Drug treatment of tuberculosis - chemotherapy

Chemotherapy of tuberculosis - is the use of anti-bacterial anti-tuberculosis drugs, aimed at the destruction of life and the suppression of infectious agents. The question of what to treat tuberculosis Tuberculosis - a full recovery is not guaranteed In our time it is not necessary. The main thing - is to choose the right drugs for chemotherapy.

By pharmacological properties TB drugs are divided into synthetic chemical drugs (drugs of gidrazidizonikotinovoy acid, pyrazinamide, tiamidy, p-aminosalicylic acid and ethambutol) acting only on the tubercle bacillus, and antibiotics (aminoglycosides, polypeptides, rifamycins, cycloserine and fluoroquinolones) with a broad spectrum of antimicrobial action not only on the causative agent of tuberculosis, and other bacterial flora.

According to the clinical effects of all anti-TB drugs are divided into primary and backup. New methods of treatment of tuberculosis are the appointment of several anti-TB drugs with different mechanisms of action. The main concern drugs that are prescribed for newly diagnosed tuberculosis to obtain data bacteriological sputum culture drug susceptibility of tubercle bacilli.

The main anti-TB drugs have bactericidal effect on tubercle bacillus (ie kill) and have a minimum number of side effects. These medications include drugs of gidrazidizonikotinovoy acid - Ginko (isoniazid, Fenazid, ftivazid and metazid) Antibiotics rifampicin (rifampin and rifabutin) and aminoglycosides (streptomycin), pyrazinamide, ethambutol. The most effective treatment for tuberculosis at the early stages of anti-TB drugs of the main group.

To reserve antituberculosis drugs are medications that can be replaced if necessary, basic (for example, when the body of the patient intolerance, insensitivity to him tubercle bacilli, and so on). Reserve antituberculosis drugs have a bacteriostatic effect (suppress the vital activity of Mycobacterium tuberculosis) and the large number of side effects. To reserve drugs are drugs of tiamidov (ethionamide, protionamid), polypeptides (capreomycin), aminoglycosides (kanamycin, amikacin), fluoroquinolones (ofloxacin, levofloxacin and moxifloxacin), cycloserine, p-aminosalicylic acid (PAS), and ethionamide and protionamid -preparaty, inhibit the synthesis of peptides of Mycobacterium tuberculosis.

Treatment of pulmonary tuberculosis - pathogenetic and symptomatic therapy

Pathogenetic treatment - is the impact of the mechanism of development of tuberculosis. Primarily for this purpose used drugs with a pronounced anti-inflammatory, anti-allergic and anti-sclerotic (hinder the development of scarring and adhesions) action, such as glucocorticoid hormones and their synthetic analogues - hydrocortisone, prednisone Prednisolone - against inflammation, allergy and pain, but with complications Dexamethasone Dexamethasone - one of the most effective glucocorticosteroids   and others. These drugs are prescribed for tuberculosis forms large inflammatory reaction accompanied by the formation of a large number of inflammatory fluid, and to prevent the formation of connective tissue.

But this group of drugs have many side effects, including help to reduce immunity. Therefore, in the complex treatment of tuberculosis is often administered immunomodulators - drugs, the recovery of the immune system. It taktivin, levamisole, diutsifon and others.

As adjuvants are sometimes used in tuberculosis tuberculin and BCG. They increase the body's resistance to infections, improve blood and lymph circulation in the inflammation, stimulates regenerative processes.

Current treatment regimens for tuberculosis include the appointment antikininovyh funds - parmidina andekalin and that also contribute to the suppression of the inflammatory response.

Since tuberculous inflammation leads to disruption of cellular metabolism and in a large number of toxic free radicals in the combined treatment is administered Antioxidants: ascorbic acid (vitamin C), tocopherol Vitamin E (tocopherol) - not to be carried away   (vitamin E), sodium thiosulfate.

To prevent the development of connective tissue of patients prescribed lidazu, as well as other drugs that reduce inflammation and eliminate the main symptoms of tuberculosis. This B vitamins, desensitizing agents, expectorants and mucus-thinning agents, and so on.

Surgical treatment of tuberculosis

Sometimes medical treatment for tuberculosis is not enough. In this case, resort to surgery. Surgical treatment of tuberculosis is carried out in various forms of tuberculosis of the lungs, pleura, hilar lymph nodes, with some complications of tuberculosis. Often surgery is performed at tuberculoma, single cavity, multi-cavity in one lung, cirrhosis of the lung, stenosis of the main bronchus or equity, pachypleuritis with impaired breathing and so on.

In most cases, surgical treatment of tuberculosis is planned, but sometimes sick and needed emergency surgery, for example, with strong recurring pulmonary hemorrhage, pneumothorax, and so on.

