Friday, April 5, 2013

Second-line anti tubercular drugs


Second-line anti tubercular drugs

These types of drugs are mostly used as an alternative to the tuberculosis therapy. In most cases, second-line anti-tubercular drugs are preserved for TB victims with special conditions. This is especially when; a patient exhibits resistance to the first-line tubercular drugs (therapy) or cases of MDR-TB (multidrug-resistance) occurring.

There exist 6 categories of the second-line tubercular drugs used as medication for TB. There are various reasons as to why a drug may be classified as a second-line tubercular drug and they include:
·        Effectiveness – less effective than the first line tubercular drugs (p-aminosalicylic acid)
·        Exhibition of toxic side-effects (cycloserine)
·        Availability – it may be hard to find in developing countries (flouroquinolones)

Second-line drugs include:

·        Aminoglycosides (amikacin – AMK, kanamycin – KM)
·        Flouroquinolones ( CIP – ciprofloxacin, moxifloxaci – MXF, leyoflaxacin)
·        Polypeptides (enviomycin, capromycin, viomycin)
·        Terizidone
·        Cycloserinee (closerine)
·        Thioamides ( prothionamide, ethionamide)

Side-effects of second-line anti-tubercular drugs

Since anti TB therapy involves a broad spectrum of drugs dispensed for a long time with regard to the TB infection characteristics; relapses, MDR – TB and XDR – TB, failures as well as re – infections, chances of experiencing adverse side-effects are high. 
Side-effects of the second-line anti-tubercular drugs naturally occur to patients undertaking their first anti-TB therapy especially so cases of drug resistance. Emergence side-effects occur in patients depending on the exhibited characteristics but may also depend on the concomitant used during therapy. However, risk factors such as HIV and AIDS infections, MDR – TB treatment, age, diabetes, smoking and adjustment to potential confounders increase the degree of side-effects in patients.

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