Sources of Fault Power, Symmetrical Fault Calculation, Calculation of Short Circuit MVA
To calculate the fault current and short circuit MVA,impedance matrix method is used for the complex network.Otherwise, thevenin's method can be used.
Summary
To calculate the fault current and short circuit MVA,impedance matrix method is used for the complex network.Otherwise, thevenin's method can be used.
Things to Remember
- The load current is normally neglected in comparison to fault current in fault analysis.
- If the load current is comparable to the fault current then it should be considered in fault analysis.
MCQs
No MCQs found.
Subjective Questions
Q1:
Write short notes on Anti-tubercular drugs.
Type: Long Difficulty: Easy
Show/Hide Answer
Answer: <h3>Anti-Tubercular Drugs</h3>
<p>Tuberculosis (TB) is an infectious disease usually caused by the bacterium Mycobacterium tuberculosis (MTB). Tuberculosis generally affects the lungs, but can also affect other parts of the body. Most infections do not have symptoms, known as latent tuberculosis. About 10% of latent infections progress to active disease which, if left untreated, kills about half of those infected. The classic symptoms of active TB are a chronic cough with blood-containing sputum, fever, night sweats, and weight loss. The historical term "consumption" came about due to the weight loss. Infection of other organs can cause a wide range of symptoms</p>
<p>The goals of TB treatment are to shorten the clinical course of TB, prevent complications, prevent the development of latency and/or subsequent recurrences, and decrease the likelihood of TB transmission. In patients with latent TB, the goal of therapy is to prevent disease progression<strong>.</strong></p>
<p>A number of drugs are to be given for treating tuberculosis. The main cause of giving the multidrug therapy (MDT) is to prevent the bacterial assistant. DOTS (Directly Observed Treatment Short Course) are an effective treatment program against TB.</p>
<p> </p>
<h4>Anti – tubercular drugs can be divided into two lines.</h4>
<table>
<tbody>
<tr>
<td width="319">
<p><strong>Class</strong></p>
</td>
<td width="319">
<p><strong>Medicine</strong></p>
</td>
</tr>
<tr>
<td width="319">
<p>First line drugs:</p>
</td>
<td width="319">
<p>Streptomycin(S), Isoniazid(H), Pyrazinamide(Z), Ethambutol(E), Rifampicin(R)</p>
</td>
</tr>
<tr>
<td width="319">
<p>Second-line drugs:</p>
</td>
<td width="319">
<p>PAS(Para amino Salicylic acid), kanamycin, Cycloserine, Capreomycin, Thiacetazone, Ethionamide, Amikacin</p>
</td>
</tr>
</tbody>
</table>
<p>National Protocol for TB treatment</p>
<p> </p>
<p><strong>Category l combined drugs</strong></p>
<p>New Smear positive, Smear Negative and EP</p>
<table>
<tbody>
<tr>
<td width="213">
<p><strong>Pre-treatment body</strong></p>
<p><strong>weight</strong></p>
<p> </p>
</td>
<td width="213">
<p><strong>Intensive Phase(2months) 1<sup>st</sup> and 2<sup>nd</sup> month(HRZE)</strong></p>
<p> </p>
</td>
<td width="213">
<p><strong>Continuation phase(daily for next 4 months) HR(combination)</strong></p>
<p> </p>
</td>
</tr>
<tr>
<td width="213">
<p>30-37kg</p>
</td>
<td width="213">
<p>2tablets</p>
</td>
<td width="213">
<p>2tablets</p>
</td>
</tr>
<tr>
<td width="213">
<p>38-54kg</p>
</td>
<td width="213">
<p>3tablets</p>
</td>
<td width="213">
<p>3tablets</p>
</td>
</tr>
<tr>
<td width="213">
<p>55-70kg</p>
</td>
<td width="213">
<p>4tablets</p>
</td>
<td width="213">
<p>4tablets</p>
</td>
</tr>
<tr>
<td width="213">
<p>71and more</p>
</td>
<td width="213">
<p>5tablets</p>
</td>
<td width="213">
<p>5tablets</p>
</td>
</tr>
</tbody>
</table>
<p> </p>
<p><strong>Category ll</strong></p>
<p><strong>Relapse, Treatment Failure, and RAD+ VE Case only</strong></p>
<table>
<tbody>
<tr>
<td width="213">
<p><strong>Pre- treatment weight of patient</strong></p>
</td>
<td colspan="2" width="213">
<p><strong>Intensive phase (3month)</strong></p>
<p><strong>1<sup>st</sup>,2<sup>nd</sup>, and 3<sup>rd</sup> months</strong></p>
<p><strong>HRZE (combination)</strong></p>
