Commonly used first-line anti-tb drugs include isoniazid, rifampicin, ethambutol, pyrazinamide, etc. What are the common adverse reactions of these drugs and what should be paid attention to?
Common adverse reactions to INH:
① Peripheral neuritis: numbness, tingling, weakened touch and pain at the extremities, especially in patients with alcoholism, diabetes, kidney disease and malnutrition. If necessary, it can be taken with vitamin B6 to prevent and relieve peripheral neuropathy.
② Central nerve damage: can induce epileptic seizure, mental behavior abnormalities, optic nerve damage, etc.
③ Liver function damage: most of the light, can be self-improvement; A few serious liver damage, symptoms are obvious, nausea, vomiting, oil, jaundice, fatigue and other discomfort; Often need to stop medicine to protect liver and other treatment.
Precautions for INH medication:
People with chronic liver disease, mental illness and epilepsy, pregnant women and nursing women should not use or use with caution; Pay attention to digestive tract reaction, distal limb sensation and mental state; Check your liver function regularly.
Common ADVERSE reactions to RFP:
① Gastrointestinal reactions: manifested as nausea, vomiting, loss of appetite, etc., some patients can be relieved by themselves, some can be relieved by adjusting the medication time, method and symptomatic treatment.
② Liver function damage: generally mild, can continue to use, if there is serious liver damage or at the same time combined with allergic reaction, it should stop.
(3) Simple skin pruritus in mild allergic reactions, fever, rash, even exfoliative dermatitis, shock and so on in severe allergic reactions. Symptomatic treatment in light cases can be improved, severe cases need to stop the drug.
(4) Hematology abnormal hemocytopenia, hemolytic anemia, leukopenia, etc.
Precautions for RFP medication:
It is forbidden for pregnant women with serious liver function damage and within 3 months of pregnancy; Body fluids and secretions will be orange; Monitor liver toxicity, hemocytotoxicity and allergy.
Common ADVERSE reactions to EMB:
(1) Optic neuritis: the performance is blurred vision, red and green color blindness, limited vision, etc., once the need to stop drugs, usually can be recovered after the withdrawal of drugs.
② Hyperuricemia may occur by inhibiting uric acid excretion.
Precautions for EMB medication: check eyesight and color discrimination regularly before and after medication; Blood uric acid levels were monitored.
EMB medication precautions:
Check eyesight and color discrimination regularly before and after medication; Blood uric acid levels were monitored.
PZA adverse reactions were related to dose course:
① Gastrointestinal reactions are manifested as nausea, vomiting and loss of appetite. Most of them are transient, or most of them can be relieved by taking them after meals, in different times, or before going to bed.
② Liver function damage requires regular monitoring of liver function.
(3) Joint pain is manifested as joint swelling, limited activity, etc., some of which can be relieved after self-treatment or painkiller treatment, and the amount can be reduced or even stopped when necessary.
Precautions for PZA medication:
Regular examination of liver function and blood uric acid; Pay attention to joint pain, rash and other reactions.