6. 약제에 따른 부작용은 PZA(7.0%), RFP(3.7%), INH(2.7%), SM(1.9%) 등의 순이었으며, 간독성은 RFP이 9예, INH 5예, PZA 3예의 순이었다.
7. 부작용에 의한 약제의 변경과 중지는 모두 32예(6.0%)이었고, 이는 대부분 간독성(10예)과 과민반응(9예)에 의한 것이었으며, RFP이 11예(2.6%), SM이 7예(1.9%), INH가 5예(1.0%), PZA 4예(4.7%), CS 3예(6.4%), EMB 2예(0.6%) 등의 순이었다.
이상의 결과로 항결핵제의 부작용은 흔히 볼 수 있으며 임상의들은 이에 대한 경각심을 항상 갖고 치료에 임할 것이며 항결핵제를 투여받고 있는 환자들에게도 충분한 교육과 주의를 주어 항결핵제에 의한 부작용을 최소화 시킬 수 있고 이에 따라 치료실패율도 줄
일 수 있다고 사료되며 아울러 이 연구가 환자를 위한 보다 정확한 통계를 위한 뒷받침이 되었으며 하는 바람이다.
Clinical Study of Adverse Reactions of Anti-Tuberculosis Drugs
Yong Wook Cho
Department of Medical Science, The Graduate School, Yonsei University
(Directed by Assoc. Prof. Sung-Kyu Kim, M.D.)
Most of all anti-tuberculosis regimens can cause adverse reactions which are very
important factors in treatment failure of tuberculosis
An analysis is presented of those adverse reactions which occurred in 530
patients treated various regimens, Adverse Reactions were detected in 130(24.6%)
patients and the age and sex difference is not statistically significant.
These are usually minor such as G-I trouble and so on, but it might be quite
serious such as acute renal failure. Hepato-toxic reactions were occurred in 3.8%
and characterized by transient elevation of transaminase, seldom accompanied by
abnormality of high serum bilirubin levels. They were normalized after withdrawal
or dosage adjustment. Allergic reactions occured in 5.3% and they were normalized
after with drawl or reducing dosage, too.
The difference between regimens and frequency of toxicity was not of statistical
significance. Even when PZA is added in regimen, there was no evidence of an
inceasing frequency of hepatotoxicity.
Analysis on the frequency of drug toxicity showed that it was caused by PAS in
25% of patients receiving it, in 8.5% by Cycloserine, in 7.0% by Pyrazinamide, in
3.7% by Rifampicin, in 2.7% by Isoniazid, in 1.9% by Streptomycin and in 1.3% by
Ethambutol.
Hepato-toxicity was mainly attributed to REP, INH and PZA. Allergic reactions
mainly attributed to SM, REP, INH, rarely to EMB.
Adverse reaction leading to alteration or withdrawal of regimen or drug occurred
in 32 cases(6.0%) and mainly attributed to PAS, CS, REP and SM.
[영문]
Most of all anti-tuberculosis regimens can cause adverse reactions which are very important factors in treatment failure of tuberculosis An analysis is presented of those adverse reactions which occurred in 530 patients treated various regimens, Adverse Reactions were detected in 130(24.6%)
patients and the age and sex difference is not statistically significant.
These are usually minor such as G-I trouble and so on, but it might be quite serious such as acute renal failure. Hepato-toxic reactions were occurred in 3.8% and characterized by transient elevation of transaminase, seldom accompanied by abnormality of high serum bilirubin levels. They were normalized after withdrawal or dosage adjustment. Allergic reactions occured in 5.3% and they were normalized after with drawl or reducing dosage, too.
The difference between regimens and frequency of toxicity was not of statistical significance. Even when PZA is added in regimen, there was no evidence of an inceasing frequency of hepatotoxicity.
Analysis on the frequency of drug toxicity showed that it was caused by PAS in 25% of patients receiving it, in 8.5% by Cycloserine, in 7.0% by Pyrazinamide, in 3.7% by Rifampicin, in 2.7% by Isoniazid, in 1.9% by Streptomycin and in 1.3% by
Ethambutol.
Hepato-toxicity was mainly attributed to REP, INH and PZA. Allergic reactions mainly attributed to SM, REP, INH, rarely to EMB.
Adverse reaction leading to alteration or withdrawal of regimen or drug occurred in 32 cases(6.0%) and mainly attributed to PAS, CS, REP and SM.