Tuberculosis Study Guide - M.M. Savula 2002

Care. Treatment
Non-specific therapies

Non-specific agents serve as adjunctive therapy in the Treatment of tuberculosis. Pathogenetic Therapy is aimed at improving the tolerability of anti-tuberculosis drugs and normalizing internal organ Functions (Vitamins B₁, B₆, B₁₂, C, E, and hepatoprotectors). During the first stage of treatment, anti-inflammatory (glucocorticosteroids, indomethacin) and desensitizing agents (diphenhydramine, diazoline, suprastin, calcium gluconate) are used as indicated. In the second stage of therapy, if healing is delayed, resolving agents (aloe extract, plasmol, Placenta suspension, vitreous body) and immunostimulating drugs (T-activin, sodium nucleinate, splenin, etc.) are prescribed.

Sanatorium treatment (in Crimea, Odesa, the Carpathians, or local health resorts) is indicated at The final stage of therapy. In recent years, it has been used less frequently.

With the Introduction of highly effective antibacterial drugs, symptomatic therapy for tuberculosis has lost its dominant role. However, for certain patients, especially those with chronic Pulmonary Tuberculosis, it remains indispensable.

When There is a large amount of sputum that is difficult to expectorate, expectorants are required. Most commonly, mukaltin (0.05 g tablets) is prescribed, which contains a mixture of Polysaccharides from the marshmallow (Althaea) herb. "Cough tablets" consist of thermopsis herb powder (0.01 g) and sodium bicarbonate (0.25 g). Combined preparations include breast elixir, prescribed at 20-40 drops three times a day, and pertussin (1 tablespoon three times a day). Terpin hydrate (tablets containing 0.25 g of terpin hydrate and 0.25 g of sodium bicarbonate) has a good expectorant effect. To thin thick sputum, mucolytics are used: bromhexine (0.08 g tablets), acetylcysteine (0.2 g powder dissolved in a small amount of Water), and lasolvan (ambroxol) in 0.03 g tablets or 15 mg/5 ml syrup.

For severe, paroxysmal coughs that disrupt the patient's general well-being and Sleep, antitussives that suppress the cough reflex are prescribed. These include libexin (0.1 g tablets) and tusuprex (0.01 g and 0.02 g tablets). In cases of particularly intolerable coughs, dionin (0.01-0.03 g) or codeine (0.015 g) is used. Codterpin tablets contain 0.015 g of codeine, along with 0.25 g each of terpin hydrate and sodium bicarbonate, thus providing both an antitussive and expectorant effect.

One of the causes of dyspnea in patients with pulmonary tuberculosis is bronchospasm. Therefore, bronchodilators are frequently used in the clinical management of tuberculosis.

Aminophylline (0.15 g tablets) or its sustained-release forms are frequently prescribed. A rapid effect is achieved after intravenous administration of aminophylline (2.4 % solution in 10 ml ampoules, administered together with isotonic sodium chloride solution). However, there are certain contraindications for the intravenous administration of this drug, so it must only be prescribed by a physician. The combination drug solutan (10-30 drops after meals) has bronchodilator and expectorant effects. In cases of concomitant obstructive Bronchitis, metered-dose inhalers (atrovent, salbutamol, combivent, etc.) are used.

Analgesics may be necessary for sharp pleural pain (analgin in 0.5 g tablets or intramuscularly as a 50 % solution in 1-2 ml ampoules). This drug, as well as paracetamol in 0.2 g tablets or aspirin in 0.5 g tablets, are used as analgesic and antipyretic agents. Less frequently, for severe postoperative pain, promedol (1 % or 2 % solution in 1 ml ampoules) is administered subcutaneously.

Sometimes, in patients with emotional lability and sleep disturbances, there is a need to use sedatives. Valerian tablets (0.02 g) or valerian tincture (20-30 drops) provide a good effect. Combination preparations like corvalol, corvaldin, and barboval contain small doses of phenobarbital In addition to valerian; they have a calming effect and improve sleep. These agents also help reduce tachycardia, which often accompanies tuberculous intoxication.

Traditional Methods of non-specific therapy have long been used in the treatment of tuberculosis. Some of them have been discarded today, while others have been tested, approved, and refined by scientific medicine. They exert a symptomatic effect or a positive impact on the patient's body by stimulating defense mechanisms, and can therefore be used in combination with Chemotherapy. These primarily include Medicinal Plants and bee products. The most popular remedies are as follows.

♦ To improve appetite, a herbal decoction is used: wormwood herb (8 parts) + common yarrow herb (2 parts). A tablespoon of the mixture is infused in a Glass of cold water for 2 hours, then boiled, strained after 10 minutes, and drunk throughout the day.

♦ Vitamin blend: rose hips (1 part) + blackcurrant fruits (1 part). Two teaspoons of the mixture are brewed in a thermos with 500 ml of boiling water, sealed, infused for 10-12 hours, and consumed at 100 ml 34 times a day. This blend improves Liver function and prevents the side effects of chemotherapy drugs.

♦ For a severe cough, a decoction of common fig in milk is used. Take 20 g of infructescences per glass of milk, boil for 10 minutes, and drink the decoction warm. For the same purpose, Iceland moss is used. A teaspoon of crushed moss is brewed with two glasses of boiling water, boiled for 5 minutes, and drunk with honey at 2 glasses a day.

♦ For night sweats, the following mixture is prescribed: Iceland moss (2 parts) + Scots pine buds (1 part). A tablespoon of this mixture is brewed with a glass of boiling water, boiled for 10 minutes, strained, cooled, and drunk at 2-3 glasses a day.

♦ For weakened patients, "elecampane wine" is recommended. Take a tablespoon of crushed elecampane ROOT per 500 ml of port wine, boil for 10 minutes, and drink 50 ml twice a day.

♦ For minor hemoptysis, liquid nettle extract may be beneficial, taken at 25-30 drops before meals.

♦ A mixture consisting of 100 g of rendered lard, 100 g of butter, 100 g of honey, 15 g of aloe juice, and 10 g of cocoa powder. The mixture is stored in the refrigerator and consumed at 1 tablespoon per glass of hot milk twice a day to strengthen the body's resistance;

♦ 20 % propolis oil at 1 tablespoon or 20 % alcoholic propolis solution at 20-30 drops 1 hour before meals in warm milk three times a day (propolis has antimicrobial, antitoxic, anti-inflammatory, analgesic, and biogenic stimulating effects, activating the body's defenses against infections).

All the listed remedies cannot be used independently, but only as an adjunct to comprehensive chemotherapy for tuberculosis.