Clinical Manual for Management of the HIV-Infected ... - myCME.com

Table 3. Monitoring for Toxicity
Side Effects Drugs Likely
Responsible
Minor Side Effects
Anorexia,
nausea,
abdominal pain
Management
Rifampin Give dose last thing at night
Joint pain Pyrazinamide Aspirin or nonsteroidal antiinflammatory
drugs
Burning in feet,
neuropathy
Isoniazid Pyridoxine 50-75 mg daily
Orange/red urine Rifampin Reassurance
Major Side Effects
Severe rash or
skin itching
Decreased
hearing,
deafness (rule
out wax in ears)
Dizziness,
vertigo,
nystagmus
Thiacetazone,
streptomycin
Jaundice Pyrazinamide,
isoniazid,
rifampin
Vomiting and
confusion
Visual
impairment
Generalized
hypersensitivity
reaction with
shock and
purpura
Stop TB therapy for severe
reactions; give supportive care;
after resolution of symptoms,
reinstitute therapy (see text)
Streptomycin Substitute ethambutol or other
Streptomycin Substitute ethambutol or other
Pyrazinamide,
isoniazid,
rifampin
Stop TB treatment until jaundice
resolves (see text)
Stop TB treatment and perform
liver function tests
Ethambutol Stop ethambutol
Rifampin Stop rifampin
Source: Harries A, Maher D, Graham S. TB/HIV: A Clinical Manual, second edition. 2004. World Health
Organization, Geneva.
References
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