Medical Management Case Study

764 Words 4 Pages
Medical Management
Treatment
The patient needs to be the hospitalized for close monitoring. Airborne isolation precaution needs to be initiated. If the patient’s AFB smear show MTB, TB treatment should be initiated. The law obligate to report all active TB to the local health department (ASA, 2000). This will help to identify and screen persons who have come in contact with the patient which untimely reduce the incidence of TB. In term of medications, this patient will be treated with infectious diseases society of America (IDSA) (2016) guideline. He will be started on isoniazid (INH) and rifampin (RIF) for six months and pyrazinamide (PZA) and ethambutol (EMB) for two months. The medication regimen will be adjusted based on sputum and sensitivity
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Vision acute and red-green colon test followed by monthly inquire about vision disturbance and color discrimination test are also recommended before starting EMB (IDSA, 2016). The patient needs to be monitored for effectiveness of drug therapy. If a three months drug therapy fail to improve symptom, it could due to drug resistance or non-adherence (Chesnutt & Prendergast, 2016). The drug resistance pattern in South Korean plays important role in his care. Drug resistance cases reported to be 5.3% to 12.2% and PZA resistance reported to be 85 % in South (CDC, 2015 and Lee et, al., 2015). IDSA (2016) is also recommended supportive treatment in an outpatient setting like case manager. Therefore, the patients will be discharged with home health …show more content…
Mody, Riddell, Kaye, and Chopra, (2014) discussion of the risk factors can be categorized into two overlapping categories: the presence of comorbidity and physiological changes. Comorbidities such as COPD, renal impairment, malnutrition, cancer, and diabetes do not only increase the risk of active TB, it can also mask the sign and symptoms of TB. This will delay treatment and can lead increase the risk of mortality. The physiological changes such as alter the immune system, renal function, pharmacokinetics, sensations of symptoms, and ability to accurately present symptoms need especially consideration while screening and treating this population. Alters immune system particularly can increase elderly’ risk of reactivation TB. The classical infection signs fever and leukocytosis may not present which could make diagnosing TB challenging. IDSA (2016) does not recommend different medication regimens for elderly. However, they should be closely monitored for adverse effects and response to medical treatment due to their age-related physiological

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