Antituberculosis DRUGS

 Introduction 17.1

Drugs called antituberculosis agents are used to treat tuberculosis, an infectious illness that can harm the lungs and other organs.

The typical "short" course of treatment for TB consists of two months of pyrazinamide, ethambutol, rifampicin (also known as rifampin in the United States), isoniazid, and pyridoxal phosphate, followed by four months of isoniazid and rifampicin alone. After six months, the patient is deemed to be free of live microorganisms. The recommended course of treatment for latent tuberculosis is six to nine months of daily isoniazid or three months of weekly (12 total doses) isoniazid/rifapentine. [1] [2]If the organism is known to be totally susceptible, isoniazid, rifampicin, and pyrazinamide are administered for two months, then isoniazid and rifampicin are administered for four months. No need for ethambutol

Classification First line

 conventional three-letter and one-letter abbreviation for each of the first-line anti-tuberculous medication names are:

B or EMA ethambutol

INH or H for isoniazid,

PZA or Z stands for pyrazinamide.

rifampicin RMP or R,

Streptomycin is either SM or S.

Rifamycin (also known as rifampin), isoniazid, pyrazinamide, and ethambutol are the first-line anti-tuberculous drugs, and their names are frequently recognized with the acronym "RIPE." Rifampicin is known as rifampin and is abbreviated RIF, whereas streptomycin is known as STM. These abbreviations and names are used only in the US and are not recognized elsewhere. Because of the high rates of resistance, streptomycin is no longer regarded by the ATS/IDSA/CDC as a first-line medication in the US exclusively. No such advice has been given by the WHO.

A standardized way of condensing drug regimens is used. The medications are listed with their single-letter abbreviations.

roughly in the chronology of entry into clinical practice, as stated above). Prefixes indicate how many months the treatment should be administered, whereas subscripts (such as so3 for three times a week) and no subscripts indicate daily dose. The majority of regimens begin with a high-intensity phase and then move on to a continuation phase, also known as a consolidation phase or eradication phase. The high-intensity phase is administered first, followed by the continuation phase, with a slash between the two phases.

In other words, 2HREZ/4HR3 stands for isoniazid, rifampicin, ethambutol, and pyrazinamide administered daily for two months, then three times a week for four months.

The remainder of this essay uses these common acronyms

.two lines

The WHO categories 2, 3, and 4 second-line medications are solely used to treat diseases (such as extensively drug-resistant tuberculosis (XDR-TB) or multidrug-resistant tuberculosis (MDR-TB)) that are refractory to first-line therapy. [4] There are three possible reasons why a drug might be classified as second-line rather than first-line: it might be less effective than first-line medications (for example, p-aminosalicylic acid); it might have toxic side effects (for example, cycloserine); or it might be effective but unavailable in many developing nations (for example, fluoroquinolones):

aminoglycosides (WHO group 2), such as kanamycin (KM) and amikacin (AMK);

polypeptides, such as capreomycin, viomycin, and enviomycin (WHO group 2);

ciprofloxacin (CIP), levofloxacin (LEV), and moxifloxacin (MXF) are fluoroquinolones (WHO group 3);

Thioamides (WHO category 4) include prothionamide and ethionamide.

cycloserine(WHO category 4) (WHO group 4)

terizidone(WHO category 5) (WHO group 5)

fourth line

Drugs in the third line (WHO group 5) may be helpful but their efficacy is questionable or unproven:

Since they are either not highly effective (such as clarithromycin) or their efficacy has not been established, these medications are mentioned here.