{"presentation":{"slides":[{"elements":[{"x":8.714596949891067,"y":4.284279569892473,"width":90.41394335511983,"height":90.32258064516128,"action":{"library":"H5P.Shape 1.0","params":{"shape":{"fillColor":"rgba(120, 218, 249, 0.817)","borderWidth":"2","borderStyle":"solid","borderColor":"rgb(0, 0, 0)","borderRadius":"0"},"type":"rectangle","line":{"borderColor":"#000000","borderWidth":"1","borderStyle":"solid"}},"subContentId":"11757d0d-2a44-40d6-8f83-5ea5e76930dd","metadata":{"contentType":"Shapes","license":"U"}},"backgroundOpacity":0,"displayAsButton":false,"buttonSize":"big","goToSlideType":"specified","invisible":false},{"x":9.803921568627452,"y":6.451612903225806,"width":88.23529411764706,"height":88.17204301075269,"action":{"library":"H5P.AdvancedText 1.1","params":{"text":"

If patients on BPaLM show clinical deterioration or no improvement by 9 weeks. send an additional specimen for smear, rapid molecular test, C&DST to all drugs at 9 weeks.<\/strong>
\n - This should be repeated at 18 weeks and 26 weeks of the regimen and also at 39 weeks if the regimen is extended.
\n
\nAt any point, after 9 weeks, if the patient is not improving clinically or radiologically, send sputum\/ EPTB specimen for C&DST and refer the patient to NDR TB Centre.<\/p>\n\n

Permanent discontinuation of Bdq, Pa or Lzd because of intolerance, toxicity, grade 03\/ severe ADR at any point of time, the patient must be declared as \u2018treatment failure\u2019 and referred to NDR TB Center for evaluation.<\/p>\n\n

For intolerance (grade 3-4) to FQ: Drop Mfx, complete the rest of the regimen as BPaL and extend the treatment up to 39 weeks.<\/p>\n\n

For intolerance (grade 3-4) to Lzd (600 mg daily) in patients: Within the first 9 weeks of treatment initiation, if Lzd (600 mg daily) need to be discontinued, despite efforts to restart Lzd at 600 mg, then discontinue the BPaLM regimen and declare the outcome as 'treatment failed'. The patient must be sent to the Nodal DR TB center for further evaluation and management.<\/p>\n"},"subContentId":"c0f1a820-bfbd-4a41-b2af-cfd61743d061","metadata":{"contentType":"Text","license":"U","title":"Untitled Text"}},"alwaysDisplayComments":false,"backgroundOpacity":0,"displayAsButton":false,"buttonSize":"big","goToSlideType":"specified","invisible":false,"solution":""},{"x":2.178649237472767,"y":4.290989247311828,"width":6.5359477124183005,"height":90.32258064516128,"action":{"library":"H5P.Shape 1.0","params":{"shape":{"fillColor":"rgb(0, 216, 255)","borderWidth":"2","borderStyle":"solid","borderColor":"rgb(0, 0, 0)","borderRadius":"0"},"type":"rectangle","line":{"borderColor":"#000000","borderWidth":"1","borderStyle":"solid"}},"subContentId":"4de5fe2c-0486-4f62-b32c-a5a9c72f8d16","metadata":{"contentType":"Shapes","license":"U"}},"backgroundOpacity":0,"displayAsButton":false,"buttonSize":"big","goToSlideType":"specified","invisible":false},{"x":4.357298474945534,"y":6.451612903225806,"width":39.97821350762527,"height":83.87096774193547,"action":{"library":"H5P.AdvancedText 1.1","params":{"text":"

