(a)
Positive take--10 mm induration or more.
(b) Doubtful take--5 mm through 9 mm induration.
(c)
Negative take--less than 5 mm induration.
(3) Conversion. Conversion refers to a positive reaction that has occurred
within one year after a known negative reaction. If the person tested is under 35 years
old, begin treatment for tuberculosis immediately.
6-5.
GENERAL CARE
How rapidly and/or how well tuberculosis lesions heal depends on two factors:
specific drug treatment and the body's defense mechanism. Bed rest is necessary only
if the patient has a fever, hemoptysis (blood-stained sputum), or a severe cough. A
patient with any of these symptoms may need a few weeks of bed rest. The patient
whose sputum contains tuberculosis bacilli should be isolated until effective treatment
has been given for at least two weeks. Generally, these and other patients whose drug
treatment has been established can return to normal physical activity.
6-6.
DRUG THERAPY
Drug treatment must continue for at least eighteen to twenty-four months. A
minimum of two drugs should be used concurrently, but there is a strong trend toward
the use of three drugs. Drug therapy appears to be most effective when taken in a
simple daily dose on an empty stomach.
a. Isoniazid.
(1) Drug use. Isoniazid (INH) should always be included in the original
treatmentand always used in conjunction with other anti-tuberculosis drugs. The dosage for
adults is 5 mg/kg per day up to 300 mg per day. This is the most effective drug at the
present time; however, there may be adverse reactions.
(2) Adverse reactions. If the dosage is the usual 5 mg/kg daily, adverse
reactions to isoniazid are unusual. Cases of hepatitis thought to have been caused by
the drug have been reported. If the patient has a liver dysfunction, be cautious in
prescribing the drug. Tell patients to be sure to stop taking the drug and notify the
doctor if any adverse signs/symptoms occur. A patient taking large doses of isoniazid
may experience peripheral neuropathy (disturbances in the peripheral nervous system)
and, occasionally, central nervous system irritability caused by depletion of pyridoxine,
one of the forms of vitamin B6. Urine retention is another possible adverse reaction
from isoniazid.
MD0568
6-5