Tuberculosis (TB) is the most dangerous infectious disease of the world, and it must be treated with certain drugs that fall under the category of anti-TB drugs. Besides infection treatment, most patients in a hospital or other healthcare system need intravenous (IV) fluids for hydration, nutrition, or drug delivery. Details about both anti-TB drugs and IV fluids are relevant to clinicians, students, and even cured patients.
Mechanism and Classes of Anti-TB Drugs:
Anti-tubercular treatment is focused on eliminating Mycobacterium tuberculosis, the causative bacterium of TB. The treatment is meant to treat the disease, avoid relapse, and avoid transmission. TB treatment typically employs a combination of medication administered simultaneously for a prolonged duration of time in a bid to avert resistance.
. First-Line Anti-TB Drugs
These are the most effective and most commonly used medications in drug-sensitive TB.
- Isoniazid (INH): Bactericidal agent that inhibits mycolic acid synthesis, which is part of the bacterial cell wall.
- Pyrazinamide (PZA): Active in acid environments such as intracellularly in macrophages, against resting bacteria.
- Ethambutol (EMB): Interferes with cell wall synthesis and blocks resistance in combination.
- Streptomycin: Aminoglycoside that inhibits protein synthesis, reserved for severe infection or where oral treatment is not possible.
- These are typically administered together in a reduced-course chemotherapy regimen (e.g., 2 months INH, RIF, PZA, EMB, then 4 months INH and RIF).
. Second-Line Anti-TB Drugs
- It is Reserved for the treatment of resistant first-line drug-TB (MDR-TB or XDR-TB).
- Fluoroquinolones (levofloxacin, moxifloxacin)
- Injectable agents (amikacin, kanamycin, capreomycin)
- Other oral agents (ethionamide, cycloserine, para-aminosalicylic acid)
. New and Repurposed Drugs
- Bedaquiline: Binds to TB bacillus ATP synthase.
- Delamanid: Inhibits mycolic acid synthesis, particularly in MDR-TB.
- Linezolid: Utilized in drug-resistant TB since it has the potential to inhibit protein synthesis.
Key Anti-TB Treatment Points
- Duration: 6 months typically for drug-susceptible TB; more so in drug-resistant types.
- Adherence: Compelling with adherence to avoid drug resistance and treatment failure.
- DOTS Strategy: Directly Observed Treatment, Short-course patients are compelled to take medication on a daily basis under observation.
- Side Effects: Hepatotoxicity (INH, RIF, PZA), optic neuritis (EMB), ototoxicity (streptomycin).
. Fluids: Types and Uses
Intravenous fluids are used in the administration of medicine when patients are unable to be hydrated or electrolyte balanced by mouth. They can be used to restore the volume of fluids, hence restoring the electrolyte balance, administer drugs, and administer nutrition.
. Crystalloids
- Consist of water and electrolytes that can traverse cell membranes freely.
- Normal Saline (0.9% NaCl): In fluid resuscitation, shock, dehydration, and hyponatremia.
- Ringer’s Lactate (RL): Sodium, potassium, calcium, lactate; administered in burns, dehydration, and surgery.
- Dextrose Solutions (5% Dextrose, D10W): Gives calories and fluid, particularly in hypoglycemia.
- Advantages: Inexpensive, readily available.
- Disadvantages: Edema with large volume use.
. Colloids
- Have large molecules that are longer in the circulation.
- Albumin: Administered in severe burn, liver failure, or shock.
- Dextran: Increases plasma but has potential for allergic reaction.
- Hydroxyethyl starch (HES): Volume expansion, but potential for renal damage.
- Pros: Longer intravascular half-life.
- Cons: More costly, risk for allergic reaction.
. Blood and Blood Products
- Packed Red Blood Cells (PRBCs): Severe anemia or severe blood loss.
- Fresh Frozen Plasma (FFP): Clotting disorders.
- Platelets: Thrombocytopenia or bleeding disorders.
The Right IV Fluid
Dependent on:
- Patient’s status: Dehydration, shock, burns, surgery.
- Electrolyte level: Sodium, potassium, calcium.
- Purpose: Resuscitation, replacement, or maintenance.
Example:
- Shock: Ringer’s lactate or normal saline.
- Hypoglycemia: Dextrose solution.
- Severe burns: Ringer’s lactate.
- Protein loss: Albumin.
Conclusion:
Anti-TB therapy and IV fluid types and uses of hydration are crucial pillars of patient management. The Anti-TB drugs cure a potentially life-threatening infectious disease, and IV hydration will help in replenishing the vital hydration, electrolytes, and nutrients.
Lynn Martelli is an editor at Readability. She received her MFA in Creative Writing from Antioch University and has worked as an editor for over 10 years. Lynn has edited a wide variety of books, including fiction, non-fiction, memoirs, and more. In her free time, Lynn enjoys reading, writing, and spending time with her family and friends.
