Department of Tuberculosis and Chest Diseases, National Institute of Tuberculosis and Respiratory Diseases, New Delhi, 110030, India.
Department of Tuberculosis and Chest Diseases, National Institute of Tuberculosis and Respiratory Diseases, New Delhi, 110030, India.
Indian J Tuberc. 2020 Dec;67(4S):S69-S78. doi: 10.1016/j.ijtb.2020.09.027. Epub 2020 Oct 3.
Multiple drugs taken for long duration in tuberculosis (TB) treatment, especially drug resistant TB (DR-TB), may produce adverse drug reactions (ADRs). Although any anti-TB drug can cause ADRs, but these are more common with drugs used for treatment of DR-TB. However, most of ADRs with these drugs are mild or moderate and can be managed if adequate supervision and monitoring is done. However, few ADRs can be severe or potentially life-threatening and may require removal of the offending drug(s). TB patients having comorbidities and on treatment for them may experience drug interaction with anti TB drugs and may require dose modification or change of drug. For a good TB treatment outcome patient's compliance should be ensured, and adverse events and drug interactions should be appropriately addressed by the clinicians. This article outlines the majority of the possible ADRs to anti-TB drugs used for management of DR-TB and their common drug interactions with practical recommendations to identify the possible drug(s) responsible and the most adequate management in each situation.
在结核病（TB）治疗中，尤其是在耐多药结核病（DR-TB）治疗中，长期服用多种药物可能会产生药物不良反应（ADR）。虽然任何抗结核药物都可能引起 ADR，但这些不良反应在治疗 DR-TB 时更为常见。然而，这些药物引起的大多数 ADR 是轻度或中度的，如果进行充分的监督和监测，是可以管理的。然而，少数 ADR 可能很严重或具有潜在的致命性，可能需要去除有问题的药物。患有合并症并正在接受治疗的结核病患者可能会与抗结核药物发生药物相互作用，可能需要调整剂量或更换药物。为了取得良好的结核病治疗效果，应确保患者的依从性，并由临床医生适当处理不良反应和药物相互作用。本文概述了用于管理 DR-TB 的抗结核药物可能出现的大多数 ADR 及其与常见药物的相互作用，并提出了一些实用建议，以确定可能的药物（药物）及其在每种情况下的最适当的管理。
