Please Help

[proton]

My sixty year old mother suffered an attack of falciferum malaria in Jul 05. She suffered from ARDS as a subsequent complication and was on the ventilator in a comatose condition for over sixty days as she also contracted HAP whilst on the vent. She also had an attack of pulminory embolism during teh time that she was on teh ventilator. By the time she came out of the vent, she was paralysed completely on her left. She was an active person walking almost 8 -10 miles everyday until she suffered from this ailment. She is a diabetic but had the condition completely under control by exercise and diet with no external insulin dependancy. MRI post ventilator revealed acute infarct of the right parietal and left occipital regions and stenosis of the distal M1 segment of the right middle cerebral artery. Over the past 3 years, she has been undergoing intense physiotherapy but has had little or no improvement as regards her restoration of movement. She has also had three seizures over the past one year and a change of drugs were recommended. She was diagonosed with TB of lymph nodes on teh 28th of March 08 and has been on medication for that as well. The following medicines are amongst those that she takes presently: R-Cinex 600mg (Rifampicin 600mg and Isoniazid 300mg) on empty stomach (a glass of milk 30-45min thereafter), Glumet-500mg (Metformin Hydrochloride) 15-20min before breakfast, Oxetol (Oxcarbazepine) 225 mg (anti-seizure/blood thinner?) after breakfast (Valparin was discontinued and replaced with Oxetol after first seizure episode); Ecosporin 150mg and B-Complex tablets post lunch and Glumet-500mg before dinner followed by Oxetol and Combutol 1000mg (Ethambutol Hydrochloride) after dinner. This the brief medical history of my mother. Can anyone advice me on the following quieries please?
     1.  I was adviced to discontinue Combutol 1000mg. This is contradicting earlier advice that the same has to be continued through the entire 6-7 month TB course. what is the correct course?

     2.  She vomits everything that she has within 20-30 min of breakfast (2 1/2 to 3 hours after consumption of R-Cinec 600mg); the vomit being reddish in colour. No more vomiting is observed thereafter i.e, after luch or dinner. Is this an acceptable side effect of the drugs she is on? Is the colour of vomit indicative of R-Cinex being vomited?

     3.  I am also worried that the Glumet 500mg and the Oxetol tablets are also being probably vomited in the morning. What is the remedy?
Thanks.

[DrNoopurMD]

Hi,

I am happy that you find the advice helpful!

[proton]

Thank you for the clear, simple explanation.

[DrNoopurMD]

Hi,

How are you?
The standard short term treatment of TB is INH, Rifampicin, combutol and pyrazinamide for two months and then INH and Rifampicin for the next 4-5 months. So I think it is ok if the doctor has discontinued combutol.
Yes the red color of the vomitus is due to rifampicin, you can try and powder the tablet before giving it to her.
Please check with the doctor about the alternate time when she can take those medications.
Do let me know if you need more information. Take care!