DECISION POINT

The patient's wife, who is now present, asks via teleconference, "Doc, I read that you can't stop TB medicine. My husband has been off it for 10 days. Won't his TB become resistant? When do we start the medicine again?"

This is a difficult clinical decision: Balancing the risk of DILI recurrence versus the risk of untreated or resistant TB.

What is your plan?

  • "The risk is too great. Stop all OAT permanently. His cough is better anyway."
  • "We must restart the drugs, but we will use the anti tuberculosis drug with no heaptotoxic effect,"
  • "His liver function has improved. Let's restart the 4-FDC, and also we will give the hepatoprotector supllement. We must treat his TB."
  • "Just switch all his drugs to second-line medicines like Levofloxacin and stretopmycin. The anti tuberculosis drug standard drugs are too dangerous."

Map: Yellow skin and worsened cough (1129)
Node: 21501
Score:

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  • Osmosis in animal cell practical
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