Correct use of anti-tuberculosis drugs
Whether the anti-tuberculosis drugs are taken correctly or not directly affects the efficacy of the drugs. Even for the uniform drug type, the blood drug concentration and peak time are different depending on the mode of administration and the time of taking the drug. Oral anti-tuberculosis drugs are generally used once a day, and the method of fasting is best.
The correct method of taking rifampicin is to take an empty stomach 2 hours before the meal. Control studies showed that the peak plasma concentration of the eater was 36% lower than that of the fasting service, and the peak time was delayed. Fasting oral rifampicin is rapidly absorbed, and the peak blood concentration can be reached in 1-2 hours, and the effective blood concentration is maintained for 8-12 hours. The milk blushing with rifampicin, the blood concentration was nearly zero after 1-2 hours of taking the drug, and the lower peak blood concentration was extended to 6 hours, and the maintenance time was not prolonged. This will greatly affect the therapeutic effect of rifampicin.
Except for rifampicin, isoniazid, ethambutol and pyrazinamide are water-soluble preparations, which are mainly absorbed in the small intestine by diffusion through the mucosa. Isoniazid should be taken on an empty stomach and should be taken at the same time as antacids, especially aluminum hydroxide. Pyrazinamide is also preferred for fasting, not only beneficial for antibacterial effect, but also synergistic with other anti-tuberculosis drugs, but because the drug can cause different degrees of gastrointestinal reactions, those who cannot adapt can consider Take it in divided doses.
Medication in the form of a meal means that one day is taken at the same time. It is wrong to take the medicine in divided doses, which makes it difficult for the medicine to exert synergy, at least the antibacterial effect is insufficient. Isoniazid, rifampicin, ethambutol, pyrazinamide combined with four drugs, is conducive to killing the rapid growth and reproduction of the flora, is important for the recovery of tuberculosis.
For patients who are difficult to suffer from gastrointestinal irritation caused by rifampic drugs, they can be changed to bedtime at night. This is no different from the average blood concentration of fasting in the morning, and is above the minimum inhibitory concentration level.
Principles of anti-tuberculosis drugs
First, early medication:
As soon as possible, the bacteria grow and reproduce vigorously, the metabolism is active, sensitive to the drug; the blood supply to the lesion is rich, and the drug is easy to infiltrate; at the same time, the patient's body resistance is also strong, and the early medication is easy to control, which is conducive to cure.
Second, the combination of drugs:
It refers to the combination of two or more drugs according to different conditions and the characteristics of anti-tuberculosis drugs to enhance the efficacy, and can avoid serious adverse reactions and delay the emergence of drug resistance. 2-4 kinds of drugs are generally used, mainly to enhance the antibacterial effect, delay bacterial resistance, reduce adverse reactions, and cross-kill resistant strains.
Third, the right amount:
It means that the dosage should be appropriate. Insufficient dose, the drug in the tissue is difficult to reach an effective concentration, and it is easy to induce bacterial resistance to cause treatment failure; if the drug dose is too large, serious adverse reactions are likely to occur and the treatment is difficult to continue.
Fourth, adhere to the regular use of the drug:
The treatment of tuberculosis must be done regularly and regularly. It is not possible to change the dosage of the drug or change the variety of the drug at random, otherwise it will be difficult to obtain successful treatment. Tuberculosis is a disease that is prone to recurrence. Premature withdrawal of the drug will cause the repressed bacteria to reproduce or prolong, resulting in treatment failure. Tuberculosis medication is divided into two periods. First, the beginning of the treatment, the use of strong drugs without interruption treatment, so that the symptoms disappear as soon as possible, the bacteria turn negative, the condition is obviously improved, this period takes 3-6 months, also called the intensive stage. The second is radical treatment, according to the condition of the disease or a single drug for thorough treatment, in order to consolidate the efficacy and prevent recurrence, this period takes about 6-18 months, also called consolidation treatment stage.