"We must restart the drugs, but we will use the anti tuberculosis drug with no heaptotoxic effect,"

"We must restart the drugs, but we will use the anti tuberculosis drug with no heaptotoxic effect, very carefully, the regimen of anti tuberculosis drugs are Rifampisin, Isoniazid, and ethambutol. With monitoring liver function.



You guide Nurse Rina through a sequential re-challenge via telemedicine:

1    Ethambutol 500 mg is given for 3 days -> LFTs remain normal.

2    Rifampicin 450. mg is added for 3 days -> LFTs remain normal.

3    Isoniazid 300 mg is added for 3 days -> LFTs rise (AST 150, ALT 180).

4    Isoniazid is stopped. LFTs return to normal.

 

 What is your plan for the final regimen of anti tuberculosis drug?


  • "We should refer the patient to the hospital to get abdominal ultrasonography, so we can find the cause of liver disease."
  • "We should continue the isoniazid but only 150 mg per day"
  • 'We will stop the isoniazid, and we will add the Levofloxacin for the TB regiment
  • "The regimen will be Rifampisin, Isoniazid, and ethambutol. But we will give the patient curcuma three times daily."

Map: Yellow Skin and Worsened Cough (1129)
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  • "We must restart the drugs, but we will use the anti tuberculosis drug with no heaptotoxic effect,"

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