Silicosis Medication

  • Author: Basil Varkey, MD, FCCP; Chief Editor: Zab Mosenifar, MD   more...
 
Updated: Jan 26, 2011
 

Medication Summary

For latent tuberculosis, isoniazid for 9 months, daily or intermittently (twice weekly directly observed treatment [DOT]), is the DOC.

For active tuberculosis, drugs commonly used in treatment include isoniazid, rifampin, pyrazinamide, streptomycin, and ethambutol. Dosages and treatment should follow established expert guidelines.[13]

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Antitubercular agents

Class Summary

Active against susceptible strains of M tuberculosis.

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Isoniazid (Nydrazid)

 

Best combination of effectiveness, low cost, and minor adverse effects. First-line drug unless known resistance or another contraindication is present.

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Rifampin (Rifadin)

 

For use in combination with at least 1 other antituberculous drug. Inhibits DNA-dependent bacterial, but not mammalian, RNA polymerase. Cross-resistance may occur. Treat for 6-9 mo and at least until 3 mo beyond negative culture results.

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Pyrazinamide (PZA)

 

Pyrazine analog of nicotinamide that may be bacteriostatic or bactericidal against M tuberculosis, depending on concentration of drug attained at site of infection. Mechanism of action is unknown. This drug should be used only in combination with other antituberculous drugs.

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Streptomycin

 

For treatment of susceptible mycobacterial infections. Use in combination with other antituberculous drugs (eg, isoniazid, ethambutol, rifampin).

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Ethambutol (Myambutol)

 

Diffuses into actively growing mycobacterial cells (eg, tubercle bacilli). Impairs cell metabolism by inhibiting synthesis of one or more metabolites, which in turn causes cell death. No cross-resistance demonstrated. This drug should be used only in combination with other antituberculous drugs.

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Contributor Information and Disclosures
Author

Basil Varkey, MD, FCCP  Professor Emeritus, Department of Internal Medicine, Division of Pulmonary and Critical Care, Medical College of Wisconsin; Consulting Pulmonologist, Froedtert Memorial Lutheran Hospital

Basil Varkey, MD, FCCP is a member of the following medical societies: American Association of Physicians of Indian Origin and American College of Chest Physicians

Disclosure: Nothing to disclose.

Coauthor(s)

Anita B Varkey, MD  Assistant Professor, Department of Medicine, Loyola University Medical Center; Associate Program Director, Internal Medicine Residency; Medical Director, General Internal Medicine Clinic, Loyola Outpatient Center

Anita B Varkey, MD is a member of the following medical societies: American College of Physicians and Society of General Internal Medicine

Disclosure: Nothing to disclose.

Specialty Editor Board

Gregory Tino, MD  Director of Pulmonary Outpatient Practices, Associate Professor, Department of Medicine, Division of Pulmonary, Allergy, and Critical Care, University of Pennsylvania Medical Center and Hospital

Gregory Tino, MD is a member of the following medical societies: American College of Chest Physicians, American College of Physicians, and American Thoracic Society

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Senior Pharmacy Editor, eMedicine

Disclosure: eMedicine Salary Employment

Om Prakash Sharma, MD, FRCP, FCCP, DTM&H  Professor, Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Southern California Keck School of Medicine

Om Prakash Sharma, MD, FRCP, FCCP, DTM&H is a member of the following medical societies: American Academy of Allergy Asthma and Immunology, American College of Chest Physicians, American College of Physicians, American Federation for Medical Research, American Osler Society, American Thoracic Society, New York Academy of Medicine, and Royal Society of Medicine

Disclosure: Nothing to disclose.

Timothy D Rice, MD  Associate Professor, Departments of Internal Medicine and Pediatrics and Adolescent Medicine, St Louis University School of Medicine

Timothy D Rice, MD is a member of the following medical societies: American Academy of Pediatrics and American College of Physicians

Disclosure: Nothing to disclose.

