Anti-tuberculosis drugs: list of the best. What tablets and other dosage forms of drugs are prescribed for the treatment of pulmonary tuberculosis? New injection anti-tuberculosis drugs

Tuberculosis belongs to the group of infectious diseases. The causative agent is a species of mycobacterium with high viability. They do not manifest themselves for a long time, becoming more active under favorable conditions. According to statistics, a third of the world's population is a carrier of the Koch bacillus. A universal cure for tuberculosis has not been invented, and the problem of epidemics in a number of countries remains unresolved. However, existing drugs for the treatment of tuberculosis help reduce the incidence rate.

Infection occurs as a result of a sharp decrease in immunity. The development of the disease is provoked by poor living conditions, poor nutrition, and chronic pathologies. More often, mycobacteria affect the respiratory system. But they also apply to the digestive, skeletal and other systems of the body. Depending on this, appropriate drug treatment for tuberculosis is prescribed.

What are anti-tuberculosis drugs

The effectiveness of recovery is determined by a set of measures. First of all, it includes drugs for tuberculosis. These chemotherapy drugs are used to both treat and prevent the disease. Tuberculosis drugs are divided based on their clinical effectiveness into groups:

1. The main means of high activity are against mycobacteria with low toxicity.
2. Reserve drugs are drugs for tuberculosis, for multidrug-resistant types of the disease.

Anti-tuberculosis drugs prevent the growth and reproduction of bacteria. At a certain concentration, some destroy the pathogen. Medicines for pulmonary tuberculosis are selected taking into account the form of the disease and the resistance of mycobacteria to a particular drug.

Photo 1. Mycobacterium tuberculosis has an oblong shape, which is why they are also called the tuberculosis bacillus.

Types of drugs for tuberculosis

The treatment regimen includes drugs belonging to one of the groups. International classification belongs to the first group effective drugs against tuberculosis. They are prescribed to prevent relapse, for prophylaxis. Their use began in 1952.

Isoniazid

The mechanism of action is based on the fact that the drug blocks the synthesis of mycolic acid, preventing the spread of infection. Active against intracellular and extracellular bacteria. It is considered an effective medicine against tuberculosis. Helps cope with the disease at any age, used for treatment and prevention. The drug is contraindicated in patients with epilepsy, atherosclerosis, and poliomyelitis.

A popular medicine against tuberculosis, it exhibits high activity in the affected area. After administration, the active substance is rapidly absorbed. It concentrates in sputum, kidneys, liver, and lungs. The risk of passage into breast milk does not allow the use of the drug during lactation. Rifampicin should not be used if the patient has a diseased liver.

Photo 2. Rifampicin - antibacterial agent wide spectrum of action used in anti-tuberculosis therapy.

Pyrazinamide

The bactericidal effect of this drug for the treatment of pulmonary tuberculosis is less pronounced. However, it has a sterilizing effect, manifesting itself at the site of infection. Affects slowly reproducing bacteria depending on their resistance. Prescribed for any form of disease. Prohibited for liver failure.

An effective medicine for the treatment of tuberculosis with a bacteriostatic effect. The active substance ethambutol hydrochloride is absorbed gastrointestinal tract and is excreted through the kidneys. The treatment course lasts 9 months and consists of several stages. The initial dosage is 15 mg per kilogram of patient weight. Take Ethambutol once a day. Gradually the dose is increased to 30 mg per kilogram of weight. Patients with renal failure the medicine is prescribed depending on the creatinine clearance. Contraindications for use are gout, diabetic retinopathy, and pregnancy. Taking Ethambutol can lead to decreased vision; it is not recommended for use for cataracts and inflammatory processes in the eyes.

Photo 3. Ethambutol is used in the treatment of tuberculosis because it has a strong bacteriostatic effect on the causative agent of the disease.

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Streptomycin

Broad spectrum antibiotic. It is prescribed by a doctor taking into account the characteristics of the course of the disease. The duration of the therapeutic course is determined individually. The maximum daily dosage of medication for the treatment of pulmonary tuberculosis is 4 grams. Contraindications for use: renal failure, cardiovascular diseases, myasthenia gravis, brain disorders. Pregnant and lactating women with tuberculosis are prohibited from taking Streptomycin.

The range of drugs for tuberculosis included in the second, reserve, group is wider. They are prescribed when it is impossible to use medicines from the first group and when previous therapy did not give positive result.

Photo 4. Streptomycin, a broad-spectrum antibiotic, is used to treat tuberculosis diseases in the form of injections.

Cycloserine

Used for more than half a century. Today, the product is obtained synthetically. The drug has a bactericidal and bacteriostatic effect. It has high absorption, which allows it to quickly reach maximum concentration in body fluids and tissues. Able to pass into breast milk. For this reason, it is contraindicated during breastfeeding and pregnancy. Prohibited for children. Taking medication for tuberculosis in adults causes headaches, drowsiness, and irritability. For mild forms of tuberculosis, the drug is prescribed at any stage of the disease.

Photo 5. Antibacterial agent Cycloserine inhibits the growth of tuberculosis pathogens that are resistant to other drugs.

Kanamycin

A popular drug with high activity against bacteria various types. Scheme of use for tuberculosis: for adults - 1 g per day once for six days, for children - 15 mg per day. On the seventh day there is a break. The duration of the course and its duration is determined by the doctor. Kanamycin is not prescribed in combination with antibiotics with nephrotoxic and ototoxic effects. The drug is contraindicated for people with hearing problems, diseases of the digestive system and pregnant women.

Photo 6. Kanamycin solution is used to treat tuberculosis with drug-resistant pathogens.

Metazide

Derivative of isonicotinic acid hydrazide. The mechanism of action of this drug is the ability to damage the membrane of pathogenic bacteria, causing their death. The daily dose is 2 g of the drug for adults and 1 g for children. It is divided into 2-3 doses. The medicine is used for any form of tuberculosis. It is prohibited for patients who have central nervous system diseases, renal failure, or heart disease. During treatment for tuberculosis, check the condition of the fundus of the eye.

