Discussing TB
Tuberculosis is the number one infectious disease killer in the world. TB is an infectious disease caused by M. tuberculosis, an organism that is inhaled into the alveolus, where it multiplies and spreads to local pulmonary areas.
Risk factors for TB
- Foreign-born (from high-prevalence countries including China, Mexico, Philipines, etc)
- Age (nonwhite patients have peak incidence of TB between ages 25-44)
- Medically underserved
- Low-income
- Ethnic minority
- Homelessness
- Productive cough, bloody streaks may be present
- Fever
- chills
- Weight loss
- Night Sweats
- Dyspnea
- fatigue
- Hemoptysis
Treatment
The typical treatment for active TB includes two phases. The initial 2-month phase of four drugs (Isoniazid, Pyrazinamide, Rifampin, ethambutol) and the Continuation phase of 4 months (18 weeks) with two drugs (Isoniazid and Rifampin)
Labs
At baseline
Sutton, S. S. (2015). McGraw-Hills NAPLEX review guide. New York: McGraw-Hill Medical.
Woo, TM., Robinson, MV. (2016). Pharmacotherapeutics for advanced practice nurse prescribers (4th ed.). FA Davis Co. Philadelphia
The typical treatment for active TB includes two phases. The initial 2-month phase of four drugs (Isoniazid, Pyrazinamide, Rifampin, ethambutol) and the Continuation phase of 4 months (18 weeks) with two drugs (Isoniazid and Rifampin)
Labs
At baseline
- CBC
- liver function tests
- creatinine
- bilirubin
- platelets
- Routine monitoring is not needed unless s/s of liver toxicity or adverse effects present.
- Assess for completion of treatment and medication adherence
- Monthly sputum cultures
- CXR upon completion of treatment for future reference
Sutton, S. S. (2015). McGraw-Hills NAPLEX review guide. New York: McGraw-Hill Medical.
Woo, TM., Robinson, MV. (2016). Pharmacotherapeutics for advanced practice nurse prescribers (4th ed.). FA Davis Co. Philadelphia
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