</td>
<td width="213">
<p><strong>Continuation phase (daily for next 5months)</strong></p>
<p><strong>HR (combination)</strong></p>
</td>
</tr>
<tr>
<td width="213"> </td>
<td width="92">
<p><strong>Streptomycin 2months</strong></p>
</td>
<td width="121">
<p><strong>HRZE Combination 2months</strong></p>
</td>
<td width="213"> </td>
</tr>
<tr>
<td width="213">
<p>30-37kg</p>
</td>
<td width="92">
<p>0.5gm</p>
</td>
<td width="121">
<p>2tablets</p>
<p> </p>
</td>
<td width="213">
<p>2tablets</p>
</td>
</tr>
<tr>
<td width="213">
<p>38-54kg</p>
</td>
<td width="92">
<p>0.75gm</p>
</td>
<td width="121">
<p>3tablets</p>
</td>
<td width="213">
<p>2tablets</p>
</td>
</tr>
<tr>
<td width="213">
<p>55-70kg</p>
</td>
<td width="92">
<p>1gm</p>
</td>
<td width="121">
<p>4tablets</p>
</td>
<td width="213">
<p>2tablets</p>
</td>
</tr>
<tr>
<td width="213">
<p>71kg and more</p>
</td>
<td width="92">
<p>1gm</p>
</td>
<td width="121">
<p>5tablets</p>
</td>
<td width="213">
<p>2tablets</p>
</td>
</tr>
</tbody>
</table>
<p> </p>
<p><strong>HRZE:</strong></p>
<p><strong>H (Isoniazid): 75mmg</strong></p>
<p><strong>R (Rifampicin): 150mmg</strong></p>
<p><strong>Z (Pyrazinamide): 400mg</strong></p>
<p><strong>E (Ethambutol): 275mg</strong></p>
<ol>
<li>
<h4>Isoniazid</h4>
</li>
</ol>
<p>It is primarily bactericidal. Fast-multiplying organisms are rapidly killed by this drugs. It acts on extracellular as well as on intracellular TB. It is a highly effective agent when used in combination with other drugs for the treatment of TB.</p>
<p><strong>Mechanism of action</strong></p>
<ul>
<li>It inhibits the enzymes essential for the synthesis of mycolic acids and micro bacterial cell wall.</li>
<li><strong>Indication</strong></li>
<li>Tuberculosis</li>
</ul>
<p><strong>Preparation</strong></p>
<ul>
<li>It is available in the form of tablets such as:</li>
<li>Isoniazid 75mg + rifampicin 150mg</li>
<li>Isoniazid 150mg + ethambutol 400mg</li>
<li>It is available in injection form such as 25mg/ml in 2ml ampoule</li>
</ul>
<p><strong>Dose</strong></p>
<ul>
<li>Adult: 3oomg per day orally as a single dose.</li>
<li>Child: 10-20 mg/kg/day (maximum 300mg)</li>
<li>For prophylaxis: 10mg/kg/day, 300mg maximum</li>
</ul>
<p><strong>Adverse effect</strong></p>
<ul>
<li><strong>CNS</strong> –convulsion, psychosis, memory disorder, stupor peripheral nerve – peripheral neuropathy, neurotoxicity</li>
<li><strong>Liver</strong> – hepatitis, elevated serum transaminase levels</li>
<li><strong>Eye</strong> – blurred vision</li>
<li><strong>Skin</strong> – various skin rashes, acne</li>
<li><strong>Miscellaneous</strong> – pellagra-like syndrome, joint pains, agranulocytosis, twitching muscles etc.</li>
</ul>
<p><strong>Drug interaction</strong></p>
<ul>
<li>Antacid reduces the absorption of isoniazid, so it should be given at least one hour before antacid.</li>
</ul>
<p>The effect of anticonvulsant may be increased with isoniazid.</p>
<p><strong>Contraindication</strong></p>
<ul>
<li>Drug-induced liver disease</li>
</ul>
<p> </p>
<p> </p>
<ol start="2">
<li>
<h4>Rifampicin</h4>
</li>
</ol>
<p>It is a semisynthetic derivative of the complex macrocyclic antibiotic rifamycin obtained from a Streptomyces. It is an anti-tubercular drug that is also used against Mycobacterium leprae.</p>
<p><strong>Mechanism of action</strong></p>
<ul>
<li>It binds strongly to DNA-dependent RNA polymerase thus inhibiting RNA synthesis in bacteria (Human RNA polymerase is not affected.)</li>
</ul>
<p><strong>Indication</strong></p>
<ul>
<li>Tuberculosis, Meningococcal infection</li>
</ul>
<p><strong>Preparation</strong></p>
<ul>
<li>It is available in the form of tablets such as Isoniazid 75mg+ Rifampicin 150mg</li>
</ul>
<p><strong>Adverse effect</strong></p>
<ul>
<li><strong>CNS –</strong> drowsiness, headache, confusion, dizziness</li>
<li><strong>Blood </strong>– thrombocytopenia, purpura, leucopenia, anaemia</li>
<li><strong>GIT </strong>– abdominal pain, nausea, diarrhea, vomiting</li>
