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Education Materials > Publications > Self-Study Modules on TB > Module 4 > Background

Self-Study Modules on Tuberculosis

This is an archived document. The links are no longer being updated.

Module 4: Treatment of Tuberculosis Infection and Disease

Background

In this module, you will learn about the principles of treating TB infection and TB disease. TB infection is treated to prevent it from progressing to TB disease. This is called preventive therapy. Some TB infected people are at very high risk of developing TB disease, and they should receive high priority for preventive therapy. TB disease is treated to cure the patient and to stop the spread of TB. As a public health worker, you may be responsible for helping TB patients take their medications as prescribed. This is very important, because patients with TB disease who do not complete treatment as prescribed may become infectious or develop drug-resistant TB.

This module also explains the possible side effects of the drugs used to treat TB infection and TB disease. If you have regular contact with TB patients, you should be aware of the signs and symptoms of these side effects. If a patient has symptoms of a serious side effect, you should notify a clinician immediately.

Objectives

After working through this module, you will be able to:

  1. List the groups of people who should receive high priority for preventive therapy.
  2. Explain the purpose of the medical evaluation for people who are being considered for preventive therapy.
  3. Describe the usual preventive therapy regimen, the preventive therapy regimens for children and HIV-infected persons, and the preventive therapy regimen for people exposed to isoniazid-resistant TB.
  4. Describe the possible adverse reactions to isoniazid.
  5. Describe how patients should be monitored for adverse reactions to isoniazid.
  6. Explain why TB disease must be treated for at least 6 months.
  7. Describe the recommended regimen for the initial treatment of TB.
  8. Describe the principles of preventing drug resistance.
  9. Explain why directly observed therapy is important.
  10. List the circumstances in which longer therapy may be necessary and the circumstances in which certain drugs should not be used for treatment.
  11. List the common adverse reactions to the drugs used to treat TB.
  12. Describe how patients should be monitored for adverse reactions to the drugs used to treat TB.
  13. Describe how patients should be monitored for adherence to TB treatment.
  14. Describe how patients should be evaluated for their response to treatment.
  15. Describe the role of the public health worker in TB treatment.

New Terms

Look for the following new terms in this module and in the glossary.

adherence to treatment - following the recommended course of treatment by taking all the prescribed medications for the entire length of time necessary

adverse reaction - negative side effect resulting from the use of a drug (for example, hepatitis, nausea, headache)

clinical evaluation - an evaluation done to find out whether a patient has symptoms of TB disease or is responding to treatment; also done to check for adverse reactions to TB medications

continuation phase - the period after the first 8 weeks of treatment, during which tubercle bacilli that remain after the initial phase are killed

daily regimen - a treatment schedule in which the patient takes a dose of each prescribed medication every day

directly observed therapy (DOT) - a strategy devised to help patients adhere to treatment; means that a health care worker or another designated person watches the TB patient swallow each dose of the prescribed drugs

ethambutol - a drug used to treat TB disease; may cause vision problems. Ethambutol should not be given to children who are too young to be monitored for changes in their vision.

hepatitis - damage to the liver, causing symptoms such as nausea, vomiting, abdominal pain, fatigue, and dark urine; hepatitis can be caused by several drugs used to treat TB infection or disease

initial phase - the first 8 weeks of treatment, during which most of the tubercle bacilli are killed

intermittent regimen - a treatment schedule in which the patient takes each prescribed medication two or three times weekly at the appropriate dosage

isoniazid - the drug that is most often used for preventive therapy and also used to treat TB disease; although relatively safe, it may cause hepatitis and other adverse reactions in some patients

liver function tests - tests done to detect damage to the liver

multidrug-resistant TB (MDR TB) - TB that is resistant to isoniazid and rifampin; more difficult to treat than drug-susceptible TB

peripheral neuropathy - damage to the sensory nerves of the hands and feet, causing a tingling sensation or a weakened sense of touch in the hands and feet

preventive therapy - medication that is given to people who have TB infection to prevent them from developing TB disease

pyrazinamide - a drug used to treat TB disease, usually during the initial phase of treatment; should not be given to pregnant women

relapse - the return of a disease after a partial recovery from the disease

rifampin - a drug used to treat TB disease; also used for preventive therapy in people with a positive skin test reaction who have been exposed to isoniazid-resistant TB. Rifampin has several possible side effects (for example, hepatitis, turning body fluids orange, drug interactions).

streptomycin - an injectable drug used to treat TB disease; may cause hearing problems. Streptomycin should not be given to pregnant women.

 


Released October 2008
Centers for Disease Control and Prevention
National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention
Division of Tuberculosis Elimination - http://www.cdc.gov/tb

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