Photo 7. Metazide has a bactericidal effect against actively reproducing mycobacterium tuberculosis.

Ethionamide, Prothionamide

The structure of these drugs is largely similar. Providing a bacteriostatic effect in the affected area, they inhibit the proliferation of tuberculous mycobacteria. The drugs are used in the treatment of patients over 14 years of age. The ability of drugs to pass into breast milk has not been established. To prevent the occurrence of undesirable consequences, the drugs are not used during lactation.

Photo 8. Prothionamide is available in tablet form and is used in conjunction with other anti-tuberculosis drugs.

Thioacetazone

A synthetic antibiotic effective against tuberculosis. Take it exclusively after meals, with plenty of water. During treatment, it is important to monitor kidney activity. If agranulocytosis is detected, stop taking the drug. Thiocetasone should not be used to treat tuberculous meningitis.

The table shows the dosages of anti-tuberculosis drugs depending on the age category of the patient and the chosen tuberculosis strategy.

Features of the use of drugs for tuberculosis

An integrated approach will ensure complete recovery. Drug treatment tuberculosis is accompanied by measures aimed at strengthening the immune system. The therapeutic complex implies that many effective drugs for tuberculosis will be used. The drugs have certain actions, which help to more effectively cope with the disease. Taking medications for tuberculosis cannot be interrupted in order to avoid the development of pathogen resistance to the drug. A full course of treatment is carried out, during which it is important to adhere to the medication regimen.

Photo 9. When treating tuberculosis, it is important to strictly adhere to the regimen of taking anti-tuberculosis drugs.

Side effects of tuberculosis drugs

Drugs for the treatment of pulmonary tuberculosis are toxic. Most of them cause various side effects. These can be both toxic complications and an allergic reaction. In the first case, the duration of treatment, dosage, and individual characteristics of the body matter. After taking the medicine, there is a deterioration in the patient’s condition, disruption of work internal organs. Allergic manifestations are more often observed after taking antibacterial agents. Expressed as rashes on skin, itching, rhinitis, Quincke's edema. Has a particular danger anaphylactic shock, which can be fatal. Allergic reaction occurs in response to an antigen drug and metabolic products. Uncontrolled use of anti-tuberculosis drugs can undermine human health.

Photo 10. Skin itching may be a symptom of an allergy to the anti-tuberculosis drug the patient is taking.

It is possible to avoid negative consequences from taking medications. Treatment is carried out under the supervision of a doctor who conducts anamnesis and a complete examination, taking into account laboratory tests, fluorography. They are made by any clinic or tuberculosis hospital. After this, it is determined which medications to treat tuberculosis in a particular case. A treatment regimen is developed based on the clinical course of the disease. The drugs are prescribed in small doses, which are increased over time. Minimize side effects chemical medications Any folk remedy for tuberculosis will help. When choosing it, consultation with a phthisiatrician is required.

Tuberculosis is one of the infectious diseases caused by a certain type of mycobacterium, which is also called Koch's bacillus. The disease is severe, contagious and very dangerous. In some cases it ends in death.

The open form of the disease is treated in a closed hospital. Treatment takes long time, upon completion, the patient is under intensive supervision of a phthisiatrician.

Mycobacterium tuberculosis can affect a variety of organs, as a result of which, for example, tuberculosis of the kidneys, skin, etc. is diagnosed. for treatment of this disease A wide range of medications are used.

Classification of drugs

All anti-tuberculosis drugs have one main feature in common - the activity of their constituent components, aimed at suppressing Mycobacterium tuberculosis. They are divided according to the principle of effectiveness and tolerability by their patients and according to the form of release.

Based on statistical clinical picture, tableted drugs for the treatment of tuberculosis are usually divided into two series:

It should be noted that for tuberculosis, take a medicine of the same name, even if it belongs to the most effective means First line is a fundamentally incorrect approach to treatment.

It leads to the formation of multidrug-resistant tuberculosis, which is much more difficult to treat and sometimes even completely useless. That is why a good phthisiatrician, when drawing up a treatment plan, uses combinations of medications, assessing the form and degree of the disease, as well as the patient’s condition and many other secondary factors.

It is important to strictly follow the treatment plan chosen by the doctor if it does not take place in a hospital and depends on the will and responsibility of the patient himself. The same can be said about various forms ah self-medication using " folk remedies" And " grandma's recipes" Any adjustment to the chosen treatment plan must be agreed with your doctor.

The common opinion “I don’t risk anything” in this case is not only wrong, but also dangerous. The risk lies precisely in the likelihood of acquiring multidrug-resistant tuberculosis. Therefore, it is very important to carry out complete, correct, and most effective treatment during primary infection.

Effect of drugs

The most well-known and frequently used anti-tuberculosis drugs differ in composition and nature of action. It is worth considering some of them in more detail from an efficiency point of view. Tablets for tuberculosis belonging to the first row can be represented by the following list:

It is necessary to understand that anti-tuberculosis drugs are potent and have a negative effect not only on the site of the disease in general and on Mycobacterium tuberculosis in particular, but also on other organs. The liver and kidneys are especially affected by their effects. Therefore, these tablets are prescribed to patients with diseases of these organs with extreme caution and taking into account the risk ratio.

Combination drugs

The need to combine several drugs in the treatment of tuberculosis in order to prevent the effect of resistance has led to the creation of combination drugs. They initially contain several initial components in different proportions. This avoids the development of Mycobacterium tuberculosis resistance and reduces the number of tablets consumed daily.

It should be noted that the volume of the daily dose of each drug included in the composition combination remedy, does not change. In other words, a combination drug is the sum of daily doses of various drugs.

There are two-, three- and four-component combination drugs. For example, Rifanag is a two-component drug consisting of Rifampicin and Isoniazid, and Mairin-P includes Rifampicin, Isoniazid, Ethambutol and Pyrazinamide.