<li><strong>Liver</strong> – hepatotoxicity, transient abnormalities in liver function test</li>
<li><strong>Genitourinary </strong>– hematuria, haemoglobinuria, acute renal failure</li>
<li><strong>Skin </strong>– urticaria, skin rash</li>
<li><strong>Respiratory</strong> – collapse shock, common cold-like symptoms</li>
<li><strong>Miscellaneous</strong> – osteomalacia, porphyria, flulike syndrome, body secretions may get red colored etc.</li>
</ul>
<p><strong>Drug interaction</strong></p>
<ul>
<li>The action of contraceptive pills is reduced by it.</li>
<li>Rifampicin induces liver enzyme which decreases the plasma concentration of the Nifedipine, Digoxin, Corticosteroids, Oral anticoagulation, ketoconazole</li>
<li>It increases the metabolism of Fluconazole, Ketoconazole, and Haloperidol.</li>
<li>The drug induces hepatic enzymes that accelerate the metabolism of several drugs including corticosteroids, digitalis, glycosides, oral hypoglycemic.</li>
</ul>
<p><strong>Contraindication</strong></p>
<ul>
<li>Pregnancy</li>
<li>Jaundice</li>
<li>Porphyria</li>
<li>Hepatic impairment</li>
<li>Elderly</li>
</ul>
<p> </p>
<p> </p>
<ol start="3">
<li>
<h4>Pyrazinamide</h4>
</li>
</ol>
<p>Its structure is similar to Isoniazid. It is Nicotinamide derivative, bactericidal drugs. It can cross blood brain barrier so that the effective against tubercular meningitis. It is effective against the intracellular organisms in macrophages.</p>
<p><strong>Mechanism of action</strong></p>
<ul>
<li>It inhibits the growth of tubercle bacilli and other Mycobacteria in a concentration of 15mg/ml.</li>
</ul>
<p><strong>Indication</strong></p>
<ul>
<li>Tuberculosis</li>
</ul>
<p><strong>Preparation</strong></p>
<ul>
<li>Tablets: 500mg, 750mg</li>
</ul>
<p><strong>Dose</strong></p>
<ul>
<li>Adult and child: 20-35mg/kg/day orally.</li>
</ul>
<p><strong>Adverse effect</strong></p>
<ul>
<li><strong>Blood</strong> – thrombocytopenia, anaemia, sideroblastic anaemia</li>
<li><strong>GIT –</strong> loss of appetite, nausea, vomiting</li>
<li><strong>Liver </strong>– liver damage, liver failure</li>
<li><strong>Urinary</strong> – dysuria</li>
<li><strong>Endocrine</strong> – hyperuricaemia</li>
<li><strong>Skin</strong> – hypertoxicity reaction, cutaneous syndrome</li>
<li><strong>Miscellaneous</strong> – gouty arthritis, arthralgia.</li>
<li><strong>Drug interaction</strong></li>
</ul>
<p>Pyrazinamide may increase serum uric acid concentration and decrease the efficiency of Allopurinol, Colchicine, and Probenecid.</p>
<p><strong>Contraindication</strong></p>
<ul>
<li>Jaundice</li>
</ul>
<p><strong>Precaution</strong></p>
<ul>
<li>Diabetic, hepatic impairment, renal impairment</li>
</ul>
<ol start="4">
<li>
<h4>Ethambutol</h4>
</li>
</ol>
<p>It is a synthetic, isonicotinic acid derivative drugs. It is highly effective against the fast multiplying bacilli. It inhibits the growth and multiplication of Mycobacterium.</p>
<p> </p>
<p><strong>Mechanism of actions</strong></p>
<ul>
<li>It interferes with mycolic and incorporation in the cell wall and inhibits RNA synthesis.</li>
</ul>
<p><strong>Indication</strong></p>
<ul>
<li>Tuberculosis</li>
</ul>
<p><strong>Preparation</strong></p>
<ul>
<li>Ethambutol 400mg, 800mg</li>
<li>Isoniazid 150mg+ Ethambutol 400mg</li>
</ul>
<p><strong>Dose</strong></p>
<ul>
<li>Adult and child over 6years: 15mg/kg orally once a day, some physician prefer to give 25mg/kg/day for the first 2months and after that 15mg/kg/day.</li>
</ul>
<p><strong>Adverse effect</strong></p>
<ul>
<li><strong>CNS </strong>– mental confusion, hallucination, peripheral neuritis</li>
<li><strong>Eye </strong>– optic neuritis, decreased visual acuity, decreased red-green color discrimination, irreversible blindness</li>
<li><strong>Blood-</strong> thrombocytopenia</li>
<li><strong>GIT</strong>- nausea, vomiting, diarrhea, abdominal pain</li>
<li><strong>Skin-</strong> toxic epidermal necrolysis</li>
<li><strong>Miscellaneous </strong>– joint pain</li>
</ul>
<p><strong>Drug interaction</strong></p>
<ul>
