Pulmonary Tuberculosis

• Bacterial infectious disease caused by Mycobacterium Tuberculosis

and spread via airborne droplets when infected persons cough, sneeze,
or laugh.
• Once inhaled, the organisms implant themselves in the lung and begin
dividing slowly causing inflammation, development of the primary
tubercle, and eventual caseation and fibrosis.
• Infection spreads via the lymph and circulatory systems.
• Men affected more often than women. The greatest number of cases
occurs in persons age 65 and over. Socially and economically
disadvantaged, alcoholic, and malnourished individual are affected
more often.
• The causative agent, M. Tuberculosis, is an AEROBIC acid- fast bacillus
spread via droplet nuclei from infected persons.

Classification of Pulmonary Tuberculosis

• Class 0: no exposure, no infection
• Class 1: exposure; no infection
• Class 2: infection; no disease (+PPD reaction but no clinical evidence
of
active TB)
• Class 3: disease clinically active
• Class 4: disease not clinically active
• Class 5: suspected disease, diagnosis pending

Assessment
• Chronic cough (sometimes with yellow mucoid sputum), dyspnea, frank
hemoptysis, rales or crackles.
• Anorexia, malaise, weight loss, afternoon low-grade fever, pallor, pain,
fatigue, night sweats.
Diagnostic tests
• Chest x-ray- indicates presence and extent of disease
process but cannot differentiate active from inactive form.
• Skin test (PPD) positive; area of induration 10mm or more
in diameter after 48 hours.
• Sputum positive for Acid-Fast Bacillus(AFB)- three samples
in diagnostic for disease
• Culture positive- most definitive diagnosis is made
• WBC and ESR increased

Client education guide: PTB

• TB is infectious; it may be cured or arrested by medications.
• TB is transmitted by droplet infection.
• Cover nose and mouth when coughing, sneezing or laughing.
• Wash hands after any contact with body substances, masks or soiled
tissues
• Wear masks when advised
• Take medications regularly, as prescribed. Multiple drug therapy is
important to reduce the occurrence of mycobacterium resistance.

Medications
Primary Anti-TB Drugs
• Isoniazid (INH) – May be used at any age and among pregnant women.
Side effects: peripheral neuritis, hepatotoxicity
Administer Vitamin B6 (pyridoxine) to prevent peripheral
neuritis
Monitor ALT (SGPT), AST (SGOT)
Used as prophylaxis for 6 months to 1 year
• Streptomycin
 Side effects: ototoxicity, nephrotoxicity

• Rifampicin
Side effects: red orange color to body secretions, hepatotoxicity,
nausea and vomiting, thrombocytopenia
• Pyrazinamide
Side effects: increased uric acid in the blood (Hyperuricemia)
• Ethambutol
Side effects: optic neuritis, skin rash
Ophthalmologic examination at regular basis
NOTE: Evaluate effectiveness of anti- TB drugs by sputum culture for acid-
fast bacilli.
Anti- TB drugs must be taken in combination to avoid bacterial
resistance.
Drugs to be taken on empty stomach for maximum absorption.
PULMONARY
TUBERCULOSIS