Among the combination drugs are:

• Mairin;
• Mairin-P;
• Rifater;
• Rifanag;
• Phthisopyram;
• Phthisoetam.

However, combination drugs are not able to neutralize the negative side effects of their constituent components. Therefore, it should be remembered that throughout treatment with the use of these drugs, it is necessary to monitor the condition of the body, monitor changes in the kidneys and liver, as well as other organs that are at risk.

Considering that the treatment of tuberculosis is very long, lasting many months, and sometimes even years in total, the negative impact of such strong drugs as anti-tuberculosis drugs is quite strong. However, the risk to organs from their exposure is still lower than the risk from the devastating effects of a disease such as tuberculosis. Therefore, these drugs have been prescribed, are prescribed and will be prescribed, at least until any alternative means with less pronounced negative actions.

Few people know which anti-TB pills are the most effective. Tuberculosis is an infectious disease, where the causative agent is Koch's bacillus, which is transmitted by airborne droplets upon contact with a patient. Most often the disease affects the lungs, but there are cases of tuberculosis of the joints, genitourinary system, bones and other organs of the body. Symptoms are not immediately recognized, which compounds the problem of treatment until late stage diseases. The active form may not appear for a long time due to strong immunity, which can contain the disease for a long time without visible signs.

Since the disease is difficult to trace in its initial form immediately after infection from a tuberculosis carrier, the disease may not manifest itself at all for a long time. The following changes in the human body may be an alarming factor:

1. Uncontrollable weight loss for no reason.
2. Fever.
3. Frequent cough, discharge of blood fragments in the sputum.
4. Unreasonable overwork.
5. Increased sweating, especially during sleep.
6. Headaches, drowsiness.

Once in the body, the infection is not always able to activate its destructive actions. The reason for this is strong immunity, which neutralizes the pathogen, neutralizing it.

There are risk factors that contribute to the transition of the disease to a progressive phase:

1. Nervous breakdowns, stressful situations, prolonged depression.
2. Insufficient amount of protein food for the body.
3. Systematic malnutrition, starvation.
4. Availability bad habits: systematic drinking of alcohol, smoking.
5. Diseases that reduce immune system person.

Previously suffered illnesses in a severe form can seriously disrupt a person’s immune system; it is this factor that is decisive whether the body can fully resist the disease, or whether the infection will enter the active phase of development.

X-ray examination is the most effective way to detect tuberculosis at an early stage of the disease. The image shows areas affected by the disease as darkening on the patient's lungs. Another way to detect an infection is to test for the Mantoux reaction; over the course of three days, the test allows one to make an assumption about the presence of the disease.

Polymerase chain reaction refers to modern species diagnosing the disease at an early stage. The study of sputum analysis using DNA diagnostics makes it possible to determine the presence of the disease with high accuracy.

An infectious disease that has become chronic, in to a greater extent Men in middle and old age are exposed. Mycobacteria are mainly active in damaging lung tissue. If treatment for tuberculosis is not detected and applied in time, the disease can fatally destroy a person's health.

Drugs to treat the disease are divided into 3 categories. Group 1 includes drugs that provide a high treatment effect and disease prevention. The most popular tablets for tuberculosis are:

1. Rifampicin.
2. Isoniazid.
3. Tubazid.

Group 2 provides a medium effect:

1. Florimycin sulfate.
2. Streptomycin sulfate.
3. Cycloserine and others.

Group 3. Drugs are aimed at curing the disease with a moderate effect.

1. PASK.
2. Thioacetazone.

Domestic phthisiology uses a different classification method for treating the disease, which provides a medicine against tuberculosis, divided in two directions. When treating the disease in the first group, the following medications are used:

1. Streptomycin.
2. Isoniazid.

The reserve group, the second, includes the following drugs against tuberculosis:

1. Cycloserine.
2. Kanamycin.
3. Ethionamide and others.

Treatment of pulmonary tuberculosis with the help of the listed drugs, in compliance with basic measures, is carried out strictly in medical institutions under the supervision of specialists.

The drugs listed above are drugs for pulmonary tuberculosis. The tablets contain antibiotics and synthetic agents. Below are the main drugs that, as has already been found in practice, most effectively cure the disease and, when taken in the correct doses, are normally tolerated by patients.

Rifampicin. The product belongs to the antimicrobial ansamycins, which provide a wide range of applications, including tuberculosis. It has a destructive effect on manifestations in bacteria, providing communication with RNA polymerase, a cell that cuts off reunification with DNA and suppresses transcription. The task of Rifampicin is to block the formation of poxviruses at the last stage of formation. The drug is well absorbed by the gastrointestinal tract and is then recirculated.

Long-term use reduces the bioavailability of the drug. When using the medication, it is not recommended to use foods with a high percentage of fat in food, as they complicate and slow down the absorption process. The drug is taken after the doctor prescribes a daily dose on an empty stomach with a glass of water; if it is poorly tolerated, the dosage is divided into two parts. Rifampin is taken according to two regimens: either 3 times a week or every day. The medicine should not be given to children under 1 year of age and to patients who regularly drink alcohol.

Isoniazid is a drug based on isonicotinic acids used in the medical industry. The increased bacteriological activity, which is characteristic of isoniazid, helps to resist mycobacteria. The drug does not exhibit a chemotherapeutic effect on pathogens of other infectious diseases.

Through the gastrointestinal tract, isoniazid enters the body through absorption and acts throughout the day. The highest concentration of the drug in the blood is observed in the first 4 hours after taking the required dose. The concentration that ensures the cessation of the action of tuberculosis bacteria is maintained for 24 hours after administration. The drug breaks the blood-brain boundary barrier, which is located between brain tissue and blood.

