Questions and Answers About TB
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TB Disease
How is TB disease treated?
What are the side effects of
drugs for TB?
Why do I need to take TB medicine
regularly?
How can I remember to take my
medicine?
How can I keep from spreading
TB?
What is multidrug-resistant
TB?
How is TB disease treated?
There is good news for people with TB disease! TB disease
can almost always be cured with medicine. But the medicine must
be taken as the doctor or nurse tells you.
The most common drugs used to fight TB are:
- isoniazid (INH)
- rifampin
- pyrazinamide
- ethambutol
- streptomycin
If you have TB disease, you will need to take several different
drugs. This is because there are many bacteria to be killed. Taking
several drugs will do a better job of killing all of the bacteria
and preventing them from becoming resistant to the drugs.
If you have TB of the lungs or throat, you are probably infectious.
You need to stay home from work or school so that you don't spread
TB bacteria to other people. After taking your medicine for a few
weeks, you will feel better and you may no longer be infectious
to others. Your doctor or nurse will tell you when you can return
to work or school.
Having TB should not stop you from leading a normal life. When
you are no longer infectious or feeling sick, you can do the same
things you did before you had TB. The medicine that you are taking
should not affect your strength, sexual function, or ability to
work. If you take your medicine as your doctor or nurse tells you,
the medicine will kill all the TB bacteria. This will keep you from
becoming sick again.
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What are the side effects of drugs for
TB?
Medicine for TB is relatively safe. Occasionally, the drugs
may cause side effects. Some side effects are minor problems. Others
are more serious. If you have a serious side effect, call your
doctor or nurse immediately. You may be told to stop taking
your medicine or to return to the clinic for tests.
The side effects listed below are serious. If you have any
of these symptoms, call your doctor or nurse immediately:
- no appetite
- nausea
- vomiting
- yellowish skin or eyes
- fever for 3 or more days
- abdominal pain
- tingling fingers or toes
- skin rash
- easy bleeding
- aching joints
- dizziness
- tingling or numbness around the mouth
- easy bruising
- blurred or changed vision
- ringing in the ears
- hearing loss
The side effects listed below are minor problems. If you
have any of these side effects, you can continue taking your medicine:
- Rifampin can turn urine, saliva, or tears orange. The doctor
or nurse may advise you not to wear soft contact lenses because
they may get stained.
- Rifampin can make you more sensitive to the sun. This means
you should use a good sunscreen and cover exposed areas so you
don't burn.
- Rifampin also makes birth control pills and implants less effective.
Women who take rifampin should use another form of birth control.
- If you are taking rifampin as well as methadone (used to treat
drug addiction), you may have withdrawal symptoms. Your doctor
or nurse may want to adjust your methadone dosage.
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Why do I need to take TB medicine regularly?
TB bacteria die very slowly. It takes at least 6 months
for the medicine to kill all the TB bacteria. You will probably
start feeling well after only a few weeks of treatment. But beware!
The TB bacteria are still alive in your body. You must continue
to take your medicine until all the TB bacteria are dead, even though
you may feel better and have no more symptoms of TB disease.
If you don't continue taking your medicine or you aren't taking
your medicine regularly, this can be very dangerous. The TB bacteria
will grow again and you will remain sick for a longer time. The
bacteria may also become resistant to the drugs you are taking.
You may need new, different drugs to kill the TB bacteria if the
old drugs no longer work. These new drugs must be taken for a longer
time and usually have more serious side effects.
If you become infectious again, you could give TB bacteria to your
family, friends, or anyone else who spends time with you. It is
very important to take your medicine the way your doctor
or nurse tells you.
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How can I remember to take my medicine?
The only way to get well is to take your medicine exactly
as your doctor or nurse tells you. This may not be easy! You will
be taking your medicine for a long time (6 months or longer), so
you should get into a routine. Here are some ways to remember to
take your medicine:
- Participate in the directly observed therapy (DOT) program at
your health department.
- Take your pills at the same time every day -- for example, you
can take them before eating breakfast, during a coffee break,
or after brushing your teeth.
- Ask a family member or a friend to remind you to take your pills.
- Mark off each day on a calendar as your take your medicine.
- Put your pills in a weekly pill dispenser. Keep it by your bed
or in your purse or pocket.
