Tuberculosis (TB) and Antimycobacterial Agents: In a Nutshell (Nursing)

00:01 So let's wrap this up.

00:02 TB is a disease caused by mycobacterium tuberculosis.

00:07 It spread by droplets in the air, coughing or sneezing and someone else inhales them, that’s when it spread.

00:14 It usually infects the lungs but it can also spread out to the brain, kidneys, or spine.

00:19 TB can be latent, meaning it's not contagious or active, it's a likely contagious.

00:25 So the medication treatment is highly recommended for latent TB to prevent future reactivation and if it is the extremely resistant doses we absolutely want them to get treatment because medication treatment for active TB MDR or XDR TB is essential.

00:42 Now we diagnose TB initially with the screening of positive skin and blood test and we confirm it with the chest x-ray and a sputum microbiological study.

00:51 First-line drugs for tuberculosis include isoniazid, rifampin, rifapentine, rifabutin, pyrazinamide, and ethambutol.

00:59 Those are a mouthful, but those are the ones that we use for first-line drugs.

01:04 Second-line drugs include the list that you see there started off with our friends a couple of antibiotics.

01:10 Now the CDC recommends - that’s the Center for Disease Control in the United States, recommends for latent TB infection, you also see that as LTBI, range from 130 to 182 doses in the intensive and continuation phases.

01:28 Remember we start out super strong in the intensive phase, we backed off a little bit in the continuation phase because we wanna get stragglers or the persisters.

01:36 Now, MDR TB and XDR TB required individualized treatment plans based on the resistance present in the TB mycobacterium.

01:43 So when you have a patient that’s been exposed to and is active MDR or XDR TB, they're gonna work very closely with the disease specialist to determine what's the best choice for this particular patient in this particular infection.

01:58 Now the Official American Thoracic Society Centers for Disease Control and Prevention/ Infectious Diseases Society of American Clinical Practice Guidelines recommends - that’s a lot, but we wanted you to know that we only brought you the highest level of recommendations - use INH, rifampin, pyrazinamide, and ethambutol, in the intensive phase of TB treatment.

02:22 The CDC also recommends use of isoniazid, and isoniazid plus rifapentine, or rifampin for the treatment of latent TB.

02:31 So that big old long lists, let's go back one more time even though we don’t always do that but I wanna make sure that you're clear on this.

02:39 When we're looking at the intensive phase of TB, we've got those four medications, so make sure as we're going through this you circle those: INH, rifampine, pyrazinamide, ethambutol.

02:52 You’ve got those all circled or underlined so they stand out for you.

02:56 Now, I put that old title who recommended that so you know that we didn’t just make that up.

03:01 These are the guidelines our country follows.

03:04 For latent TB, we've got a couple of plans there.

03:07 Make sure you have those underlined or circled there.

03:10 So keep in mind and please be compassionate with your patients because TB treatment is inconvenient.

03:18 It has uncomfortable side effects that you as a nurse play a really important role in helping those patients understand the benefits of consistent medication and adherence.

03:28 So be patient with them, listen to them, let them vent to you but gently remind them of the benefits to them, their family and their community when they follow an effective treatment plan.