The drug is eliminated mainly through the kidneys during urination. The drug has proven itself in the treatment of newly identified foci of diseases manifested in acute form. The medicine is prescribed according to a combination regimen together with anti-tuberculosis drugs: fluoroquinolones, sulfonamides, broad-spectrum antibiotics. The medication has different forms of release: it can be administered intramuscularly, by inhalation, intravenously, by taking tablets and capsules.

Pyrazinamide. The main task of the drug is to penetrate and act destructively on Mycobacterium tuberculosis. Penetrates easily into areas affected by the disease. An acidic environment helps improve the effect of treatment.

Resistance is possible, which decreases when combined with other drugs used in the treatment of tuberculosis. The product is produced only in the form of tablets; the substance contains 250 and 500 mg of the drug.

Self-treatment of serious infectious diseases such as tuberculosis is excluded. Only constant observation by specialists, repeated examinations, tests and general monitoring can guarantee a complete cure for the disease. All drugs are classified as chemotherapeutic substances that must be taken for a long time without interruption.

Like any medications, anti-tuberculosis tablets have their own characteristics and limitations when taking in the treatment of pulmonary tuberculosis.

1. Pyrazinamide. The drug is available only in tablet form, taken during breakfast with a small amount of liquid. At times, partial intolerance to the drug is observed, in which case the dosage should be divided into 2 or 3 times. During administration, patients may experience an unpleasant metallic taste in the mouth, upset stomach, and nausea. Ethambutol, Rifampicin are compatible with the drug for long-term use of chronic forms of the disease. The likelihood of developing hepatotoxic effects increases when combined with Rifampicin, while Ethambutol mitigates side effects, but the effect of treatment is weakened.
2. Isoniazid. Various release forms make it possible to widely use the drug for the treatment of chronic tuberculosis. To avoid side effects, use Pyridoxine, which is administered intramuscularly at the same time or later, 30 minutes after administration. The course of treatment with the drug is prescribed by a doctor, the required period for recovery ranges from 1 month to six months.
3. Rifampicin. The drug is taken by the patient before meals and washed down with liquid. It is prescribed both orally and intravenously using a dropper. In case of poor tolerance, the drug is divided into parts to take the daily dose. In the treatment of pulmonary tuberculosis, the drug is used in stages, divided into three dosage regimens, combined with other drugs.

Side effects

The above drugs help cure serious infectious disease, but you should not remain silent about their side effects. Only direct control medical workers is able to prevent unwanted effects of drugs on the human body during their use and in the future.

1. Rifampicin. It is forbidden to take if you have had infectious hepatitis less than one year ago, jaundice, severe pulmonary heart failure, chronic renal failure, during lactation, or in infancy.
2. Isoniazid. It is forbidden to prescribe to patients who have previously suffered from polio, with impaired liver and kidney function, with atherosclerosis, a tendency to convulsive seizures, and epilepsy. It is necessary to prescribe the drug with extreme caution during pregnancy or pulmonary heart failure. Patients suffering from epilepsy may experience an increase in seizures. For inflammation of the veins, the drug is strictly prohibited. In rare cases, during use, men may experience gynecomastia, and women may experience menorrhagia. During treatment, patients may experience mild euphoria, worsening sleep periods, and sometimes the development of psychosis.
3. Pyrazinamide. Disorders of the digestive system were noted: diarrhea, poor health, nausea, vomiting. During administration, an unpleasant metallic taste is felt in the mouth. The drug disrupts liver function, worsens appetite, and worsens hepatic ulcers. Undesirable side effects from the central nervous system are observed in the form of dizziness, headaches, nervousness, and depression. Allergic manifestations on the skin of the hands are possible: redness, rash.

Only a doctor has the right to prescribe drugs for the treatment of tuberculosis after careful comprehensive surveys patient in medical institutions, any self-medication can lead not only to undesirable results, but also to a fatal outcome.

Tuberculosis usually affects men over 40 years of age. There are several types of this disease. The most common is pulmonary tuberculosis, but tuberculosis of the joints and bones, and tuberculosis of the genitourinary system are also found. Despite all its seriousness, this disease can be cured with the help of modern medical supplies, in particular various tablets that are sold in pharmacies. How are they different?

Different types of tablets have been proposed by the International Union Against Tuberculosis. They can be divided into three separate categories:

1. Tablets with flomiricin sulfate.
2. Tablets based on streptomycin sulfate.
3. Preparations with cycloserine.

Another classification is also used. She divides all tuberculosis pills into two large groups:

1. First row: Streptomycin, Isoniazid and others.
2. Second row: Ethionamide, Cycloserine, Kanamycin.

As you can see, they are mainly used against tuberculosis various antibiotics and products of synthetic origin.

Let's take a closer look at the popular anti-tuberculosis pills.

Isoniazid

A bactericidal drug that is used to treat tuberculosis patients. Shows strong activity against intracellular and extracellular bacteria Mycobacterium tuberculosis. It is also used as a disease prevention for those people and family members who are in constant contact with infected patients.

The dose is determined by the attending TB doctor. It depends on the severity of the disease and its form. Typically, Isoniazid tablets are taken once a day (300 mg). Treatment can last several months, depending on the severity of the form. In no case should you exceed the maximum daily dose of 300 mg.

Isoniazid is prohibited from being taken by patients who suffer from epilepsy, poliomyelitis, atherosclerosis, and also suffer from seizures. Patients taking this drug should be prepared for side effects: headaches, gynecomastia, allergies, nausea and even vomiting.

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Rifampicin

A popular antibiotic that is often used to treat patients with tuberculosis. It has a good bactericidal effect and inhibits the synthesis of Mycobacterium tuberculosis RNA. May exhibit additional activity against Clostridium spp., Streptococcus spp., Staphylococcus spp., Bacillus anthracis, Legionella pneumophila, Rickettsia prowazekii, Neisseria meningitidis, Chlamydia trachomatis.

Take the tablets only on an empty stomach, with plenty of water. The dosage is standard for children and adults - once a day, 10 mg per kilogram of weight.