How to cure tuberculosis? Only in a specialized medical institution under the supervision of a qualified professional.

Galina Romanenko

What fluoroquinolones

Fluoroquinolones - is artificially created chemicals that are used in medicine as an anti-bacterial drugs. In our lives, they came in the eighties of the last century as a second-generation drugs in this group (eg, ofloxacin, ciprofloxacin). Fluoroquinolones have a wide spectrum of antimicrobial activity, including staphylococci, high bactericidal (kills bacteria) activity, good speed of absorption and distribution of human tissues.

Ten years later, the third appeared fluoroquinolones (levofloxacin, sparfloxacin), and fourth (moxifloxacin) generation, which were characterized by a high activity against gram-positive bacteria (particularly pneumococcal), intracellular pathogens, and better absorbability.

Fluoroquinolones have a bactericidal effect, that is, kill pathogens by suppressing the activity of a vital enzyme of microbial cells DNA gyrase, thereby violating the synthesis of DNA, causing the destruction of microbial cells.

The mechanism of action of ciprofloxacin

Ciprofloxacin belongs to the second generation fluoroquinolone, it means that the action time of the drug tested. Various pharmaceutical companies it sold under the name akvatsipro, altsipro, arfloks, afenoksin, betatsiprol, Vero ciprofloxacin protsipro, tseprova, tsefobak, tsiloksan, tsipreks, Cipro, tsiprobay, tsiprobid, tsiprolet, tsiprofloksabol and others.

Ciprofloxacin - an antibacterial drug broad spectrum capable of suppressing an infection caused by various pathogens. It can be effective even against bacteria resistant to other fluoroquinolones. Ciprofloxacin is a complete blockade of DNA gyrase, violates the biosynthesis of DNA, growth and division of bacteria. Furthermore, it destroys the cell wall and membrane of bacteria, thus accelerating the rapid death of the bacterial cell.

Available in the form of tablets, injectable solution, infusion solution, eye and ear drops, eye ointments. It is used to treat infections of all organs and systems, in addition to infections of the central nervous system (CNS does not reach therapeutic concentrations).

Indications for use

Ciprofloxacin is used to treat:

• respiratory tract infections - acute and chronic bronchitis, pneumonia, pleurisy, lung abscess, and so on;
• infection of upper respiratory tract - inflammation of the middle ear, sinuses, sore throat, inflammation of the pharynx and larynx;
• eye infections, including the prevention of infectious complications after eye surgery;
• infections of the genitourinary system - Ciprofloxacin is effective in infections of any part of the urinary tract and genitals of men and women;
• infections, sexually transmitted diseases - gonorrhea (even caused by antibiotic-resistant gonococci), chancroid, chlamydia (in syphilis and trichomoniasis Ciprofloxacin is not effective);
• Infections of the abdominal cavity and gastrointestinal tract - inflammation of the gallbladder and biliary tract, intra-abdominal abscesses, peritonitis, salmonellosis Salmonellosis - features of the disease   and so on;
• infections of skin and soft tissue - festering wounds, ulcers, abscesses, and so on;
• bone and joint infections - osteomyelitis, arthritis;
• peritonitis (inflammation of the membrane lining the inside of the abdomen), blood poisoning.
• Contraindications Ciprofloxacin

Ciprofloxacin is not indicated:

• hypersensitivity to drugs of fluoroquinolones group;
• during pregnancy (clinical studies in pregnant women were not conducted) and breastfeeding a child;
• in childhood and adolescence (impaired growth);
• with a deficiency in the body, glucose-6-phosphate dehydrogenase (an enzyme that has been actively involved in metabolic processes, the lack of it leads to hemolytic anemia);
• viral diseases of the eye.

Side effects

During the course of treatment with ciprofloxacin may experience the following side effects:

• the part of the digestive system: nausea, vomiting, diarrhea, abdominal pain Abdominal pain: Types and Symptoms Irritation of the mucous membrane of the esophagus, stomach and intestines if swallowed, abnormal liver function, goiter;
• Central nervous system: headache, dizziness, tinnitus, depression Depression - a little more than a bad mood , Anxiety, insomnia, blurred vision, taste, smell;
• Skin and soft tissue irritation of the soft tissues when administered intramuscularly;
• Allergic reactions: rash, pruritus, angioedema, urticaria, bronchospasm, allergic reactions to the sun's rays;
• Other side effects: volatile joint pain Joint pain - how to understand what is going on? , The appearance of protein in the urine.

Ciprofloxacin can be produced by different names, but the package must be indicated its international non-proprietary name under which it and you can find out.

Galina Romanenko