1.<\/strong><\/span><\/p>\n\n

\n
\n
\n
\n
\n
\n2.<\/strong><\/span><\/p>\n\n

<\/p>\n\n

3.<\/strong><\/span>
\n <\/p>\n\n

4.<\/strong><\/span><\/p>\n"},"subContentId":"3927620a-3f58-4883-952f-69e9fcc336bd","metadata":{"contentType":"Text","license":"U","title":"Untitled Text"}},"alwaysDisplayComments":false,"backgroundOpacity":0,"displayAsButton":false,"buttonSize":"big","goToSlideType":"specified","invisible":false,"solution":""}],"slideBackgroundSelector":{}},{"elements":[{"x":8.714596949891067,"y":4.270838709677419,"width":88.23529411764706,"height":79.56989247311827,"action":{"library":"H5P.Shape 1.0","params":{"shape":{"fillColor":"rgba(120, 218, 249, 0.817)","borderWidth":"2","borderStyle":"solid","borderColor":"rgb(0, 0, 0)","borderRadius":"0"},"type":"rectangle","line":{"borderColor":"#000000","borderWidth":"1","borderStyle":"solid"}},"metadata":{"contentType":"Shapes","license":"U"},"subContentId":"36382f24-f10b-4208-95a9-a6d85dbd08ae"},"backgroundOpacity":0,"displayAsButton":false,"buttonSize":"big","goToSlideType":"specified","invisible":false},{"x":11.982570806100219,"y":8.575268817204302,"width":83.87799564270152,"height":77.41935483870967,"action":{"library":"H5P.AdvancedText 1.1","params":{"text":"

For intolerance (grade 3-4) to Lzd (600 mg daily) in patients after 9 weeks of treatment initiation on BPaLM regimen, all attempts must be made to continue Linezolid at lower dose after the management of the side-effect for the entire duration of treatment.
\n
\nAll efforts must be made to ensure that the patient consumes Lzd at full or lower dose up to at least 26-39 weeks of treatment to consider counting the drug efficacy.<\/p>\n\n

The patient must be sent to the N\/DDR TB center for detailed assessment regarding the temporary interruption, reintroduction of Linezolid at full dose or reintroduction at lower dose to the patient.<\/p>\n\n

In case of reduction in the dose of Linezolid, the treatment must be extended upto 39 weeks and the patient must be followed up, more frequently by the physician clinically, radiologically and microbiologically.<\/p>\n\n

After all efforts, in case the side-effects are worsening, the regimen must be stopped, and the patient must be shifted to individualized longer oral M\/XDR-TB regimen by the N\/DDR TB Center.<\/p>\n"},"subContentId":"c2eb8465-82ca-4f2c-b6fb-0bd0e7a6fb8b","metadata":{"contentType":"Text","license":"U","title":"Untitled Text"}},"alwaysDisplayComments":false,"backgroundOpacity":0,"displayAsButton":false,"buttonSize":"big","goToSlideType":"specified","invisible":false,"solution":""},{"x":2.178649237472767,"y":4.29436559139785,"width":6.5359477124183005,"height":79.56989247311827,"action":{"library":"H5P.Shape 1.0","params":{"shape":{"fillColor":"rgb(0, 216, 255)","borderWidth":"2","borderStyle":"solid","borderColor":"rgb(0, 0, 0)","borderRadius":"0"},"type":"rectangle","line":{"borderColor":"#000000","borderWidth":"1","borderStyle":"solid"}},"metadata":{"contentType":"Shapes","license":"U"},"subContentId":"4f527151-6948-48d8-b456-a4b9a0d44435"},"backgroundOpacity":0,"displayAsButton":false,"buttonSize":"big","goToSlideType":"specified","invisible":false},{"x":4.357298474945534,"y":10.75268817204301,"width":2.6143790849673203,"height":8.602150537634408,"action":{"library":"H5P.AdvancedText 1.1","params":{"text":"