<li>Aluminum salts may reduce the effectiveness of the drugs.</li>
</ul>
<p><strong>Contraindication</strong></p>
<ul>
<li>Pregnancy, lactation mother, severe renal impairment, optic neuritis.</li>
<li><strong>Precaution</strong></li>
<li>History of epilepsy, renal insufficiency, neonates, impaired pretreatment visual</li>
</ul>
<p>Acuity.</p>
<p> </p>
<p> </p>
<ol start="5">
<li>
<h4>Streptomycin</h4>
</li>
</ol>
<p>It was introduced in 1947. It was the first chemotherapeutic agent introduced for treatment of TB. It is obtained from Streptomyces griseus.</p>
<p> </p>
<p><strong>Mechanism of action</strong></p>
<ul>
<li>Aminoglycosides are usually bactericidal in action. It is also the protein synthesis inhibitors because it binds to the isolated 30s ribosomal subunit of a ribosome and induces misreading of m- RNA condons.</li>
</ul>
<p> </p>
<p><strong>Indication</strong></p>
<ul>
<li>Tuberculosis</li>
<li>Sub -acute bacterial endocarditis</li>
<li>Brucellosis</li>
<li>Plague</li>
</ul>
<p><strong>Preparation</strong></p>
<ul>
<li>Tit is available in the form of vials such as:</li>
<li>Streptomycin 1gm vial(dry power)</li>
</ul>
<p> </p>
<p> </p>
<p><strong>Dose</strong></p>
<ul>
<li>Adult :by deep I/M injection in a daily dose of 1gm in adult aged 40 years and weighing 50kg or more(the dose is reduced to 500-750mg/day inpatient less than 40years or weighing under 50kg.)</li>
</ul>
<p>Child: 15-20mg/kg/deep IM</p>
<p><strong>Adverse effect</strong></p>
<ul>
<li><strong>Peripheral nerve</strong>- neuromuscular blockade, numbness , tingling sensation</li>
<li><strong>GIT</strong>: paraesthesia of mouth</li>
<li><strong>Kidney</strong>: renal damage</li>
<li><strong>Ear</strong> : auditory and vestibular nerve damage</li>
<li><strong>Skin</strong> : rash , exfoliative dermatitis , erythematous rashes</li>
<li><strong>Miscellaneous</strong> : giddiness , ataxia , hypersensitivity reaction</li>
<li><strong>Local</strong>: pain and swelling at the site of injection</li>
</ul>
<p><strong>Drug interaction</strong></p>
<ul>
<li>Increase the risk of nephrotoxicity if taken with cephalosporins</li>
</ul>
<p>Increase the risk of ototoxicity if taken with Furosemide</p>
<p><strong>Contraindication</strong></p>
<ul>
<li>Pregnancy , hypersensitivity to the aminoglycosides</li>
</ul>
<p><strong>Precaution</strong></p>
<ul>
<li>To be used with caution in geriatric patient and those who are suffering from kidney damage.</li>
</ul>
<p> </p>
<p><strong>Nursing Management</strong></p>
<ul>
<li>Watch for a side effect of the drugs and inform to a doctor.</li>
<li>Visual function test is recommended before and periodically during ethambutol therapy. Patient should be told to stop drugs immediately and seek advice if there is visual deterioration</li>
<li>The side effect of isoniazid is peripheral neuritis so tab pyridoxine 10mg should be given with isoniazid.</li>
<li>Liver function test should be done before and regularly during therapy.</li>
<li>Rifampicin should be given on empty stomach or 1 hour before or 2 hours after a meal.</li>
<li>Patient on rifampicin should be warm that the drug causes an orange –red discoloration of urine, faeces, and other body secretion. It is harmless so do not be frighten.</li>
<li>Patient receiving streptomycin should have hearing and dizziness checked regularly.</li>
<li>Teach the patient about drugs, and how important it is to finish the full course of treatment, default (patient stopping the medicine before treatment is finished) is one of the main reason for resistance. Default resistance may lead to a death of TB patient.</li>
<li>Notice whether relatives or other person living the patient have symptoms of TB.</li>
<li>Streptomycin should be started after test and deep I\M should be given.</li>
</ul>
<p> </p>
