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Antifungal drugs are considered in Chapter Tuberculosis is caused by infection with Mycobacterium tuberculosis or Mycobacterium bovis. Although the lungs are the major site of infection, the organism can also infect other tissues such as bones, joints and the brain. In the lungs, mycobacteria infect alveolar macrophages and this initiates an inflammatory reaction that involves many of the cells of the immune system.
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The majority of prescription, supply and administration of medicines should be provided on a named patient basis. Under a PGD, the supply and administration of medicine should apply only when this route offers advantages to the patient without compromising safety. Only specific professional groups can work within a PGD, including radiographers, paramedics, nurses, podiatrists, physiotherapists, speech therapists and pharmacists.
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Attacks of asthma can be prevented by prophylactic use of cromoglicate, although this drug is of no use in an acute attack or in chronic bronchitis. Leukotriene receptor antagonists can be used to reduce the inflammation of asthma particularly in the late phase. Inhaled corticosteroids are useful for treatment and prophylaxis of asthma and for reducing acute exacerbations of bronchitis. In severe cases oral corticosteroids might be needed, although long-term use is best avoided. Severe acute asthma is treated as an emergency with oxygen, inhalation of salbutamol and possibly inhaled antimuscarinics and intravenous and oral corticosteroids, intravenous salbutamol, aminophylline and antibiotics if necessary.
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