5.<\/strong><\/span><\/p>\n"},"subContentId":"257b4848-1597-4116-96ac-57bd66052b26","metadata":{"contentType":"Text","license":"U","title":"Untitled Text"}},"alwaysDisplayComments":false,"backgroundOpacity":0,"displayAsButton":false,"buttonSize":"big","goToSlideType":"specified","invisible":false,"solution":""},{"x":4.357298474945534,"y":25.77290322580645,"width":6.5359477124183005,"height":12.903225806451612,"action":{"library":"H5P.Shape 1.0","params":{"shape":{"fillColor":"rgb(0, 216, 255)","borderWidth":"0","borderStyle":"solid","borderColor":"#000","borderRadius":"0"},"type":"circle","line":{"borderColor":"#000000","borderWidth":"1","borderStyle":"solid"}},"subContentId":"4e3eac27-bd46-4c65-81dc-861804a402cb","metadata":{"contentType":"Shapes","license":"U"}},"backgroundOpacity":0,"displayAsButton":false,"buttonSize":"big","goToSlideType":"specified","invisible":false},{"x":4.357298474945534,"y":38.70967741935483,"width":6.5359477124183005,"height":12.903225806451612,"action":{"library":"H5P.Shape 1.0","params":{"shape":{"fillColor":"rgb(0, 216, 255)","borderWidth":"0","borderStyle":"solid","borderColor":"#000","borderRadius":"0"},"type":"circle","line":{"borderColor":"#000000","borderWidth":"1","borderStyle":"solid"}},"metadata":{"contentType":"Shapes","license":"U"},"subContentId":"f5d13246-b27f-407a-9ffb-83114729ac9f"},"backgroundOpacity":0,"displayAsButton":false,"buttonSize":"big","goToSlideType":"specified","invisible":false},{"x":4.357298474945534,"y":51.61290322580645,"width":6.5359477124183005,"height":12.903225806451612,"action":{"library":"H5P.Shape 1.0","params":{"shape":{"fillColor":"rgb(0, 216, 255)","borderWidth":"0","borderStyle":"solid","borderColor":"#000","borderRadius":"0"},"type":"circle","line":{"borderColor":"#000000","borderWidth":"1","borderStyle":"solid"}},"metadata":{"contentType":"Shapes","license":"U"},"subContentId":"cbd0b610-e8e5-47bc-9344-9a73b72b1f5c"},"backgroundOpacity":0,"displayAsButton":false,"buttonSize":"big","goToSlideType":"specified","invisible":false},{"x":4.357298474945534,"y":66.66666666666666,"width":6.5359477124183005,"height":12.903225806451612,"action":{"library":"H5P.Shape 1.0","params":{"shape":{"fillColor":"rgb(0, 216, 255)","borderWidth":"0","borderStyle":"solid","borderColor":"#000","borderRadius":"0"},"type":"circle","line":{"borderColor":"#000000","borderWidth":"1","borderStyle":"solid"}},"metadata":{"contentType":"Shapes","license":"U"},"subContentId":"fdb78194-1f2b-422e-a278-aaef244a9d62"},"backgroundOpacity":0,"displayAsButton":false,"buttonSize":"big","goToSlideType":"specified","invisible":false},{"x":7.625272331154684,"y":30.10752688172043,"width":2.6143790849673203,"height":5.161290322580645,"action":{"library":"H5P.AdvancedText 1.1","params":{"text":"

a.<\/strong><\/span><\/p>\n"},"subContentId":"06eb3b1f-5da8-47e8-bb1f-132ed27d1b6c","metadata":{"contentType":"Text","license":"U","title":"Untitled Text"}},"alwaysDisplayComments":false,"backgroundOpacity":0,"displayAsButton":false,"buttonSize":"big","goToSlideType":"specified","invisible":false,"solution":""},{"x":7.625272331154684,"y":43.01075268817204,"width":2.6143790849673203,"height":5.161290322580645,"action":{"library":"H5P.AdvancedText 1.1","params":{"text":"

b.<\/strong><\/span><\/p>\n"},"metadata":{"contentType":"Text","license":"U","title":"Untitled Text"},"subContentId":"f52558dd-fbb3-46a3-b3a9-fedd77c25775"},"alwaysDisplayComments":false,"backgroundOpacity":0,"displayAsButton":false,"buttonSize":"big","goToSlideType":"specified","invisible":false,"solution":""},{"x":7.625272331154684,"y":55.91397849462365,"width":2.6143790849673203,"height":5.161290322580645,"action":{"library":"H5P.AdvancedText 1.1","params":{"text":"