NOTE: Remember to keep all medicine out of reach of children.
If you forget to take your pills one day, skip that dose and take
the next scheduled dose. Tell your doctor or nurse that you missed
a dose. You may also call your doctor or nurse for instructions.
The best way to remember to take your medicine is to get directly
observed therapy (DOT). If you get DOT, you will meet with a health
care worker every day or several times a week. You will meet at
a place you both agree on. This can be the TB clinic, your home
or work, or any other convenient location. You will take your medicine
at this place.
DOT helps in several ways. The health care worker can help you
remember to take your medicine and complete your treatment. This
means you will get well as soon as possible. With DOT, you may need
to take medicine only 2 or 3 times each week instead of every day.
The health care worker will make sure that the medicine is working
as it should. This person will also watch for side effects and answer
questions you have about TB.
Even if you are not getting DOT, you must be checked at different
times to make sure everything is going well. You should see your
doctor or nurse regularly while you are taking your medicine. This
will continue until you are cured.
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How can I keep from spreading TB?
The most important way to keep from spreading TB is to
take all your medicine, exactly as directed by your doctor or nurse.
You should also keep all of your clinic appointments! Your doctor
or nurse needs to see how you are doing. You may need another chest
x-ray or a test of the phlegm you may cough up. These tests will
show whether the medicine is working. They will also show whether
you can still give TB bacteria to others. Be sure to tell the doctor
about anything you think is wrong.
If you are sick enough with TB to go to a hospital, you may be
put in a special room. These rooms use air vents that keep TB bacteria
from spreading. People who work in these rooms must wear a special
face mask to protect themselves from TB bacteria. You must stay
in the room so that you will not spread TB bacteria to other people.
Ask a nurse if you need anything that is not in your room.
If you are infectious while you are at home, there are certain
things you can do to protect yourself and others near you. Your
doctor may tell you to follow these guidelines to protect yourself
and others:
- The most important thing is to take your medicine.
- Always cover your mouth with a tissue when you cough, sneeze,
or laugh. Put the tissue in a closed paper sack and throw it away.
- Do not go to work or school. Separate yourself from others and
avoid close contact with anyone. Sleep in a bedroom away from
other family members.
- Air out your room often to the outside of the building (if it
is not too cold outside). TB spreads in small closed spaces where
air doesn't move. Put a fan in your window to blow out (exhaust)
air that may be filled with TB bacteria. If you open other windows
in the room, the fan also will pull in fresh air. This will reduce
the chances that TB bacteria stay in the room and infect someone
who breathes the air.
Remember, TB is spread through the air. People cannot get infected
with TB bacteria through handshakes, sitting on toilet seats, or
sharing dishes and utensils with someone who has TB.
After you take medicine for about 2 or 3 weeks, you may no longer
be able to spread TB bacteria to others. If your doctor or nurse
agrees, you will be able to go back to your daily routine. Remember,
you will get well only if your take your medicine exactly as your
doctor or nurse tells you.
Think about people who may have spent time with you, such as
family members, close friends, and coworkers. The local health department
may need to test them for latent TB infection. TB is especially
dangerous for children and people with HIV infection. If infected
with TB bacteria, these people need preventive therapy right away
to keep from developing TB disease.
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What is multidrug-resistant TB (MDR TB)?
When TB patients do not take their medicine as prescribed,
the TB bacteria may become resistant to a certain drug. This means
that the drug can no longer kill the bacteria.
Drug resistance is more common in people who:
- have spent time with someone with drug-resistant TB disease
- do not take their medicine regularly
- do not take all of their prescribed medicine
- develop TB disease again, after having taken TB medicine in
the past
- come from areas where drug-resistant TB is common
Sometimes the bacteria become resistant to more than one drug.
This is called multidrug-resistant TB, or MDR TB. This is a very
serious problem. People with MDR TB disease must be treated
with special drugs. These drugs are not as good as the usual drugs
for TB and they may cause more side effects. Also, some people with
MDR TB disease must see a TB expert who can closely observe their
treatment to make sure it is working.
People who have spent time with someone sick with MDR TB disease
can become infected with TB bacteria that are resistant to several
drugs. If they have a positive skin test reaction, they may be given
preventive therapy. This is very important for people who
are at high risk of developing MDR TB disease, such as children
and HIV-infected people.
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