chapter6 - Chapter 6 Treatment of Tuberculosis Disease Table of Contents Chapter Objectives 139 Introduction.

chapter6 - Chapter 6 Treatment of Tuberculosis Disease...

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Chapter 6: Treatment of Tuberculosis Disease 139 Table of Contents Chapter Objectives 139 Introduction 141 Treatment and Monitoring Plan 143 Adherence Strategies 143 TB Disease Treatment Regimens 151 TB Disease Treatment Regimens for Specific Situations 165 Patient Monitoring 176 Evaluating Response to Treatment 178 Chapter Summary 186 References 187 Chapter Objectives After working through this chapter, you should be able to Describe tuberculosis (TB) disease treatment adherence strategies; Identify anti-TB drugs; Describe treatment regimens for TB disease; Describe patient monitoring; and List common adverse drug reactions to TB medications. Chapter 6 Treatment of Tuberculosis Disease
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Chapter 6: Treatment of Tuberculosis Disease 141 Introduction The major goals of treatment for TB disease are to Cure the individual patient; Minimize risk of death and disability; and Reduce transmission of M. tuberculosis to other persons. To ensure that these goals are met, TB disease must be treated for at least 6 months and in some cases even longer. Most of the bacteria are killed during the first 8 weeks of treatment; however, there are persistent organisms that require longer treatment. If treatment is not continued for a long enough duration, the surviving bacteria may cause the patient to become ill and infectious again, potentially with drug-resistant disease. There are several options for daily and intermittent therapy, but the goal of treatment for TB disease should be to provide the safest and most effective therapy in the shortest period of time. Given adequate treatment, almost all patients will recover and be cured. Regimens for the treatment of TB disease must contain multiple drugs to which the bacteria are susceptible. The standard of care for initiating treatment of TB disease is four-drug therapy. Treatment with a single drug can lead to the development of a bacterial population resistant to that drug. Likewise, the addition of a single drug to a failing anti-TB regimen can lead to additional resistance. When two or more drugs to which in vitro susceptibility has been demonstrated are given together, each helps prevent the emergence of tubercle bacilli resistant to the others. The standard of care for initiating treatment of TB disease is four-drug therapy. Treatment with a single drug can lead to the development of a bacterial population resistant to that drug. Study Questions 6.1 The major goals for treatment of TB disease include which of the following? A. Curing the individual patient B. Minimizing risk of death and disability C. Reducing transmission of M. tuberculosis to other persons D. A, B, and C are all correct. E. Only A and B are correct.
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Chapter 6: Treatment of Tuberculosis Disease 142 Are the following statements about TB treatment true or false?
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