c.<\/strong><\/span><\/p>\n"},"metadata":{"contentType":"Text","license":"U","title":"Untitled Text"},"subContentId":"5d73f3ec-5a97-4fa6-84b5-f0df2e5f12a1"},"alwaysDisplayComments":false,"backgroundOpacity":0,"displayAsButton":false,"buttonSize":"big","goToSlideType":"specified","invisible":false,"solution":""},{"x":7.625272331154684,"y":70.96774193548387,"width":2.6143790849673203,"height":5.161290322580645,"action":{"library":"H5P.AdvancedText 1.1","params":{"text":"

d.<\/strong><\/span><\/p>\n"},"metadata":{"contentType":"Text","license":"U","title":"Untitled Text"},"subContentId":"0d458ce2-bd12-4652-96c5-d92736cc012e"},"alwaysDisplayComments":false,"backgroundOpacity":0,"displayAsButton":false,"buttonSize":"big","goToSlideType":"specified","invisible":false,"solution":""}],"slideBackgroundSelector":{}}],"keywordListEnabled":true,"globalBackgroundSelector":{},"keywordListAlwaysShow":false,"keywordListAutoHide":false,"keywordListOpacity":90},"override":{"activeSurface":false,"hideSummarySlide":false,"summarySlideSolutionButton":true,"summarySlideRetryButton":true,"enablePrintButton":false,"social":{"showFacebookShare":false,"facebookShare":{"url":"@currentpageurl","quote":"I scored @score out of @maxScore on a task at @currentpageurl."},"showTwitterShare":false,"twitterShare":{"statement":"I scored @score out of @maxScore on a task at @currentpageurl.","url":"@currentpageurl","hashtags":"h5p, course"},"showGoogleShare":false,"googleShareUrl":"@currentpageurl"}},"l10n":{"slide":"Slide","score":"Score","yourScore":"Your Score","maxScore":"Max Score","total":"Total","totalScore":"Total Score","showSolutions":"Show solutions","retry":"Retry","exportAnswers":"Export text","hideKeywords":"Hide sidebar navigation menu","showKeywords":"Show sidebar navigation menu","fullscreen":"Fullscreen","exitFullscreen":"Exit fullscreen","prevSlide":"Previous slide","nextSlide":"Next slide","currentSlide":"Current slide","lastSlide":"Last slide","solutionModeTitle":"Exit solution mode","solutionModeText":"Solution Mode","summaryMultipleTaskText":"Multiple tasks","scoreMessage":"You achieved:","shareFacebook":"Share on Facebook","shareTwitter":"Share on Twitter","shareGoogle":"Share on Google+","summary":"Summary","solutionsButtonTitle":"Show comments","printTitle":"Print","printIngress":"How would you like to print this presentation?","printAllSlides":"Print all slides","printCurrentSlide":"Print current slide","noTitle":"No title","accessibilitySlideNavigationExplanation":"Use left and right arrow to change slide in that direction whenever canvas is selected.","accessibilityCanvasLabel":"Presentation canvas. Use left and right arrow to move between slides.","accessibilityProgressBarLabel":"Choose slide to display","containsNotCompleted":"@slideName contains not completed interaction","containsCompleted":"@slideName contains completed interaction","slideCount":"Slide @index of @total","containsOnlyCorrect":"@slideName only has correct answers","containsIncorrectAnswers":"@slideName has incorrect answers","shareResult":"Share Result","accessibilityTotalScore":"You got @score of @maxScore points in total","accessibilityEnteredFullscreen":"Entered fullscreen","accessibilityExitedFullscreen":"Exited fullscreen","confirmDialogHeader":"Submit your answers","confirmDialogText":"This will submit your results, do you want to continue?","confirmDialogConfirmText":"Submit and see results","slideshowNavigationLabel":"Slideshow navigation"}}

Search

Implementation Consideration for BPaLM regimen

Content Status

Type

Linked Node

Implementation Consideration for BPaLM regimen

Content Creator

Reviewer