For patients who suffer from jaundice, pyelonephritis, hepatitis, kidney disease, taking Rifampicin is contraindicated. Also, the tablets should not be taken if the patient may develop an allergy to rifampicin. The drug can be prescribed to pregnant women only when the disease can have negative consequences for their health and life. In some cases, after taking the pills, unpleasant symptoms may occur: Quincke's edema, diarrhea, vomiting, hepatitis, eosinophilia, headaches, irregularities in the menstrual cycle.

Rifabutin

A popular antibiotic that belongs to the rifamycin group. It is used to treat pulmonary tuberculosis, as it is active against M. avium intracellulare complex and M. tuberculosis. Active ingredient, which is part of the drug, is rifabutin.

You can take Rifabutin tablets, regardless of meals, once a day. The drug can be used as a prophylactic agent. In this case, the patient should take the tablet once at a dosage of 300 mg. If tuberculosis was diagnosed not for the first time, therapy with Rifabutin continues for at least six months.

If the patient is also diagnosed with liver or kidney failure or intolerance to rifabutin, these tablets should not be taken. Pregnant women and nursing mothers should not take the drug. Sometimes patients note that taking Rifabutin leads to vomiting, nausea, diarrhea, headaches, bronchospasms, anemia, and arthralgia.

Streptomycin

A popular antibiotic that belongs to the group of drugs with aminoglycosides. Shows activity against the following bacteria: Mycobacterium tuberculosis, Neisseria gonorrhoeae, Salmonella spp., Escherichia coli, Yersinia spp., Shigella spp., Klebsiella spp., Haemophilus influenzae, Francisella tularensis, Corynebacterium diphtheriae, Staphylococcus spp., Enterobacter spp., Streptococcus spp. ..

The attending physician individually determines the appropriate dosage and duration of therapy for each patient. But you cannot take more than the established maximum daily dose: 4 g of the drug.

Patients with myasthenia gravis, obliterating endarteritis, cardiovascular or renal failure, and brain disorders are prohibited from taking the drug. Also, the product should not be used by pregnant women and patients during lactation.

Streptomycin can lead to the development of some unpleasant symptoms: diarrhea, albuminoria, hearing loss, nausea and vomiting, headache, allergies.

Kanamycin

A popular antibiotic that is included in the list of aminoglycosides. It has fairly high activity against many bacteria: Staphylococcus spp., Klebsiella pneumoniae, Escherichia coli, Salmonella spp., Shigella spp., Enterobacter spp., Proteus spp., Neisseria meningitidis, Neisseria gonorrhoeae.

For the treatment of adult patients who suffer from tuberculosis, Kanamycin is used according to the following regimen: six days, 1 g once every 24 hours. For the treatment of children: 15 mg once every 24 hours. On the seventh day they take a break. The doctor determines the duration of treatment depending on the severity of the disease.

Patients with hearing problems, liver problems, and gastrointestinal diseases cannot take Kanamycin. Also, the drug should not be used by pregnant women. The drug should not be taken simultaneously with those antibiotics that have nephrotoxic and ototoxic effects. Sometimes taking the antibiotic Kanamycin can be accompanied by the following unpleasant symptoms: headaches, increased fatigue and drowsiness, granulocytopenia, anemia, constant ringing in the ears, hearing impairment, frequent urination, cylindruria, allergy.

Metazide

Metazide is a derivative of isonicotinic acid hydrazide. It damages the membrane of Mycobacterium tuberculosis bacteria, which leads to their death.

Adults can take no more than 2 g per day of Metazide, children – 1 g. It is necessary to divide this dose into several doses (two or three). The drug is used to treat all forms of tuberculosis.

Patients with angina pectoris, diseases of the central nervous system, heart defects and renal failure are completely prohibited from taking Metazide tablets. The same applies to pregnant women. During therapy, it is necessary to examine the fundus from time to time.

When using the anti-tuberculosis drug Metazide, some patients may experience side effects: peripheral neuritis, dizziness, which is accompanied by severe headaches, convulsions, insomnia, euphoria, memory loss, vomiting, nausea, diarrhea, pain in the heart (only with long-term use) .

Viomycin

Tablets for tuberculosis, which are based on active substance(antibiotic) viomycin. It has a bacteriostatic specific effect against many bacteria: Streptomyces floridae, Mycobacterium tuberculosis. It is a second-line anti-tuberculosis drug.

The attending physician prescribes the dosage and duration of therapy individually for each patient. They depend on the severity of the disease and its form.

Patients with impaired kidney function or intolerance to antibiotics cannot take this drug. Use with extreme caution in children, as the tablets may affect hearing development. Do not administer simultaneously with other tuberculosis tablets (monomycin, neomycin or kanamycin). Very often, while taking Viomycin, hearing impairment, headaches, proteinuria and allergies are possible.

Cycloserine

An anti-tuberculosis drug that contains the antibiotic cycloserine. Is different wide range actions. Can act bactericidal or bacteriostatic against the following bacteria: Mycobacterium tuberculosis, Rickettsia spp..

You need to take Cycloserine anti-tuberculosis tablets before meals. It is better to take the medicine after meals. For the first 12 hours, drink 0.25 g. Then the dose can be increased by 250 mg every eight hours. Do not take more than the maximum daily dose (1 g).

Patients with hypersensitivity, epilepsy, diseases of the central nervous system, mental disorders, renal and heart failure, and alcoholism are prohibited from taking the drug. When treating children, take with caution.

Cycloserine tablets can lead to the following side effects: heartburn, vomiting, diarrhea, sleep disturbances, headaches, psychosis, emotional depression, memory impairment, tremor, coughing, fever.

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Ethambutol

Tablets for tuberculosis, which contain ethambutol hydrochloride. They differ in their bacteriostatic effect against atypical and typical mycobacteria.

