WEST VISAYAS STATE UNIVERSITY College of Nursing La Paz, Iloilo City

Vision: WVSU as one of the top universities in Southeast Asia. Mission: To produce globally competitive, lifelong learners. Core Values: Service, Harmony, Excellence Name of Student: Bernardo Paul Ponsaran III Year, Section & RLE Group: 3D Group 1 Clinical Rotation: Medical and Reverse Isolation Ward Date Submitted: Feb.27, 2014

Critiquing of a Journal Reading/Article 1. Name(s) of the author(s): Naveen Chhabra, M. L. Aseri, Ramakant Dixit and S. Gaur 2. Title of the article: Pharmacotherapy for Multi-drug Resistant Tuberculosis 3. Title of journal, volume number, date, month and page numbers: Journal of Pharmacology and Pharmacotherapeutics; April-Jun 2012; 98104 4. Statement of the problem or issue discussed: The possible drug management for patients diagnosed with Multi-drug resistant tuberculosis as well as the intervention for the adverse effects of such.

Guide Questions: 1. What does the author want me to know about this topic? Tuberculosis has been a life-long disease that has been feared by many because of its high rate of communicability and mortality all over the world. Thats why TB program for prevention and treatment has been all over the streets, the internet and even in the television. And at the very least, this has lowered the cases of such epidemic. However, during the course of the treatment, we cant deny that there are instances wherein there is a poor medical supervision, improper drug of choice and poor compliance among the patients. This where Multi-drug Resistant Tuberculosis or resistance to isoniazid or rifampicin takes its course. The emergence of this disease is now a health problem faced by countries across the globe. Ergo, it demands a higher generations of drugs that has been found out to be a source of even graver adverse effects. This article talks about this drugs and how to manage their dangerous effects.

2. What information does he/she give me about this topic? Multi-drug resistance tuberculosis is defined as the resistance to rifampicin and isoniazid, with or without resistance to other anti-TB drugs. This means patients with MDR-TB requires higher generation of medications and this imply higher levels of toxicity. Thats why before initiating a drug therapy for these patients thorough assessment of the history of treatment of the patient and meticulous laboratory studies should be done first. If it is found out that the patient is indeed positive for MDR-TB, category four regimen is given to him and this includes medications such as Ofloxacin, Kanamycin, Ethionamide, Pyrazinamide, Ethambutol and Cycloserine during the 6-9 months of the intensive phase. On the other hand, during the 18 months of continuation phase, 4 drugs are given namely Ofloxacin, Ethionamide, Ethambutol and Cycloserine. An immunomudolator can also be used during the course of the treatment to prevent the occurrence of secondary infections where the patients is very susceptible with. Another important information the author want us to know is the importance of the close supervision that should be given to the patient during the course of the treatment so as to avoid Extensive Drug Resistance Tuberculosis which is a more potent disease. 3. Does the article have a research base? Is the research-base timely? Yes, this is a compilation of Related Literatures and this is published in the Journal of Pharmacology and Pharmacotherapeutics in their April-June 2012 edition. 4. Based on the journal reading/article, what researchable problem/s related to my clients condition can I identify? In the case of my client, a PTB class 5, the degree of compliance of antituberculosis medications may be a problem and possible MDR-TB will occur. Especially if the patient has financial constraints, that would affect them severely since the TB need to be managed through medication by not stopping the compliance to drug regimen. 5. Is the material practical and feasible to my actual clients case? If not, what is/are the problems? Yes, with the information provided by the author, I can reinforce to my patient the importance of compliance to medications so as not to develop resistance to any of such. 6. What information/s shared by the author can I incorporate in my clients nursing care plan? In giving care to my client, I need to emphasize the importance of compliance to medications. Most of our client has deficient knowledge about this disease and the medications taken, for that, we nurses should provide health teachings about the medications and manage side effects/adverse reactions of the drug and list of management are listed in thearticle. Also, further explain what multi-drug resistance TB is all about. Lastly, We should incorporate the prevention of occurrence and development of MDR-TB to all of our PTB clients.