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التحقق:: ما هي عاصمة فلسطين المحتلة ؟

الرسالة:: <p>[QUOTE="kinghamada, post: 53703"]<p style="text-align: left"><span style="color: #000000"><font face="Times New Roman">This is an approach to treatment of <a href="http://www.med4al.com/2025/07/tuberculosis-causes-risk-pathology.html" target="_blank" class="externalLink ProxyLink" data-proxy-href="http://www.med4al.com/2025/07/tuberculosis-causes-risk-pathology.html" rel="nofollow">Pulmonary tuberculosis </a>, with illustration of Drug doses , side effects, recommended course and possible combinations.</font></span></p> <p style="text-align: left"><span style="color: #000000"><font face="Times New Roman">We are going to discuss the differential diagnosis (DDx) of tuberculosis</font></span></p> <p style="text-align: left"><span style="color: #000000"><font face="Times New Roman"><b>A. Medical (Drug) treatment of Tuberculosis</b></font></span></p> <p style="text-align: left"><span style="color: #000000"><font face="Times New Roman"><br /></font></span></p> <p style="text-align: left"><span style="color: #000000"><font face="Times New Roman"><br /></font></span></p> <p style="text-align: left"><span style="color: #000000"><font face="Times New Roman">1- Bed rest and isolation of patients who are excreting the organism</font></span></p> <p style="text-align: left"><span style="color: #000000"><font face="Times New Roman">2- Good nourishment</font></span></p> <p style="text-align: left"><span style="color: #000000"><font face="Times New Roman">3- Drugs:</font></span></p> <p style="text-align: left"><span style="color: #000000"><font face="Times New Roman"><b>Rules </b></font></span></p> <p style="text-align: left"><span style="color: #000000"><font face="Times New Roman">1- Long course to avoid relapse</font></span></p> <p style="text-align: left"><span style="color: #000000"><font face="Times New Roman">2- Combinations to avoid resistance (at least two antimicrobial agents)</font></span></p> <p style="text-align: left"><span style="color: #000000"><font face="Times New Roman">3- Rifampicin shortens the course of treatment to 9 months.</font></span></p> <p style="text-align: left"><span style="color: #000000"><font face="Times New Roman">4- I N H must be used</font></span></p> <p style="text-align: left"><span style="color: #000000"><font face="Times New Roman">5- Side effects of drugs must be known.</font></span></p> <p style="text-align: left"><span style="color: #000000"><font face="Times New Roman"><br /></font></span></p> <p style="text-align: left"><span style="color: #000000"><font face="Times New Roman"><br /></font></span></p> <p style="text-align: left"><span style="color: #000000"><font face="Times New Roman"><b>Drugs</b></font></span></p> <p style="text-align: left"><span style="color: #000000"><font face="Times New Roman">• <b>I.N.H</b>: the most effective constant drug, it is bactericidal, it interferes with lipid and nucleic acid synthesis.</font></span></p> <p style="text-align: left"><span style="color: #000000"><font face="Times New Roman">Dose: 200-300 mg/day (5mg/kg)</font></span></p> <p style="text-align: left"><span style="color: #000000"><font face="Times New Roman">Side effects: hepatotoxicity, polyneuropathy. Pyridoxine 10 mg/d is given to prevent polyneuropathy.</font></span></p> <p style="text-align: left"><span style="color: #000000"><font face="Times New Roman"><br /></font></span></p> <p style="text-align: left"><span style="color: #000000"><font face="Times New Roman"><br /></font></span></p> <p style="text-align: left"><span style="color: #000000"><font face="Times New Roman"><br /></font></span></p> <p style="text-align: left"><span style="color: #000000"><font face="Times New Roman">INH is acetylated in the liver, so rapid acetylators are more liable to develop hepatitis</font></span></p> <p style="text-align: left"><span style="color: #000000"><font face="Times New Roman">due to the acetylated ****bolite, however slow acetylators are more liable to</font></span></p> <p style="text-align: left"><span style="color: #000000"><font face="Times New Roman">develop neuropathy.</font></span></p> <p style="text-align: left"><span style="color: #000000"><font face="Times New Roman"><br /></font></span></p> <p style="text-align: left"><span style="color: #000000"><font face="Times New Roman"><br /></font></span></p> <p style="text-align: left"><span style="color: #000000"><font face="Times New Roman">• <b>Streptomycin</b> (Bactericidal):</font></span></p> <p style="text-align: left"><span style="color: #000000"><font face="Times New Roman">- Dose: 1gm I.M daily</font></span></p> <p style="text-align: left"><span style="color: #000000"><font face="Times New Roman">- Main side effects: ototoxicity ( irreversible)</font></span></p> <p style="text-align: left"><span style="color: #000000"><font face="Times New Roman">• <b>Rifampicin</b> (Bactericidal, it inhibitis DNA dependent RNA polymerase) (10 mg/kg).</font></span></p> <p style="text-align: left"><span style="color: #000000"><font face="Times New Roman">450-600 mg/d, it is hepatotoxic, it also causes vasculititis, hypersensitivity nephritis and flu like symptoms.</font></span></p> <p style="text-align: left"><span style="color: #000000"><font face="Times New Roman"><br /></font></span></p> <p style="text-align: left"><span style="color: #000000"><font face="Times New Roman"><br /></font></span></p> <p style="text-align: left"><span style="color: #000000"><font face="Times New Roman">• <b>Ethambutol</b> ((Bacteriostatic inhibiting RNA synthesis)</font></span></p> <p style="text-align: left"><span style="color: #000000"><font face="Times New Roman">10-25 mg/kg, it leads to optic neuritis</font></span></p> <p style="text-align: left"><span style="color: #000000"><font face="Times New Roman"><br /></font></span></p> <p style="text-align: left"><span style="color: #000000"><font face="Times New Roman"><br /></font></span></p> <p style="text-align: left"><span style="color: #000000"><font face="Times New Roman">• <b>Pyrazinamid</b> (PZA) (Bactericidal)</font></span></p> <p style="text-align: left"><span style="color: #000000"><font face="Times New Roman">20- 30 mg/kg, (It may lead to hepatitis and hyperuricemia)</font></span></p> <p style="text-align: left"><span style="color: #000000"><font face="Times New Roman"><br /></font></span></p> <p style="text-align: left"><span style="color: #000000"><font face="Times New Roman">B- <b>Surgical ttt :</b></font></span></p><p style="text-align: left"><span style="color: #000000"><font face="Times New Roman"><span style="color: #000000"><font face="Times New Roman"><font size="4"><b><span style="color: Red">Read more at</span></b></font> : <a href="http://www.med4al.com/2025/07/treatment-tuberculosis-ddx.html" target="_blank" class="externalLink ProxyLink" data-proxy-href="http://www.med4al.com/2025/07/treatment-tuberculosis-ddx.html" rel="nofollow"><font size="5"><b><u>Treatment of Tuberculosis , regimens and differential diagnosis</u></b></font></a>   </font></span></p></font></span></p><p style="text-align: left"><span style="color: #000000"><font face="Times New Roman"><span style="color: #000000"><font face="Times New Roman"><br /></font></span></p></p> <p style="text-align: left"></font></span></p> <p style="text-align: left"><span style="color: #000000"><font face="Times New Roman"><br /></font></span></p> <p style="text-align: left"><span style="color: #000000"><font face="Times New Roman"><br /></font></span></p> <p style="text-align: left"><span style="color: #000000"><font face="Times New Roman"><br /></font></span></p> <p style="text-align: left"><br /></p><p>[/QUOTE]</p><p><br /></p>

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