Treatment is carried out in stages. First, 15 mg per kilogram of the patient’s body weight is prescribed once a day. The dose is gradually increased to 30 mg per kilogram of weight. The course of therapy is nine months. If the patient has been diagnosed with renal failure, the dosage is prescribed based on creatinine clearance.

Patients with cataracts, various inflammatory processes in the eyes, gout, diabetic retinopathy, kidney failure, they cannot take Ethambutol, as the medicine can cause severe side effects. The drug is also prohibited for pregnant women and young children.

Very often, retrobulbar inflammation may occur while taking these tablets. optic nerve, which leads to deterioration of visual acuity. Patients also report headaches, nausea, an unpleasant taste in the mouth, hallucinations, sleep disturbances, and convulsions.

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Prothionamide

Prothionamide, which is used to treat tuberculosis, is a second-line drug. The mechanism of action is to block the synthesis of mycolic acid, which is considered the main structural element in the membrane wall of bacteria. Can be used with other anti-tuberculosis drugs to reduce the possibility of developing resistance.

You should take the tablets strictly after meals. Adults take 0.25 g three times a day; if the patient tolerates the drug well, the dose can be increased to 0.50 g.

Patients who were also diagnosed with liver cirrhosis acute gastritis, acute hepatitis, colitis, they cannot take Prothionamide. The drug is also prohibited for use by alcohol abusers and pregnant women.

During therapy with Prothionamide, patients may experience the following side effects: vomiting, loss of appetite, hypersalivation, pellagra-like reaction, hypoglycemia, gynecomastia, hypothyroidism, headache, mental disorders.

Pyrazinamide

An anti-tuberculosis drug of synthetic origin, which belongs to the second line of drugs for tuberculosis. Used to treat tuberculosis of any form simultaneously with other drugs in this group. It has a bactericidal or bacteriostatic effect on bacteria, depending on their sensitivity.

The dosage is prescribed by the attending physician individually. In this case, the maximum daily dose of Pyrazinamide tablets is 2 g of the drug if taken once a day, and 3 g of the drug if taken twice a week.

Patients with pyrazinamide intolerance or severe liver failure should not take the tablets. In some cases, taking Pyrazinamide can lead to nausea, vomiting, liver dysfunction, arthralgia, allergies, and gout.

Ftivazid

Tablets for tuberculosis based on isonicotinic acid hydrazide derivative. They are distinguished by selective activity against the bacteria Mycobacterium tuberculosis.

Tablets should be taken two to three times a day at a dosage of 500 mg at a time (adults) or 30 mg per kilogram of weight (children). Do not exaggerate the maximum daily dose– 3 years

Patients with angina pectoris, diseases of the central nervous system, heart defects, and kidney diseases are contraindicated to take Ftivazid tablets. In some cases, patients develop the following symptoms while taking Ftivazid: gynecomastia, menorrhagia, heart pain, allergies, vomiting, psychosis, memory impairment, headaches.

Thioacetazone

Synthetic antibacterial agent against tuberculosis. Thioacetazone tablets can only be taken after meals. The dosage is usually prescribed by your doctor, but is most often: 0.1 or 0.15 g per day. The dose can be divided into several doses. Be sure to take the drug with enough water.

The drug cannot be used to treat tuberculous meningitis. The patient must be carefully monitored during therapy. Be sure to monitor the functioning of the kidneys and liver. It is necessary to discontinue use if the patient has agranulocytosis.

Patients with impaired kidney and liver function, intolerance to thioacetazone, or diseases of the hematopoietic organs are prohibited from taking these tablets. In some cases, the following side effects were found: diarrhea, vomiting, painful sensations in the abdominal area, hepatitis, agranulocytosis, anemia, leukopenia, dermatitis, cylindruria, headaches.

PASK tablets

Anti-tuberculosis drug, with the active substance in the form of aminosalicylic acid.

PASK tablets should be taken half an hour to an hour after meals. Drink plenty of water. Adults are prescribed 12 g per day, divided into three to four doses. If the patient is too exhausted, the dose is reduced to 6 g. For the treatment of children, 0.2 g per kilogram of weight is used three to four times a day. But the dosage should not exceed 10 g per day.

Patients with hypersensitivity to salicylates, liver and kidney diseases, gastrointestinal ulcers, myxedema, and epilepsy are prohibited from taking the drug. In some patients, taking PASK tablets caused side effects: constipation or diarrhea, vomiting, abdominal cramps, jaundice, hepatitis (sometimes fatal), urticaria, hypoglycemia, vasculitis, hypothyroidism, proteinuria, dermatitis, anemia.

Capreomycin

Antibiotic for the treatment of tuberculosis, a derivative of aminosalicylic acid. It is effective only against the bacteria Mycobacterium tuberculosis.

As a rule, Capreomycin is prescribed in combination with other anti-tuberculosis drugs. The dosage is always individual, as it depends on the form of tuberculosis and the severity of the disease. Therapy can last from six months to a year.

It is not recommended to use Capreomycin to treat patients under 18 years of age, since its effectiveness in this case has not been established. Patients with liver and kidney failure should use the tablets with extreme caution. Prohibited for pregnant women.

Tuberculosis is a difficult disease that requires immediate treatment. No one has yet succeeded in inventing ideal tablets for tuberculosis that provide high guarantees. The problem of treating this infection is still relevant, but some progress has already been made. In particular, the most effective medicine for tuberculosis - a complex of anti-tuberculosis drugs.

Treatment of tuberculosis involves getting rid of alarming symptoms and foci of the disease. Timely course of treatment undertaken for initial stages, most effective. Treatment of tuberculosis in the final stages is not an easy undertaking and is often useless, which is why it is so important to diagnose the disease in time, while healing is still possible.

Medicines of varying effectiveness are used to treat the infection. The most effective medications include Rafampicin and Isoniazid, which are used most often, combined with others. The combination is created based on the form of tuberculosis disease and stage. Previous treatments are also taken into account.

