Drug Interactions- summary-

Corticosteroids or immunosuppressants -

reactivity to the test may be depressed or suppressed  for upto 6 week  in individuals who are
receiving corticosteroids or immunosuppreressive agents

Live viral vaccines -

reactivity may be temporarily depressed by certain live virus vaccines( measles, mumps,
rubella, oral polio, yellow fever and varicella )

Tuberculosis ( TB ) skin test

Local -

Very rare-  vesiculation, ulceration or necrosis, may appear at the test site in highly sensitive
persons. Cold packs or topical steroid preparations may  be employed for symptomatic
relief of associated pain, pruritus and discomfort.

Uncommon- immediate erythematous or other reactions may occur at the injection site.

Systemic- rare sytemic allergic reactions reported- manifested by immediate skin rash,
or generalized rash, within 24 hours. Rections were treated with epinephrine and steroids
and resolved .

Allergy to any of the component

Special Precautions/warnings-

SC injection - avoid injecting tuberculin PPD ( Mantoux ) SC. If this occurs, no local reaction will develop, and the test cannot be interpreted

False -negative reactions- anything that impairs or attentuates cell- mediated imunity (CMI ) potential can cause a false negative tuberculin reaction ( viral infections , particularly
HIV , live virus vaccines, severe protein nutrition, lynphoma, leukemia, sarcoidosis, use
of glucocorticosteroids and other imunosuppresants drugs)

HIV  infection-  because active disease  can develop rapidly in HIV infected persons, the
highest priority for contact investigation should be given to persons potentially coinfected
with HIV and TB.

Active TB- tuberculin PPD ( mantoux ) should be adminstered wth caution or not at all in
persons documented active tuberculosis or documented treatment in the past because
of the severity of reactions  ( vesuculation, ulceration, necrosis ) that may appear at the
test site.

Sterile technique - a separate syringe needle must be used in each individual injection
to prevent the possibilty  of transmission of viral hepatitis or other infections agents from
one person to another.

Administration- special care must be taken to ensure that the product is given intradermally and on the volar aspect of the forearm. Do not adminster IV, IM, or SC.

Pregnancy - Before prescribing , consider if the potential benefits outweigh the potential risk for performing the tuberculin test on a pregnant woman or a  woman of child bearing age

Lactation- there is no reason to withhold breast-feeding after tuberculosis skin testing
or to avoid skin testing in breast feeding mothers.

Children- there is no age contraindication to tuberculin  skin testing of infants
Very young children are at an increased  risk for active tuberculosis once infected,

Therfore during contact investigation, priority with regards to skin testing and evaluation for
preventive therapy should be given to infants and young children who have been exposed
with persons with active tuberculosis

Indication-

Tuberculosis ( TB ) skin test

Dosage-

The Mantoux test is performed by injecting intradermally with a syringe and needle,
0.1ml of tuberculin purified protein derivative (Mantoux ) .
For the intradermal ( Mantoux ) tuberculin test, the dose is 5US units (TU) per
test dose of 0.1ml. 

Pregnancy -
Before prescribing , consider if the potential benefits outweigh the potential risk
for performing the tuberculin test on a pregnant woman or a  woman of child bearing age

Lactation-
There is no reason to withhold breast-feeding after tuberculosis skin testing
or to avoid skin testing in breast feeding mothers.

Children-
There is no age contrindication to tuberculin  skin testing of infants

Very young children are at an increased  risk for active tuberculosis once infected,
Therfore during contact investigation, priority with regards to skin testing and evaluation for
preventive therapy should be given to infants and young children who have been exposed
with persons with active tuberculosis,