Chief Editor

Zab Mosenifar, MD  Director, Division of Pulmonary and Critical Care Medicine, Director, Women's Guild Pulmonary Disease Institute, professor and Executive Vice Chair, Department of Medicine, Cedars Sinai Medical Center.David Geffen School of Medicine at UCLA.

Zab Mosenifar, MD, is a member of the following medical societies: American College of Chest Physicians, American College of Physicians, American Federation for Medical Research, and American Thoracic Society

Disclosure: Nothing to disclose.

References

  1. Centers for Disease Control and Prevention. Silicosis-related years of potential life lost before age 65 years--United States, 1968-2005. MMWR Morb Mortal Wkly Rep. Jul 18 2008;57(28):771-5. [Medline].

  2. Rosenman KD, Reilly MJ, Kalinowski DJ, Watt FC. Silicosis in the 1990s. Chest. Mar 1997;111(3):779-86. [Medline].

  3. Sonnenberg P, Murray J, Glynn JR, Thomas RG, Godfrey-Faussett P, Shearer S. Risk factors for pulmonary disease due to culture-positive M. tuberculosis or nontuberculous mycobacteria in South African gold miners. Eur Respir J. Feb 2000;15(2):291-6. [Medline].

  4. Caplan A, Payne RB, Withley JL. A broadened concept of Caplan's syndrome related to rheumatoid factors. Thorax. 1962;17:205-209.

  5. Yucesoy B, Vallyathan V, Landsittel DP, et al. Polymorphisms of the IL-1 gene complex in coal miners with silicosis. Am J Ind Med. Mar 2001;39(3):286-91. [Medline].

  6. Verma DK, Vacek PM, des Tombe K, et al. Silica exposure assessment in a mortality study of vermont granite workers. J Occup Environ Hyg. Feb 2011;8(2):71-9. [Medline].

  7. Chaudhury N, Phatak A, Paliwal R, Raichaudhari C. Silicosis among agate workers at Shakarpur: An analysis of clinic-based data. Lung India. Oct 2010;27(4):221-4. [Medline]. [Full Text].

  8. Linch KD. Respirable concrete dust--silicosis hazard in the construction industry. Appl Occup Environ Hyg. Mar 2002;17(3):209-21. [Medline].

  9. Centers for Disease Control and Prevention. Silicosis in dental laboratory technicians--five states, 1994-2000. MMWR Morb Mortal Wkly Rep. Mar 12 2004;53(9):195-7. [Medline].

  10. Goodman GB, Kaplan PD, Stachura I, Castranova V, Pailes WH, Lapp NL. Acute silicosis responding to corticosteroid therapy. Chest. Feb 1992;101(2):366-70. [Medline].

  11. Gupta R, Vats M, Dadhich P, et a. Steroid pulse therapy in silicosis. Chest. 2003;124:2155.

  12. Sharma SK, Pande JN, Verma K. Effect of prednisolone treatment in chronic silicosis. Am Rev Respir Dis. Apr 1991;143(4 Pt 1):814-21. [Medline].

  13. American Thoracic Society, Centers for Disease Control and Prevention, Infectious Diseases Society of America. Treatment of tuberculosis. MMWR Recomm Rep. Jun 20 2003;52:1-77. [Medline].

  14. Rosenman KD, Moore-Fuller M, Reilly MJ. Connective tissue disease and silicosis. Am J Ind Med. Apr 1999;35(4):375-81. [Medline].

  15. Mulloy KB. Silica exposure and systemic vasculitis. Environ Health Perspect. Dec 2003;111(16):1933-8. [Medline].

  16. Hogan SL, Cooper GS, Savitz DA, et al. Association of silica exposure with anti-neutrophil cytoplasmic autoantibody small-vessel vasculitis: a population-based, case-control study. Clin J Am Soc Nephrol. Mar 2007;2(2):290-9. [Medline].

 
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