[The adverse reactions of anti-tuberculosis drugs and its management]

This paper reviews adverse reactions to anti-tuberculous drugs. Hepatotoxicity occur with isoniazid, rifampicin, pyrazinamide and ethionamide. Risk factors include high age, malnutrition and high alcohol consumption. Liver function should be followed every two weeks to prevent serious hepatotoxicity. If this occurs drugs should be stopped until improvement of liver functions. Fulminant hepatitis has poorer prognosis in regimen with pyrazinamide than without. The Combination of pyrazinamide and ethionamide is frequently hepatotoxic and should be avoided. Gastric reactions occur frequently. Elderly persons are highly intolerant to rifampicin. Peripheral neuritis is reported with isoniazid, ethambutol and ethionamide, but effectively prevented with pyridoxine. Allergic reaction including fever or rash occur with many anti-tuberculosis drugs. If necessary desensitization to re-introduce the drugs. Ocular toxicity due to ethambutol occur infrequently with a dose of 15 mg/kg. Drug interactions are frequent in tuberculosis treatment. Rifampicin reduce serum the concentration of such drugs as Methadone, Corticosteroid, and Theophylline.