<p>Tuberculosis (TB) is an infectious disease usually caused by the bacterium Mycobacterium tuberculosis (MTB). Tuberculosis generally affects the lungs, but can also affect other parts of the body. Most infections do not have symptoms, known as latent tuberculosis. About 10% of latent infections progress to active disease which, if left untreated, kills about half of those infected. The classic symptoms of active TB are a chronic cough with blood-containing sputum, fever, night sweats, and weight loss. The historical term "consumption" came about due to the weight loss. Infection of other organs can cause a wide range of symptoms</p>
<p>The goals of TB treatment are to shorten the clinical course of TB, prevent complications, prevent the development of latency and/or subsequent recurrences, and decrease the likelihood of TB transmission. In patients with latent TB, the goal of therapy is to prevent disease progression<strong>.</strong></p>
<p>A number of drugs are to be given for treating tuberculosis. The main cause of giving the multidrug therapy (MDT) is to prevent the bacterial assistant. DOTS (Directly Observed Treatment Short Course) are an effective treatment program against TB.</p>
<p> </p>
<h4>Anti – tubercular drugs can be divided into two lines.</h4>
<table>
<tbody>
<tr>
<td width="319">
<p><strong>Class</strong></p>
</td>
<td width="319">
<p><strong>Medicine</strong></p>
</td>
</tr>
<tr>
<td width="319">
<p>First line drugs:</p>
</td>
<td width="319">
<p>Streptomycin(S), Isoniazid(H), Pyrazinamide(Z), Ethambutol(E), Rifampicin(R)</p>
</td>
</tr>
<tr>
<td width="319">
<p>Second-line drugs:</p>
</td>
<td width="319">
<p>PAS(Para amino Salicylic acid), kanamycin, Cycloserine, Capreomycin, Thiacetazone, Ethionamide, Amikacin</p>
</td>
</tr>
</tbody>
</table>
<p>National Protocol for TB treatment</p>
<p> </p>
<p><strong>Category l combined drugs</strong></p>
<p>New Smear positive, Smear Negative and EP</p>
<table>
<tbody>
<tr>
<td width="213">
<p><strong>Pre-treatment body</strong></p>
<p><strong>weight</strong></p>
<p> </p>
</td>
<td width="213">
<p><strong>Intensive Phase(2months) 1<sup>st</sup> and 2<sup>nd</sup> month(HRZE)</strong></p>
<p> </p>
</td>
<td width="213">
<p><strong>Continuation phase(daily for next 4 months) HR(combination)</strong></p>
<p> </p>
</td>
</tr>
<tr>
<td width="213">
<p>30-37kg</p>
</td>
<td width="213">
<p>2tablets</p>
</td>
<td width="213">
<p>2tablets</p>
</td>
</tr>
<tr>
<td width="213">
<p>38-54kg</p>
</td>
<td width="213">
<p>3tablets</p>
</td>
<td width="213">
<p>3tablets</p>
</td>
</tr>
<tr>
<td width="213">
<p>55-70kg</p>
</td>
<td width="213">
<p>4tablets</p>
</td>
<td width="213">
<p>4tablets</p>
</td>
</tr>
<tr>
<td width="213">
<p>71and more</p>
</td>
<td width="213">
<p>5tablets</p>
</td>
<td width="213">
<p>5tablets</p>
</td>
</tr>
</tbody>
</table>
<p> </p>
<p><strong>Category ll</strong></p>
<p><strong>Relapse, Treatment Failure, and RAD+ VE Case only</strong></p>
<table>
<tbody>
<tr>
<td width="213">
<p><strong>Pre- treatment weight of patient</strong></p>
</td>
<td colspan="2" width="213">
<p><strong>Intensive phase (3month)</strong></p>
<p><strong>1<sup>st</sup>,2<sup>nd</sup>, and 3<sup>rd</sup> months</strong></p>
<p><strong>HRZE (combination)</strong></p>
</td>
<td width="213">
<p><strong>Continuation phase (daily for next 5months)</strong></p>
<p><strong>HR (combination)</strong></p>
</td>
</tr>
<tr>
<td width="213"> </td>
<td width="92">
<p><strong>Streptomycin 2months</strong></p>
</td>
<td width="121">
<p><strong>HRZE Combination 2months</strong></p>
</td>
<td width="213"> </td>
</tr>
<tr>
<td width="213">
<p>30-37kg</p>
</td>
<td width="92">
<p>0.5gm</p>
</td>
<td width="121">
<p>2tablets</p>
<p> </p>
</td>
<td width="213">
<p>2tablets</p>
</td>
</tr>
<tr>
<td width="213">
<p>38-54kg</p>
</td>
<td width="92">
<p>0.75gm</p>
</td>
<td width="121">
<p>3tablets</p>
</td>
<td width="213">
<p>2tablets</p>
</td>
</tr>
<tr>
<td width="213">
<p>55-70kg</p>
</td>
<td width="92">
<p>1gm</p>
</td>
<td width="121">
<p>4tablets</p>
</td>
<td width="213">
<p>2tablets</p>
</td>
</tr>
<tr>
<td width="213">
<p>71kg and more</p>
</td>
<td width="92">
<p>1gm</p>
</td>
<td width="121">
<p>5tablets</p>
</td>
<td width="213">
<p>2tablets</p>
</td>
</tr>
</tbody>
</table>
<p> </p>