Medicines for the treatment of tuberculosis are differentiated by their effectiveness and the series to which they belong.

• first;
• second;
• third.

First-line drugs include medications that form the basis of treatment. This category includes the already mentioned Rafampicin and Isoniazid, as well as some other drugs for pulmonary tuberculosis. They are characterized by increased activity and toxicity within normal limits.

Patients with pulmonary tuberculosis transmitted for the first time are prescribed first-line drugs. Second-line anti-TB drugs are used in cases where previous treatments have proven ineffective or are intolerable to the patient.

Second-line drugs are otherwise called reserve drugs. Compared to first-line drugs, they are not as active and are often much more toxic.

1. They don't give such a strong effect.
2. Must be purchased in larger quantities than first-line drugs.
3. They have a much higher price.

Third-line drugs include all other drugs that have low activity.

Medicines used: comparative characteristics

Medicines belonging to the same series may have different mechanisms of action, composition, form and many other parameters. They are united only by similar efficiency: high, medium or low. Let's carry out comparative characteristics the most commonly used medications to draw conclusions.

As already mentioned, the most effective medications belong to this category - we will talk about them.

• Rafimpicin;

Each of these medications is different, so it only makes sense to consider them one at a time.

Isoniazid is an anti-tuberculosis drug that is available in tablet form. Its action is aimed at destroying mycobacterium tuberculosis in the patient’s body, and the greatest activity occurs during their reproduction. It is worth noting that the mechanism of action of this drug has not yet been fully studied to confirm anything, but, if you believe the assumptions of the researchers, its action is associated with the suppression of the protective function of mycobacteria by influencing individual components of the cell wall.

Most of the drug is excreted from the body along with waste products. A small amount is eliminated in parallel with feces, the rest - with urine.

Isoniazid has shown excellent results in the fight against active forms of the disease, but it is not limited to this. Quite often, isoniazid is prescribed as a prophylactic for those who, for one reason or another, are at increased risk. These may be people whose tuberculosis has not yet been confirmed. In such cases, the basis for suspicion becomes positive reaction Mantoux. However, not all experts recommend taking medications if suspicion arises - this can have unpleasant consequences. It is recommended to wait for a diagnosis before taking active steps.

The dose is calculated based on the individual characteristics of the disease. The same applies to the duration of the course.

Having a great effect on the body, Isoniazid predictably provokes side effects, affecting various organ systems.

1. Nervous.
2. Digestive.
3. Blood
4. Endocrine.

Based on this, various anxiety symptoms may be associated with taking the medication - frequent headaches, sleep problems, psychosis, nausea and vomiting, heart pain. Various types of skin rashes are possible.

There are a number of medications that can target and reduce the side effects of the pill. This is Thiamine, Pyridoxine.

Rifampicin is an anti-tuberculosis drug that is available in capsule form. Like Isoniazid, it is capable of destroying mycobacterium phthisis, having high activity. This drug is not as often used as Isoniazid due to the fact that drug resistance to it develops much faster in mycobacteria.

Like isoniazid, it is excreted from the body mainly with waste products. Can be excreted along with bile.

Suitable for use against active forms of tuberculosis. When administered orally, the highest concentration can be 600 mg in a child and 1.2 g in an adult. Exceeding this dose is unacceptable.

1. Digestive.
2. Blood.
3. Endocrine.
4. Nervous.
5. Excretory.

The side effects associated with taking yarifampicin, however, are completely different, although they are also common - nausea and vomiting, lack of appetite, a sharp increase in bilirubin levels, possible blood clots, a decrease in the level of leukocytes in the blood, severe headaches, decreased vision, kidney failure, impairment menstruation in women, changes in the color of various discharges.

The drug is strictly contraindicated for people who have recently suffered from a number of diseases, which include jaundice and hepatitis. Not recommended for people who are overly sensitive to the drug. There is a risk for pregnant women, especially those nearing the end of their pregnancy. In addition, the drug is not prescribed to people suffering from liver or kidney failure. Children and newborns should only take it in special cases, otherwise they should avoid it.

You can avoid the emergence of drug resistance in mycobacteria by using Rifampicin in combination with other drugs.

Pyrazinamide is an anti-tuberculosis drug that is available in tablet form. Like previous drugs, it has the ability to destroy Mycobacterium tuberculosis. Its effect on the tuberculosis bacillus is not yet fully known, but it is obvious that it is much wider. It was found that pyrazinamide can also inhibit the process of mycobacterial division. It copes well with one of the main tasks of anti-tuberculosis treatment - getting rid of foci of infection.

Excreted by the kidneys. The highest concentration is found in urine in the next 24 hours.

Let's use it against most forms of tuberculosis together with Isoniazid and Rifamycin. But, unlike them, it has much fewer side effects. They are mainly associated with the digestive system - vomiting, nausea, liver failure, diarrhea. Otherwise, various types of skin rashes and increased sensitivity to light and ultraviolet rays are possible.

The drug is contraindicated in people suffering liver failure or having sensitivity to it. As for the possibility of using the drug for pregnant women, everything is uncertain - due to the lack of research, nothing can be said. It is only known that the drug is excreted in breast milk, and this point should be taken into account.

This is not to say that, like Rifampicin, the drug should be taken by children only in extreme cases. There are no contraindications for this if you follow the dosage.

One pattern is clearly visible: the drug must be used in combination with others, otherwise resistance occurs quite quickly.

Ethambutol is an anti-tuberculosis drug that is available in tablet form. Unlike its predecessors, it is not capable of destroying mycobacteria, but skillfully prevents their further spread, stopping the division processes, presumably by influencing the formation of RNA. The weakness of this drug is that it poses a threat only to actively spreading mycobacteria and is completely useless against those that are at rest.

The medicine is excreted from the body in the urine. Partially in its original form, partially in the form of metabolites. Effective against various forms of tuberculosis.

It has more side effects than Pyrazinamide, but less than Rifampicin.

