Timely detected pulmonary tuberculosis is cured in a period of time from 10 calendar months to 1.5 years. How long the treatment lasts depends on the severity of the disease process and on the appointment of the most appropriate individually selected drug.
Tuberculosis in our time is a curable disease
Combined treatment is in the prerogative of modern antibacterial therapy of tuberculosis. This is because when receiving different drugs at the same time, resistance of microbacteria to the drug develops much more slowly. The patient is prescribed 2 or 3 drugs at once for a course. Fortunately, the possibilities of medicine today are extensive. It can only be anti-tuberculosis drugs of the 1st line or their combined combination of the compositions of the 1st and 2nd lines.
Classification of anti-tuberculosis drugs is built according to the degree of their effectiveness. By the way, many thanks to our research institutes for the invention of such a drug as Isoniazid. This is one of the main anti-tuberculosis drugs, its advantage is veryhigh bacteriostatic activity. At the same time, its administration is especially effective in patients who fell ill for the first time.
Next on the list
The second most effective treatment after Isoniazid is Rifampicin. It's also a great and effective tool. The activity of subsequent drugs can be distributed in the following sequence: "Streptomycin", "Kanamycin", then "Pyrazinamide", "Ethionamide", followed by "Prothionamide", "Ethambutol", and 3 more: "Florimycin", "Pask", anti-tuberculosis drug "Thioacetazone".
All medicines that act on mycobacteria and help solve the clinical problems of patients have been divided into groups of anti-TB drugs:
- 1 line antibacterial essential TB drugs,
- 2nd line reserve drugs.
What is the difference between drugs of the 1st and 2nd rows
In the first row are the main drugs, claiming the highest rate of effectiveness of chemotherapeutic agents and their derivatives. Have minimal toxicity.
2nd line anti-tuberculosis drugs, which include reserve drugs, do not have such a high result in the fight against Koch's bacillus, while they are quite toxic. They are prescribed to patients in the event that their body is immune to drugs of the 1st line or there isintolerance to these medicines.
Sad statistics show that any drugs become addictive over time, that is, the effectiveness is significantly reduced. Also, the main anti-tuberculosis drugs become addictive after a certain time, and therefore mycobacteria become immune to them. For example, if only one specific drug is taken in isolation, then mycobacteria resistance to it is observed after 2-4 months.
Tuberculosis drugs: use and potency
The bulk of anti-tuberculosis drugs have a bacteriostatic effect on mycobacteria, that is, they reduce their virulence and suppress the ability to multiply. Similarly, "Isoniazid" and "Rifampicin" in concentrated doses have the ability to act bactericidal. To obtain a stable therapeutic effect, as well as to prevent and avoid possible relapses, taking anti-tuberculosis drugs should continue for a long time.
With all this, the choice and prescription of the best combination of drugs, as well as the period of their use, directly depend on the form of tuberculosis that is occurring in the patient at that time, on the means by which the previous treatment was carried out (if any), on the patient's tolerance certain medications, on how sensitive Mycobacterium tuberculosis is to selected drugs.
Better match
Combinationanti-tuberculosis drugs are planned based on the fact that the treatment program must necessarily include one or two first-line drugs. Of course, if they do not have any contraindications or resistance to them. In this case, the dose of all drugs taken, as a rule, does not decrease.
When prescribing (phthisiologist's memo), it must be taken into account that such an anti-tuberculosis drug as streptomycin and its derivatives cannot be combined with florimycin, kanamycin and other antibiotics that have nephrotoxic and ototoxic effects.
What kind of drug "PASK"
"PASK" is an anti-tuberculosis drug with a bacteriostatic effect. May the days of the learned pharmacologists who created it be long. Very active against tuberculosis mycobacteria. It is effective in the treatment of various forms and various localizations of tuberculosis. It gives an even better effect when other anti-tuberculosis drugs are combined with it.
The drug has the Latin name "PASK-AKRI". It is produced either in sachets of 4 g or in a jar of 100 g. One sachet of the drug "PASK" contains 3.2 sodium aminosalicylate, and one tablet contains 1 g of sodium para-aminosalicylate. The tablets are coated with a stomach-protecting coating and are on sale packaged in 50/100/500/1000 pcs. packed.
What is better to combine with
Anti-tuberculosis drug "PASK" in terms of tuberculostaticactivity is inferior to such drugs as isoniazid and streptomycin, therefore it should be prescribed simultaneously with more active agents. Combination therapy slows down the development of drug resistance and enhances the effect of concomitant drugs.
