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PEDIATRIC TUBERCULOSIS
The
tuberculosis in children
upto 14 years.
The RNTCP Revised National
Tuberculosis Control Programme
OBJECTIVES
To
Ensuring
cure
Minimizing relapses
Preventing development of drug resistance
To
PRINCIPLES
Appropriate
combination of at least
4 anti tubercular drugs to avoid
drug resistance
Prescription of correct dosage
To be taken regularly and for the
prescribed duration to prevent the
relapse after combination
COMPONENTS
Domicilliary
treatment
As
Short
course chemotherapy
Treatment
CONTD.
Intermittent
As
regimen
Direct
observation of treatment
Ensures
adherence
CONTD.
The
CASE DEFINITIONS
New
Relapse:
Treatment
CONTD.
Pulmonary
CONTD
Failure
ANTI-TUBERCULAR DRUGS
The
activity
Sterilizing activity
The ability to prevent resistance.
CONTD
The
Isoniazid(H)s
Rifampicin
(R)
Pyrazinamide (Z)
Streptomycin (S)
Ethambutol (E)
Isoniazid(10mg/kg) for 6 months in
children for chemoprophylaxis who are
in contact with active tuberculosis even
though we give BCG vaccination
CONTD
Isoniazid,
Rifampicin, pyrazinamide
and streptomycin are the most
powerful bactericidal drugs.
Rifampicin
is the most potent
sterilizing drug
Ethambutol is used in association
with more powerful drugs to prevent
the
development
of
resistant
Tubercular bacilli
CONTD
After
DOSAGES
The
CATEGORIZATION
There
kg
9-12 kg
13-16 kg,
17-20 kg
21-24 kg
25-30 kg.
CONTD
The
categorization
of
patients are the same as in
adultsIntensification
phase-2months
Continuation phase- 6 months
INSTRUCTIONS
CONTD
The
CONTD
The
anti-tubercular
drugs
have
bactericidal effect even after withdrawal
as referred to as lag period needs to be
remembered.
The antitubercular drugs have common
side effects which the nurse has to
inform the parents about like the
jaundice when taking isoniazid, Rifampicin
and pyrazinamide while ethambutol has
impaired vision as the side effect.
CONTD
Check the physicians order before administering
the drugs.
Read the medication label carefully as many
products come in similar wrappers, colors and
shapes.
Follow the 10 rights of drug administration while
administering the drug.
CONTD
The drugs can be crushed and administered to
the patients when the child has difficulty in
swallowing the drugs.
The child who is able to swallow the drug, the
nurse has to place the drug under the tongue.
The nurse needs to chart the administration of
drug in the treatment card with date, time and
dose.
Monitor the after affects of the drugs and
report if nay abnormal findings to the physician.
The drug Rifampicin needs to be taken 1 hour
before meal or 2 hours after meals
DRUG ADMINISTRATION
It
NURSING RESPONSIBILITES
Adherence
Nutrition
Counseling
Lifestyle
Precautions
Side
effects