PULMONARY

TUBERCULOSIS
By Group 1:
Armenton, Leighanne Banzon, Emmanuel Jay
Molinas, Camelot Montecalvo, Jolina
Quiña, Rhea Mae Simbajon, Rimyrlen
Villarba, Rica
 WHAT IS PTB?
 It is an infectious disease that primarily affects
the lung parenchyma (a portion in the lungs
involved in gas exchange). Transmitted to
other parts of the body includes meninges,
kidneys, bones and lymph nodes
 It is caused by Mycobacterium tuberculosis
(M tuberculosis). It is spread through the air
when a person with TB disease of the
lungs or throat coughs, speaks or sings,
and people nearby breathe in these
bacteria and become infected.
RISK FACTORS
 Close contact with someone who has active tb
 Immunocompromised status (eg, those with HIV infection, cancer, transplanted organs, and prolonged
highdose corticosteroid therapy)
 Substance abuse
 Any person w/o adequate health care
 Preexisting medical conditions or special treatment (eg, diabetes, chronic renal failure, malnourishment,
selected malignancies, hemodialysis, transplanted organ, gastrectomy, jejunoileal bypas)
 Immigration from countries with a high prevalence of TB ( Southeastern Asia, Africa, Latin America,
Carribean
 Institutionalization (eg, prisons, psychiatric institutions)
 Living in overcrowded substandard housing
 Being a healthcare worker performing high-risk activities
Transmission

Coughs, sneezes, or spread infected droplets

Bacteria is transmitted in the alveoli through airways

Tubercle bacilli is deposited in the lungs

Immune response responds by sending leukocytes to fight infection

(T cells/ B cells)
 Inflammation results – leukocytes are replaced by Macrophages ( a type of wbc that kills, remove and
stimulates the action of other immune system cells

Bacilli are then ingested by the macrophages carried off by the lymphatics to lymph nodes

Tubercle Formation – Bacilli and Macrophages ingested and fuse to form Epithelioid cell tubercles (cells
of the mononuclear phagocyte system found in certain granulomas mainly associated with intense
immunological activity)

Dissemination
If the tubercles and inflames nodes rupture, infection contaminates then it will spread through the blood
and lyphatic circulation to distant therefore it is called Hematogenous Dissemination
DIAGNOSTIC TESTS
 Tuberculin skin test ‘The Mantoux Method’
 X-ray
 Tb Blood Test (Interferon Gamma release assay
DOC
NURSING CONCERNS
 Promoting airway clearance
 Advocating treatment regimen
 Promoting activity and nutrition
 Preventing transmission
CONSTITUTIONAL
MANIFESTATIONS
 Anorexia
 Low grade fever
 Night Sweats
 Fatigue
 Weight Loss
PULMONARY SYMPTOMS
 Dyspnea
 Non resolving bronchopneumonia
 Chest tightness
 Non productive cough
 Mucopurulent sputum with hemoptypsis
 Chest pain
PTB MANAGEMENT
PTB is treated with antituberculosis agents for 6-12 months.
DOTS: Stands for Directly Observed Treatment, Short-course. DOTS is a strategy used to reduce
the number of tuberculosis (TB) cases. In DOTS, healthcare workers observe patients as they take
their medicine.

First Line Antitubercular Medications

• Streptomycin 15mg/kg
• Isoniazid or INH (Nydrazid) 5 mg/kg (300 mg max per day)
• Rifampicin 10 mg/kg
• Pyrazinamide 15-30 mg/kg
• Ethambutol (Myambutol) 15-25 mg/kg daily for 8 weeks and continuing for up to 4-7 months
SECOND LINE MEDICATIONS
 Capreomycin 12-15 mg/kg
 Ethionamide 15 mg/kg
 Paraaminosalycilate sodium 200-300 mg/kg
 Cycloserine 15 mg/kg
 Vitamin b (pyridoxine) usually administered with INH
Multidrug-resistant TB (MDR TB) is caused by TB bacteria that are resistant
to at least isoniazid and rifampin, the two most potent TB drugs. 

Fluoroquinolones have become a mainstay of regimens used to treat MDR-

TB, as their mechanism of action is distinct from both isoniazid and
rifampicin. Levofloxacin and moxifloxacin are the two most frequently
recommended agents, and the WHO has recommended the use of these drugs
for the treatment of MDR-TB.