1. Nervous.
2. Digestive.
3. Musculoskeletal.

Many side effects are observed from the nervous system. Taking the drug may cause the patient to experience depressive moods, dizziness, vision problems, and problems distinguishing colors. In addition, it causes nausea and vomiting, loss of appetite, arthritis, and skin rashes.

Contraindicated for pregnant women, children under thirteen years of age, diabetics, people with kidney failure, problems with the organs of vision and those with hypersensitivity.

Treatment using Ethambutol alone is again not possible due to the high likelihood of drug resistance. Particularly good results are obtained when used with Isoniazid and Rifampicin.

When prescribing a drug to a child, the doctor must ensure that his health condition will be strictly monitored. Possible visual impairment, kidney and liver problems.

First-line drugs have bacteriostatic and bactericidal effects. They should be used in combination with other drugs to avoid drug resistance.

Second line drugs

Second-line drugs are used when first-line drugs are ineffective, which is why they are called reserve drugs.

• Ethionamide.

Let's consider the mechanism of their action and try to find similarities.

Cycloserine is an anti-tuberculosis drug that is available in capsule form. Capable of destroying mycobacteria and preventing their further spread. Drug resistance to the drug occurs at least six months after the start of use.

Cycloserine is effective against chronic forms of tuberculosis in combination with other medications.

Second-line medications also have a number of side effects.

1. Nervous.
2. Blood.
3. Digestive.

Trouble sleeping, headaches and nausea are the first signs that indicate side effects. But these are far from the most serious consequences. The greatest damage is dealt circulatory system- heart failure worsens. The least damage occurs to the digestive system, but with the nervous system, in addition to those already listed, many more unpleasant phenomena are associated - nightmares, memory impairment, suicidal tendencies, depression. All this indicates the need to carefully monitor the patient’s condition in order to be able to keep him from rash actions.

The drug is contraindicated for people who have impaired normal activity of the nervous system, epileptics, alcoholics and those who have heart failure. Children are advised to take it very carefully. For pregnant women - only in critical situations. Otherwise you should refrain from taking it. Renal failure is also a good reason to avoid using Cycloserine.

Ethionamide

Ethionamide is an anti-tuberculosis drug that is available in powder form. Stops the proliferation of mycobacteria in the body. Most active the drug is observed in an acidic environment. Under its influence, foci of the disease resolve. Drug resistance occurs quite quickly.

It is used to treat various forms of tuberculosis if the use of other drugs does not bring the desired results.

The drug is contraindicated for people under fourteen years of age, epileptics, diabetics, people with stomach ulcers, various diseases, as a result of which the functioning of the liver is disrupted. Not recommended for pregnant women.

1. Nervous.
2. Digestive.
3. Blood.

Headaches, depression, convulsions, suicidal tendencies, sleep disturbances, psychoses, nausea, loss of appetite and, as a result, anorexia, tachycardia and many other side effects are observed. An allergic reaction is possible.

Second-line drugs have a strong effect mainly on nervous system. They have the same effect as first-line drugs, but are much less effective and are used only when there is no other option.

Third line drugs

Doctors know the least about third-line drugs.

• PASK.

Let's try to compare them.

Thioacetazone is an anti-tuberculosis drug that is available in powder form. It has the ability to stop the proliferation of Mycobacterium tuberculosis. Resistance to it does not arise immediately.

Contraindicated for pregnant women, people with liver, heart or kidney failure, and diabetics.

Side effects include a decrease in the level of leukocytes in the blood, the formation of blood clots, diarrhea, vomiting, nausea, headaches, and skin rashes.

PASK

PASK is an anti-tuberculosis drug, which is available in the form of tablets with a special coating. Like Thioacetazone, it affects the ability of mycobacteria to divide. Has a weak effect.

Side effects include diarrhea, nausea, vomiting, psychosis, decreased levels of leukocytes in the blood and much more.

Contraindicated for pregnant women, people with liver or kidney failure, epileptics, people with cirrhosis of the liver.

Third-line drugs have a bacteriostatic effect and are used only in extreme cases due to their low activity.

Prevention of tuberculosis

Prevention of tuberculosis is aimed at reducing the incidence rate.

1. Diagnose tuberculosis in a timely manner.
2. Register tuberculosis patients.

It is important to monitor healthy people, which, due to circumstances, are subject to great risk. It is necessary to register them, conduct preventive measures and research to detect infection in its early stages. It cannot be denied that they are at risk of getting sick.

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Time is over

• Congratulations! The likelihood that you will develop tuberculosis is close to zero.

  But don’t forget to also take care of your body and undergo regular medical examinations and you won’t be afraid of any disease!
  We also recommend that you read the article on.

• There is reason to think.

  It is impossible to say with certainty that you have tuberculosis, but there is such a possibility; if this is not the case, then there is clearly something wrong with your health. We recommend that you undergo a medical examination immediately. We also recommend that you read the article on.

• Contact a specialist urgently!

  The likelihood that you are affected is very high, but it is not possible to make a diagnosis remotely. You should immediately contact a qualified specialist and undergo a medical examination! We also strongly recommend that you read the article on.

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1. Task 1 of 17

   1 .

   Does your lifestyle involve heavy physical activity?

2. Task 2 of 17

   2 .

   How often do you take a tuberculosis test (eg Mantoux)?

3. Task 3 of 17

   3 .

   Do you carefully observe personal hygiene (shower, hands before eating and after walking, etc.)?

4. Task 4 of 17

   4 .

   Do you take care of your immunity?

5. Task 5 of 17

   5 .

   Have any of your relatives or family members had tuberculosis?

6. Task 6 of 17

   6 .

   Do you live or work in an unfavorable environment(gas, smoke, chemical emissions from enterprises)?

7. Task 7 of 17

   7 .

   How often are you in damp, dusty or moldy environments?

8. Task 8 of 17

   8 .

   How old are you?