Thank you for posting
How long has she been on quadtab? She is definitely presenting with a side effect of one of the active antiTB drugs which is hepatotoxic. The drugs that could be accused are Isoniazid (INH) = drug-induced hepatitis, rifampicin (RMP) and Pyrazinamide
(PZA)= hepatotoxic. They damage the liver and presents with jaundice. PZA is the most frequent causative agent, while INH is the next and RMP the least frequent.
The course of treatment of PTB is 2RHEZ/4RH i.e two months of treatment with rifampicin, ethambutol, isoniazide and pyrazinamide and four months of rifampicin and ethambutol ( totally six months of PTB). This could be modified to upto 9 months depending if there is resistance or adherence problems.
What to do now? If your mother is already upto 2months treatment, PZA and INH could be dropped and she placed only on RMP and EMB for four months. If still presenting with jaundice or signs of hepatotoxicity
( elevated liver enzymes
, jaundice, elevated bilirubins), then 2nd line regimen is well indicated here.
Some school of thoughts will try to maintain same regimen ( benefits out way the risk) while another school of thoughts will prefer switching to second line regimen in order to prevent permanent liver damage
. Elevations in liver enzymes is normal in the first 2-3 weeks. Test dosing of total bilirubin
and liver enzymes should be done to determine which drug is responsible.
I suggest your mother should be placed on Streptomycin
and Ethambutol until her transaminases are normal and if her tuberculosis
is so serious that her drugs can not be stopped totally.
Hope this helps and wish your mother a quick recovery