|Symptoms ||Which drugs cause ||Action by Health Workers
|Upper abdominal pain – Frequent
||All oral anti-TB drugs
||Indicates gastritis. Advise patients to increase fluid intake. Patients should not take antacids/acid lowering agents together with first line anti-TB drugs as it reduces the absorption of drugs. Refer to Medical Officer.
||All oral anti-TB drugs
||Reassure patient. Advice patient to take drugs embedded in a banana. Give drugs with less water and over a longer period of time (e.g. 20 minutes). However, later in the day, patients should take sufficient water. If above measures fail, refer to Medical Officer.
|Nausea, vomiting with yellowness of skin and dark colour urine
||Mainly by Pyrazinamide, Rifampicin and Isoniazid
||Indicates Liver toxicity. Refer to Medical officer urgently
|Loose motions >4 times, liquid stools
||Mainly by PAS, Ethionamide, Isoniazid, Rifampicin, Ofloxacin, Levofloxacin, Moxifloxacin
||Counsel patients on food and personal hygiene. Advice 200 ml Oral rehydration solution (ORS) after every loose stool to maintain hydration. Refer to Medical officer.
|Loose motions associated with dryness of skin and mouth decreased urination, tiredness and sunken eyes
||Same as above
||Indicates Dehydration (Serious) Refer to Medical officer urgently
|Itching / Rashes
||Mainly by Ethambutol,Rifampicin,Streptomycin
||Reassure patient. If rash persists, refer to Medical Officer
|Itching / Rashes involving very large body area or present in mouth, nose associated with swelling and fever
||Mainly by Ethambutol,Rifampicin Streptomycin
||Indicates systemic involvement (Serious) Refer to Medical officer urgently
|Tingling /burning /numbness in hands and feet
||Mainly Isoniazid, Cycloserine
||Check that patientis taking Pyridoxine. Refer to Medical officer.
|Pain in Joints
||Paracetamol can be given if only 1-2.joints are involved. Reassure patient that it is a self-limiting condition. If > 2 joints are involved or pain is not relieved, refer to Medical officer.
|Impaired vision: Pain, Blurring of vision, Disturbance in color vision
||Indicates Eye toxicity.Refer to Medical officer urgently
|Flu-like syndrome: Chills, dry cough, shortness of breath, loss of appetite, body ache, malaise
||Which drugs cause Mainly Rifampicin
||Reassure patient. If not controlled, refer patient to Medical Officer for evaluation.
|Swelling of face or legs, less or no urine
||Amikacin, Kanamycin, Capreomycin, Streptomyin
||Indicates Kidney toxicity.Refer to Medical officer urgently
|Seeing abnormal things, change of thoughts, suicidal thoughts
||Indicates Psychiatric disturbances.Refer to Medical officer urgently
|Tiredness, lethargy, headache,giddiness, pale look, palpitations
||Mainly Linezolid, Isoniazid, Rifampicin, Pyrazinamide, Ofloxacin, Levofloxacin,Moxifloxacin
||Indicates Anemia. Patients can be advised rest in DOTS center post-dosing to avoid giddiness. Advice patients on nutritionRefer to Medical Officer for evaluation.
|Ringing in ears, Loss of hearing, dizziness and loss of balance leading to recurrent fall
||Mainly Streptomycin, Amikacin, Kanamycin, Capreomycin
||Indicates Ear toxicity.Refer to Medical officer urgently
|Slowness of activities, swelling of face, swelling in neck, disproportionate weight gain
||Mainly PAS and Ethionamide
||Indicates Thyroid involvement.Refer to Medical officer urgently
|Pain and swelling in muscles and Tendons, difficulty in movement
||Ofloxacin, Levofloxacin and Moxifloxacin
||Indicates Tendonitis.Refer to Medical officer urgently
||Isoniazid, Cycloserine, Ofloxacin, Levofloxacin, Moxifloxacin
||Refer to Medical officer urgently
|Orange and reddish color of urine sweat, phlegm (sputum), saliva or tears may be noticed. As this is quite common with rifampicin, reassure patients.