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Adverse Drug Reactions due to Longer oral M/XDR-TB Regimen
Learning ObjectivesAdverse Drug Reactions due to Longer oral M/XDR-TB Regimen
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The table below showcases the adverse drug events that may be caused by drugs used for longer oral Multi (M)/ Extensively Drug-resistant TB (XDR-TB) regimen. In these situations, replacement drugs are used instead of these drugs.
ADVERSE DRUG EVENTS | DRUGS |
---|---|
QT prolongation | Bedaquiline (Bdq), Fluoroquinolone (FQ), Clofazimine (Cfz) |
Rash, allergic reaction and anaphylaxis | Any drug |
Gastrointestinal symptoms | Ethionamide (Eto), P-Aminosalicylic Acid (PAS), Pyrazinamide (Z), Ethambutol (E), Bdq, Cfz, Linezolid (Lzd), FQs |
Diarrhoea and/or flatulence | PAS, Eto |
Hepatitis | Z, Eto, PAS, Bdq |
Giddiness | Amikacin (Am), Eto, FQ and/or Z |
Haematological abnormalities | Lzd |
Hypothyroidism | Eto, PAS |
Arthralgia | Z, FQ, Bdq |
Peripheral neuropathy | Lzd, Cycloserine (Cs), Am, FQ, rarely Eto, E |
Headache | Bdq, Cs |
Depression | Cs, FQ, Eto |
Psychotic symptoms | Cs, Isoniazid (H), FQ |
Suicidal ideation | Cs, Eto |
Seizures | Cs, H, FQ |
Tendonitis and tendon rupture | FQ |
Nephrotoxicity (renal toxicity) | Am |
Vestibular toxicity (tinnitus and dizziness | Am, Cs, FQs, Eto, Lzd |
Hearing loss | Am |
Optic neuritis | E, Lzd, Eto, Cfz |
Metallic taste | Eto, FQs |
Electrolyte disturbances (Hypokalaemia and Hypomagnesaemia | Am |
Gynaecomastia | Eto |
Alopecia | Eto |
Superficial fungal infection and thrush | FQ |
Lactic acidosis | Lzd |
Dysglycaemia and Hyperglycaemia | Eto |
Resources
- Guidelines for Programmatic Management of Drug-resistant Tuberculosis in India, March 2021.
- WHO Consolidated Guidelines on Tuberculosis: Module 4 - Treatment: Drug Resistant TB Treatment, 2020.
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