<p><strong>HRZE:</strong></p>
<p><strong>H (Isoniazid): 75mmg</strong></p>
<p><strong>R (Rifampicin): 150mmg</strong></p>
<p><strong>Z (Pyrazinamide): 400mg</strong></p>
<p><strong>E (Ethambutol): 275mg</strong></p>
<ol>
<li>
<h4>Isoniazid</h4>
</li>
</ol>
<p>It is primarily bactericidal. Fast-multiplying organisms are rapidly killed by this drugs. It acts on extracellular as well as on intracellular TB. It is a highly effective agent when used in combination with other drugs for the treatment of TB.</p>
<p><strong>Mechanism of action</strong></p>
<ul>
<li>It inhibits the enzymes essential for the synthesis of mycolic acids and micro bacterial cell wall.</li>
<li><strong>Indication</strong></li>
<li>Tuberculosis</li>
</ul>
<p><strong>Preparation</strong></p>
<ul>
<li>It is available in the form of tablets such as:</li>
<li>Isoniazid 75mg + rifampicin 150mg</li>
<li>Isoniazid 150mg + ethambutol 400mg</li>
<li>It is available in injection form such as 25mg/ml in 2ml ampoule</li>
</ul>
<p><strong>Dose</strong></p>
<ul>
<li>Adult: 3oomg per day orally as a single dose.</li>
<li>Child: 10-20 mg/kg/day (maximum 300mg)</li>
<li>For prophylaxis: 10mg/kg/day, 300mg maximum</li>
</ul>
<p><strong>Adverse effect</strong></p>
<ul>
<li><strong>CNS</strong> –convulsion, psychosis, memory disorder, stupor peripheral nerve – peripheral neuropathy, neurotoxicity</li>
<li><strong>Liver</strong> – hepatitis, elevated serum transaminase levels</li>
<li><strong>Eye</strong> – blurred vision</li>
<li><strong>Skin</strong> – various skin rashes, acne</li>
<li><strong>Miscellaneous</strong> – pellagra-like syndrome, joint pains, agranulocytosis, twitching muscles etc.</li>
</ul>
<p><strong>Drug interaction</strong></p>
<ul>
<li>Antacid reduces the absorption of isoniazid, so it should be given at least one hour before antacid.</li>
</ul>
<p>The effect of anticonvulsant may be increased with isoniazid.</p>
<p><strong>Contraindication</strong></p>
<ul>
<li>Drug-induced liver disease</li>
</ul>
<p> </p>
<p> </p>
<ol start="2">
<li>
<h4>Rifampicin</h4>
</li>
</ol>
<p>It is a semisynthetic derivative of the complex macrocyclic antibiotic rifamycin obtained from a Streptomyces. It is an anti-tubercular drug that is also used against Mycobacterium leprae.</p>
<p><strong>Mechanism of action</strong></p>
<ul>
<li>It binds strongly to DNA-dependent RNA polymerase thus inhibiting RNA synthesis in bacteria (Human RNA polymerase is not affected.)</li>
</ul>
<p><strong>Indication</strong></p>
<ul>
<li>Tuberculosis, Meningococcal infection</li>
</ul>
<p><strong>Preparation</strong></p>
<ul>
<li>It is available in the form of tablets such as Isoniazid 75mg+ Rifampicin 150mg</li>
</ul>
<p><strong>Adverse effect</strong></p>
<ul>
<li><strong>CNS –</strong> drowsiness, headache, confusion, dizziness</li>
<li><strong>Blood </strong>– thrombocytopenia, purpura, leucopenia, anaemia</li>
<li><strong>GIT </strong>– abdominal pain, nausea, diarrhea, vomiting</li>
<li><strong>Liver</strong> – hepatotoxicity, transient abnormalities in liver function test</li>
<li><strong>Genitourinary </strong>– hematuria, haemoglobinuria, acute renal failure</li>
<li><strong>Skin </strong>– urticaria, skin rash</li>
<li><strong>Respiratory</strong> – collapse shock, common cold-like symptoms</li>
<li><strong>Miscellaneous</strong> – osteomalacia, porphyria, flulike syndrome, body secretions may get red colored etc.</li>
</ul>
<p><strong>Drug interaction</strong></p>
<ul>
<li>The action of contraceptive pills is reduced by it.</li>
<li>Rifampicin induces liver enzyme which decreases the plasma concentration of the Nifedipine, Digoxin, Corticosteroids, Oral anticoagulation, ketoconazole</li>
<li>It increases the metabolism of Fluconazole, Ketoconazole, and Haloperidol.</li>
<li>The drug induces hepatic enzymes that accelerate the metabolism of several drugs including corticosteroids, digitalis, glycosides, oral hypoglycemic.</li>
</ul>
<p><strong>Contraindication</strong></p>
<ul>
<li>Pregnancy</li>
<li>Jaundice</li>
<li>Porphyria</li>
