EPTB Before counselling- PTB After counselling- PTB Before counselling_ After counselling- EPTB Effect of drugs before and after patient counselling Gastric upset Dizziness Color changes in urine Itching Chest pain

slide 5:

Sattanathan K et al / Int. J. of Allied Med. Sci. and Clin. Research Vol-51 2017 121-126 125 of two types: Pulmonary and Extra pulmonary forms of TB EPTB the former being the commonest. The problem of EPTB is still high both in developing and developed countries. In India EPTB forms 10 to 15 percent of all types of TB. 16 17 This study shows that highest percentage of both male and female Pulmonary Tuberculosis patients were found between the age group of 10- 20 years. The WHO estimated that over half a million children 0-14 years fell ill with TB and 80 000 HIV-negative children died from the disease in 2013 18 19. It shows that smokers and alcoholic were the higher risk of developing PTB and EPTB. There is a strong association between heavy alcohol use/alcohol use disorders AUD and TB. A meta- analysis on the risk of TB for these factors yielded a pooled relative risk of 2.94 95 CI: 1.89-4.59. Numerous studies show pathogenic impact of alcohol on the immune system causing susceptibility to TB among heavy drinkers. In addition there are potential social pathways linking AUD and TB. Heavy alcohol use strongly influences both the incidence and the outcome of the disease and was found to be linked to altered pharmacokinetics of medicines used in treatment of TB social marginalization and drift higher rate of re-infection higher rate of treatment defaults and development of drug-resistant forms of TB. Based on the available data about 10 of the TB cases globally were estimated to be attributable to alcohol. 19 20 It shows that Cough Chest pain Night sweats Tiredness Anorexia Shortness of breath Haemoptysis Fever were the major symptoms of TB. People infected with TB bacteria have a lifetime risk of falling ill with TB of 10. However persons with compromised immune systems such as people living with HIV malnutrition or diabetes or people who use tobacco have a much higher risk of falling ill. 21 When a person develops active TB disease the symptoms cough fever night sweats weight loss etc. may be mild for many months. This can lead to delays in seeking care and results in transmission of the bacteria to others. People ill with TB can infect up to 10-15 other people through close contact over the course of a year. Without proper treatment up to two thirds of people ill with TB will die 21 22 It shows that the patient counseling was effective to control the adverse effect of drugs. CONCLUSION The clinical manifestations of TB are of two types: Pulmonary and extra pulmonary forms of TB. Tuberculosis patients were more found between the age group of 10-20 years. It concluded that smokers and alcoholic were the higher risk of developing PTB and EPTB. The Cough Chest pain Night sweats Tiredness Anorexia Shortness of breath Hemoptysis and Fever were the major symptoms of TB. It concluded that the patient counseling was effective to control the adverse effect of Anti-TB drugs. For those who do not have proper knowledge on medication therapy there will be a possibility of reoccurrence of the disease. By conducting programs at various public places about Tuberculosis will create awareness about disease and can be helpful to prevent the onset of TB. REFERENCES 1. Rosye H. R. Tanjung and Yohanis Ngili Nucleotide Sequences and Mutations in Katg Gene in Clinical Isolates of Mycobacterium tuberculosis Isolates Resistant to Isoniazid in Papua-Indonesia International Journal of PharmTech Research. 95 2016 334-341 2. Pratap Chandran R.Antimycobacterial Activity of Glycyrrhiza Glabra Linn. Root Extract against Mycobacterium Smegmatis International Journal of PharmTech Research .73 2015 458-463. 3. R.K. Mali1 R.R. Somani M.P. Toraskar K.K. Mali P.P. Naik P. Y. Shirodkar Synthesis of some Antifungal and Anti-tubercular 1 2 4-Triazole Analogues International Journal of ChemTech Research 12 2009 168-173 4. World Health Organization "The sixteenth global report on tuberculosis"2011.

slide 6:

Sattanathan K et al / Int. J. of Allied Med. Sci. and Clin. Research Vol-51 2017 121-126 126 5. Richardo Ubyaan1 Agnes E. Maryuni Alvian Sroyer Epiphani . Y. Palit Jukwati Irwandi Y. Suaka and Yohanis Ngili. Molecular Analysis of Rifampin-Resistant Mycobacterium tuberculosis Strains Isolated from Papua International Journal of ChemTech Research. 44 2012 1803-1811. 6. Menzies D Al Jahdali H Al Otaibi B. Recent developments in treatment of latent tuberculosis infection. The Indian journal of medical research. 1333 2011 257–66. 7. Ghosh Thomas M. Habermann Amit K. Mayo Clinic internal medicine : concise textbook. Rochester MN: Mayo Clinic Scientific Press. 2008 789. 8. Jindal editor-in-chief SK Textbook of pulmonary and critical care medicine. New Delhi: Jaypee Brothers Medical Publishers. 2011 525. 9. Nareshvarma Seelam Synthesis characterization and in-vitro anti TB studies of Isoxazole analogues International Journal of PharmTech Research 89 2015 127-134. 10. Thulasi Krishna Haridas S.Thiruvengadam V.I.Bishor Development of a PCR Based Nucleic Acid Lateral Flow Assay Device for Detection of Mycobacterium Tuberculosis Complex International Journal of PharmTech Research 65 2014 1695-1702 11. Vikrant Arya A Review on Anti-Tubercular Plants International Journal of PharmTech Research. 32 2011 872-880. 12. World Health Organization. "Global tuberculosis control–surveillance planning financing WHO Report 2006". Retrieved 2006. 13. Shiny Georgeand P. Shanmugapandiyan Synthesis and Antitubercular Evaluation of 5-Chloro-2-5- Substituted Phenyl-1H-tetrazol-1-yl Pyridine International Journal of ChemTech Research 55 2013 2603-2608 14. Ahmed N Hasnain S. "Molecular epidemiology of tuberculosis in India: Moving forward with a systems biology approach". Tuberculosis 2011 407–3. 15. "Core Curriculum on Tuberculosis: What the Clinician Should Know". Centers for Disease Control and Prevention CDC Division of Tuberculosis Elimination. 5 2011 24. 16. Jindal Textbook of pulmonary and critical care medicine. New Delhi: Jaypee Brothers Medical Publishers. 2011 544. 17. Azger Dusthackee Gomathi Sekar Drug resistance among extrapulmonary TB patients: Six years’ experience from a supranational reference laboratory. Indian J Med Res 142 2015 568-574 18. Niobe-Eyangoh "Genetic Biodiversity of Mycobacterium tuberculosis Complex Strains from Patients with Pulmonary Tuberculosis in Cameroon". Journal of Clinical Microbiology 41 6 2003 2547–53. 19. "WHO Disease and injury country estimates". World Health Organization. 2004. Retrieved 2009. 20. Alimuddin Zumla M.D. Ph.D. Mario Raviglione M.D. Richard Hafner M.D. and C. Fordham von Reyn M.D. current concepts Tuberculosis The England Journal of Medicine 368 2013 745-55. 21. Treatment of Tuberculosis WHO Guidelines 2010. 22. Fielder J. F. C. P. Chaulk M. Dalvi "A High Tuberculosis Case-Fatality Rate in a Setting of Effective Tuberculosis Control: Implications for Acceptable Treatment Success Rates."International Journal of Tuberculosis and Lung Disease” 2002 1114-1117 How to cite this article: Sattanathan K Venu.V Mathew George. Stuedy and evaluation of adverse effect on Anti-Tuberculosis drugs. Int J of Allied Med Sci and Clin Res 2017 51: 121-126. Source of Support: Nil. Conflict of Interest: None declared.

authorStream Live Help