Antituberculars are medications used to treat tuberculosis. Tuberculosis (also called consumption) was an epidemic disease until the advent of antibiotics.
There were many treatments, some mildly effective (such as collapsing the affected lung, rest and good nutrition, and sanatoriums in high mountain areas - probably due to ultraviolet destruction of exhaled tuberculosis bacilli, so the patients were not continuously getting reinfected), some downright dangerous (such as medications containing arsenic, mercury or other toxic compounds, bloodletting and other quack remedies).
With the advent of antibiotics, tuberculosis seemed a thing of the past, and many health agencies trumpeted confidently about the eradication of tuberculosis, just as smallpox had been eradicated. Unfortunately, improper antibiotic use has led to the development of multi-drug resistant tuberculosis. The populations at highest risk in the US include people with AIDS, IV drug users, homeless people and illegal immigrants. Much of this group is also among those least likely to adhere to the very rigorous, uncomfortable (due to side effects) and prolonged treatment regimen necessary to kill tuberculosis bacilli.
Frequently people (of all walks of life) with tuberculosis take the medications until their symptoms subside, then stop. (Sound familiar? I admit, me too...)This wipes out a large amount of the bacterial population, but tuberculosis bacilli have the bad habit of forming cavities inside the lung which the body walls off with fibrous tissue and calcification. This prevents the bacteria from invading farther, but it also prevents white blood cells and drugs from reaching the bacilli inside. After a variable period of time, these cavities become filled with a cheesy material swarming with bacilli (caseous tubercle). If the cavity erodes into a bronchiole, the tuberculosis bacilli are released back into the lung to wreak havoc once again.
Because of the incidence of multi-drug resistant tuberculosis, the treatment for tuberculosis consists of a combination of several medications for anywhere from 9 months to 2 years.
Antituberculars
Brand/Generic Drug Names
Myambutal/ethambutol, Laniazid/isoniazid, Rifadin/rifampin, streptomycin, Mycobutin/rifabutin, Seromycin/cycloserine, Trecator/ethionamide, Nemasol/aminosalicylate sodium, Capastat/capreomycin, Tebrazid/pyrazinamide
Common uses
pulmonary tuberculosis
Pharmacology
inhibit RNA or DNA, interfere with lipid or protein synthesis, decreasing tubercle bacillus production
Class contraindications
severe kidney disease, hypersensitivity
Class precautions
pregnancy, breastfeeding, liver disease
Interactions
varies by drug
Adverse Reactions
nausea, vomiting, anorexia, rash, renal failure, nephrotoxicity, ototoxicity, hepatic necrosis
Additional Information
Assess liver and kidney function, anemia
Ensure culture and sensitivity is performed before initiating therapy
Evaluate therapeutic response: decreased tuberculosis symptoms, negative culture and sensitivity
Date of most recent Update
August 08, 2002
Further information is available in the writeup for the
specific name(s) of this medication class