Professional Documents
Culture Documents
MB Adult
(12 blister packs)
Rifampicin 600 mg once a month
Clofazimine 300 mg once a month
Clofazimine 50 mg and dapsone 100 mg every day
Multi Drug Therapy
Multi Drug Therapy
Keeping good records
Good records include:
Patient identification (name, age, sex, address)
Remark on history of complaint (what, how long,
progress)
Remark on history of previous treatment (what,
where, how long, result)
Current treatment (diagnosis, classification, any
visible disability, date of first dose, date of next
appointment)
Record of special events (what event, date, how
managed, referral)
Date of cure
Information to patients
About the disease
Caused by a bacteria
Affects skin and sometimes nerves
Progresses slowly
Easy to diagnose and cure
Lead normal life, do not change life style
Information to patients
About the treatment
Side-effects
Disabilities
Leprosy reactions
1 or 2 patients in 10 may develop reactions
Reactions are not a side effect of MDT. They are the
bodys response to leprosy
More commonly seen in MB cases (more than 5
lesions)
Signs and symptoms include
Skin: patch/s becomes reddish and/or swollen; sometimes
painful reddish nodules appear
Nerves: pain in the nerve and/or joint;
loss of sensation and weakness of muscles (commonly of
hands, feet and around eyes)
General: fever, malaise, swelling of hands/feet
Managing reactions (1)
Early diagnosis and prompt treatment of
reactions
Every patient should be informed about the signs and
symptoms of reactions
Inform them to go as soon as possible to the health
centre
Reassure patients that:
reactions can be treated
they are not a side-effect to MDT
does not mean that MDT is not working
Managing reactions (2)
Rest is very important:
Help to get leave from work or school for a
few days (e.g. medical certificate)
Control of pain and fever
Aspirin or paracetamol
Continue MDT regularly
Managing reactions (3)
Reactions which only involve the skin:
rest and pain-killers are usually sufficient.
If there is no improvement within few days or
worsening, then specific treatment is needed
Reactions which involves the nerves
start treatment with a course of corticosteroids (e.g.
prednisolone) as soon as possible
will control all signs/symptoms of reaction
Before starting treatment with
prednisolone
Make sure that you have adequate stock
One course will require 336 tablets of 5 mg each
The course lasts for 12 weeks
It is better to examine the patient once every 14
days and reduce the dose
Advise to take the total daily dose every morning
If you do not have adequate stock, then start
treatment and refer to another centre/hospital
Always send a written note with the patient,
when you refer
Suggested course of
prednisolone
40 mg (8 tablets) every morning for 14 days
30 mg (6 tablets) every morning for 14 days
20 mg (4 tablets) every morning for 14 days
15 mg (3 tablets) every morning for 14 days
10 mg (2 tablets) every morning for 14 days
5 mg (1 tablets) every morning for 14 days
Note: Continue rest and aspirin or paracetamol as
required
Examine the patient every 14 days before
reducing the dose
If there is no improvement or worsening, refer to hospital
Continue MDT regularly
Why do disabilities occur?
Disabilities such as loss of sensation and
deformities of hands/feet/eyes occur
because:
Late diagnosis and late treatment with MDT
Advanced disease (MB leprosy)
Leprosy reactions which involve nerves
Lack of information on how to protect
insensitive parts
Disabilities can be prevented
The best way to prevent disabilities is:
early diagnosis and prompt treatment with MDT
Inform patients (specially MB) about common
signs/symptoms of reactions
Ask them to come to the centre ASAP
Start treatment for reaction ASAP
Inform them how to protect insensitive hands/
feet /eyes
Involve family members in helping patients
Care of feet
Cracks and fissures Soak in water
Apply cooking
oil/Vaseline
Use footwear
Soak in water
Wounds/injury Apply cooking oil/Vaseline
Clean and apply clean bandage
Protect when working/cooking
Oil massage
Weakness/paralysis Exercises
Refer
Care of eyes
Redness and pain Aspirin or paracetamol
Atropine and steroid
ointment
Cover with eye pad
Injury to cornea
Apply antibiotic ointment
Refer