<li>Hepatic impairment</li>
<li>Elderly</li>
</ul>
<p> </p>
<p> </p>
<ol start="3">
<li>
<h4>Pyrazinamide</h4>
</li>
</ol>
<p>Its structure is similar to Isoniazid. It is Nicotinamide derivative, bactericidal drugs. It can cross blood brain barrier so that the effective against tubercular meningitis. It is effective against the intracellular organisms in macrophages.</p>
<p><strong>Mechanism of action</strong></p>
<ul>
<li>It inhibits the growth of tubercle bacilli and other Mycobacteria in a concentration of 15mg/ml.</li>
</ul>
<p><strong>Indication</strong></p>
<ul>
<li>Tuberculosis</li>
</ul>
<p><strong>Preparation</strong></p>
<ul>
<li>Tablets: 500mg, 750mg</li>
</ul>
<p><strong>Dose</strong></p>
<ul>
<li>Adult and child: 20-35mg/kg/day orally.</li>
</ul>
<p><strong>Adverse effect</strong></p>
<ul>
<li><strong>Blood</strong> – thrombocytopenia, anaemia, sideroblastic anaemia</li>
<li><strong>GIT –</strong> loss of appetite, nausea, vomiting</li>
<li><strong>Liver </strong>– liver damage, liver failure</li>
<li><strong>Urinary</strong> – dysuria</li>
<li><strong>Endocrine</strong> – hyperuricaemia</li>
<li><strong>Skin</strong> – hypertoxicity reaction, cutaneous syndrome</li>
<li><strong>Miscellaneous</strong> – gouty arthritis, arthralgia.</li>
<li><strong>Drug interaction</strong></li>
</ul>
<p>Pyrazinamide may increase serum uric acid concentration and decrease the efficiency of Allopurinol, Colchicine, and Probenecid.</p>
<p><strong>Contraindication</strong></p>
<ul>
<li>Jaundice</li>
</ul>
<p><strong>Precaution</strong></p>
<ul>
<li>Diabetic, hepatic impairment, renal impairment</li>
</ul>
<ol start="4">
<li>
<h4>Ethambutol</h4>
</li>
</ol>
<p>It is a synthetic, isonicotinic acid derivative drugs. It is highly effective against the fast multiplying bacilli. It inhibits the growth and multiplication of Mycobacterium.</p>
<p> </p>
<p><strong>Mechanism of actions</strong></p>
<ul>
<li>It interferes with mycolic and incorporation in the cell wall and inhibits RNA synthesis.</li>
</ul>
<p><strong>Indication</strong></p>
<ul>
<li>Tuberculosis</li>
</ul>
<p><strong>Preparation</strong></p>
<ul>
<li>Ethambutol 400mg, 800mg</li>
<li>Isoniazid 150mg+ Ethambutol 400mg</li>
</ul>
<p><strong>Dose</strong></p>
<ul>
<li>Adult and child over 6years: 15mg/kg orally once a day, some physician prefer to give 25mg/kg/day for the first 2months and after that 15mg/kg/day.</li>
</ul>
<p><strong>Adverse effect</strong></p>
<ul>
<li><strong>CNS </strong>– mental confusion, hallucination, peripheral neuritis</li>
<li><strong>Eye </strong>– optic neuritis, decreased visual acuity, decreased red-green color discrimination, irreversible blindness</li>
<li><strong>Blood-</strong> thrombocytopenia</li>
<li><strong>GIT</strong>- nausea, vomiting, diarrhea, abdominal pain</li>
<li><strong>Skin-</strong> toxic epidermal necrolysis</li>
<li><strong>Miscellaneous </strong>– joint pain</li>
</ul>
<p><strong>Drug interaction</strong></p>
<ul>
<li>Aluminum salts may reduce the effectiveness of the drugs.</li>
</ul>
<p><strong>Contraindication</strong></p>
<ul>
<li>Pregnancy, lactation mother, severe renal impairment, optic neuritis.</li>
<li><strong>Precaution</strong></li>
<li>History of epilepsy, renal insufficiency, neonates, impaired pretreatment visual</li>
</ul>
<p>Acuity.</p>
<p> </p>
<p> </p>
<ol start="5">
<li>
<h4>Streptomycin</h4>
</li>
</ol>
<p>It was introduced in 1947. It was the first chemotherapeutic agent introduced for treatment of TB. It is obtained from Streptomyces griseus.</p>
<p> </p>
<p><strong>Mechanism of action</strong></p>
<ul>
<li>Aminoglycosides are usually bactericidal in action. It is also the protein synthesis inhibitors because it binds to the isolated 30s ribosomal subunit of a ribosome and induces misreading of m- RNA condons.</li>
</ul>
<p> </p>
<p><strong>Indication</strong></p>
<ul>
<li>Tuberculosis</li>
<li>Sub -acute bacterial endocarditis</li>
<li>Brucellosis</li>
<li>Plague</li>
</ul>
<p><strong>Preparation</strong></p>
<ul>
<li>Tit is available in the form of vials such as:</li>