Pharmacokinetics of "PASK"
The drug has a high (90%) absorption. Metabolized in the liver. It is able to easily penetrate through histohematic barriers and be distributed in tissues. The highest concentration of the drug is observed in the lungs, kidneys and liver. More moderately, "PASK" (an anti-tuberculosis drug) penetrates into the cerebrospinal fluid. But in the case of inflammation of the membranes in the cerebrospinal fluid, the concentration of aminosalicylic acid is 10-50% of its concentration in the blood plasma. Most (80%) of the drug is excreted primarily in the urine.
Second line drugs
Antituberculous drugs of the 2nd line, when properly selected and timely prescribed, have an excellent therapeutic effect, expressed in detoxification of the body, plus also in a significant regression of inflammatory changes in the lung tissues, and even in the cure of bronchial tuberculosis.
According to medical studies, when treating children and adults with complicated, chronic and destructive forms of tuberculosis with various combinations of drugs of series II, given the presence in patients of clinical resistance and resistance of bacterial strains to drugs of the I series, in 65 percent of cases there was received, which is very pleasing, additionalclinical effect.
Tuberculosis drugs side effects
And, of course, those who take the drugs described in the article are interested in their possible side effects. Moreover, of the drugs introduced into practice in recent years, anti-tuberculosis drugs deserve special consideration. This is due to the fact that this disease will soon cross the epidemiological threshold, despite a significant decrease in the incidence rate after the Second World War. It is also important that the treatment of tuberculosis, as mentioned above, is a rather lengthy process, and the negative effect of drugs is precisely manifested either with an overdose of such, or with its long-term use.
Some statistics
With anti-tuberculosis therapy, according to the records of foreign and domestic representatives of medicine, the side effects of the respective drugs and the frequency of their occurrence are as different as the nature of the course of the disease. For example, out of 3148 patients treated with agents active against mycobacteria, adverse reactions were observed only in 12.2% of people, and in most of them these were manifestations of an allergic nature, and only 74 patients developed toxic poisoning.
Based on published materials, it can be concluded that the observed side effects of anti-TB drugs vary in the frequency of reactions. Their large fluctuations are explained by heterogeneous treatment conditions,when not only the drugs used are important, but also the form of tuberculosis, as well as the age of the patients, even the types of medical institutions (hospital, sanatorium, clinic, institute).
Research continues
Drugs that are detrimental to Koch's bacillus include a number of natural and semi-synthetic compounds that have one common property - their activity against, that is, Mycobacterium tuberculosis (M.tuberculosis). Anti-tuberculosis drugs, the classification of which, as mentioned at the beginning of the article, divides drugs into 2 rows (basic and reserve), are of great interest to scientists.
Special attention is paid to the development of resistance of tuberculosis mycobacteria. All studies are carried out in the laboratory, and on this issue, the results showed that in most patients, the degree of drug resistance during treatment can change both upward and downward, sometimes reaching almost complete restoration of sensitivity.
Reduce adverse reactions
When side effects occur during treatment, the first step is to reduce the dose of drugs or replace some drugs with others. In a severe case of an adverse reaction, the anti-tuberculosis drug is temporarily prohibited from taking, followed by replacement with another one. To prevent and eliminate the symptoms of coronary insufficiency, the patient is prescribed, depending on the indications, any of the drugs of a number of antispasmodics, for example:"Eufillin", "Papaverine", "Teofedrin", "Zelenin" drops, etc.
The characteristics and severity of side effects in anti-tuberculosis therapy are quite diverse. Anti-tuberculosis drugs, which have the same chemical classification of specific manifestations, are combined into one group to simplify the research work.
Tuberculosis Therapy
In the treatment of tuberculosis diseases in our time, prevention of the spread of infection is also considered an important task. The threat comes from patients with open pulmonary tuberculosis. Their intensive treatment will help reduce the number of infections, as well as prevent new cases of this unpleasant disease.
Because the treatment is long, the patient needs a lot of patience and self-discipline. After all, tuberculosis causes damage not only to the affected organ, but to the whole organism as a whole. It is very important to start antimicrobial therapy on time, in which the most powerful artillery is used, that is, the main anti-tuberculosis drugs. Thanks to them, it is possible to stop bacilli excretion at an early stage, which will contribute to the restoration of the affected organ with little or no damage to the whole organism.
Complex treatment, which will be prescribed taking into account the age and the identified form of the disease, includes the impact on pathological processes in the diseased organ, reducing the level of concomitant symptoms (pain, cough) using inhalations and various methodsphysiotherapy.
The prescribed group of medicines must be taken regularly, as an unsystematic approach can cause the development of resistance to them. Treatment must be carried out in a hospital under the supervision of a doctor. After discharge, observation by a phthisiatrician is mandatory.
A serious approach and the fulfillment of all medical prescriptions and appointments is the key to a full recovery. Tuberculosis is not a death sentence these days.
