Anti-TB Therapy — RIPE + Side Effects

Standard RIPE for 2 months, then RI for 4 months (total 6). R — Rifampicin • Orange body fluids (tears, urine, sweat) • Hepatitis • Potent CYP450 inducer I — Isoniazid (INH) • Peripheral neuropathy (give B6/pyridoxine) • Hepatitis • Drug-induced lupus (anti-histone antibodies) • CYP450 inhibitor P — Pyrazinamide • Hyperuricaemia (precipitates gout) • Hepatitis • Joint pain E — Ethambutol • Optic neuritis (red-green colour vision loss) • Avoid in young children who can't report vision changes MDR-TB: resistant to ≥ R + I → second-line drugs (fluoroquinolones, aminoglycosides, linezolid)