<li>Streptomycin 1gm vial(dry power)</li>
</ul>
<p> </p>
<p> </p>
<p><strong>Dose</strong></p>
<ul>
<li>Adult :by deep I/M injection in a daily dose of 1gm in adult aged 40 years and weighing 50kg or more(the dose is reduced to 500-750mg/day inpatient less than 40years or weighing under 50kg.)</li>
</ul>
<p>Child: 15-20mg/kg/deep IM</p>
<p><strong>Adverse effect</strong></p>
<ul>
<li><strong>Peripheral nerve</strong>- neuromuscular blockade, numbness , tingling sensation</li>
<li><strong>GIT</strong>: paraesthesia of mouth</li>
<li><strong>Kidney</strong>: renal damage</li>
<li><strong>Ear</strong> : auditory and vestibular nerve damage</li>
<li><strong>Skin</strong> : rash , exfoliative dermatitis , erythematous rashes</li>
<li><strong>Miscellaneous</strong> : giddiness , ataxia , hypersensitivity reaction</li>
<li><strong>Local</strong>: pain and swelling at the site of injection</li>
</ul>
<p><strong>Drug interaction</strong></p>
<ul>
<li>Increase the risk of nephrotoxicity if taken with cephalosporins</li>
</ul>
<p>Increase the risk of ototoxicity if taken with Furosemide</p>
<p><strong>Contraindication</strong></p>
<ul>
<li>Pregnancy , hypersensitivity to the aminoglycosides</li>
</ul>
<p><strong>Precaution</strong></p>
<ul>
<li>To be used with caution in geriatric patient and those who are suffering from kidney damage.</li>
</ul>
<p> </p>
<p><strong>Nursing Management</strong></p>
<ul>
<li>Watch for a side effect of the drugs and inform to a doctor.</li>
<li>Visual function test is recommended before and periodically during ethambutol therapy. Patient should be told to stop drugs immediately and seek advice if there is visual deterioration</li>
<li>The side effect of isoniazid is peripheral neuritis so tab pyridoxine 10mg should be given with isoniazid.</li>
<li>Liver function test should be done before and regularly during therapy.</li>
<li>Rifampicin should be given on empty stomach or 1 hour before or 2 hours after a meal.</li>
<li>Patient on rifampicin should be warm that the drug causes an orange –red discoloration of urine, faeces, and other body secretion. It is harmless so do not be frighten.</li>
<li>Patient receiving streptomycin should have hearing and dizziness checked regularly.</li>
<li>Teach the patient about drugs, and how important it is to finish the full course of treatment, default (patient stopping the medicine before treatment is finished) is one of the main reason for resistance. Default resistance may lead to a death of TB patient.</li>
<li>Notice whether relatives or other person living the patient have symptoms of TB.</li>
<li>Streptomycin should be started after test and deep I\M should be given.</li>
</ul>
<p> </p>
Videos
Tuberculosis Medications
Sources of Fault Power, Symmetrical Fault Calculation, Calculation of Short Circuit MVA
Sources of Fault Power:
- Synchronous generator
- Synchronous motor
- Induction motor
Symmetrical Fault calculation:
Symmetrical fault calculation is simple and easier as the system is balanced even after the fault.
To determine the fault current in more complicated system:
- Create a per-phase per-unit equivalent circuit of the power system using either sub-transient reactances (if sub-transient currents are needed) or transient reactances (if transient currents are needed).
- Find the Thevenin equivalent circuit looking from the fault point, then divide the Thevenin voltage by the Thevenin impedance.
- This approach always works but can get complex while dealing with complex systems.
- Then fault current (If) = fault current in p.u.∗ Base current.
- Where base current equals to:
In the case of a complex network that has a number of buses and generating stations.This method is suitable when software is to be used for analysis.
Short Circuit MVA:
Short circuit MVA or fault power =Fault level in p.u. × base power
=(Voltage in p.u. × If in p.u.) × base power.
Lesson
Power system Fault Calculation
Subject
Electrical Engineering
Grade
Engineering
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