      Document 0114
 DOCN  DRG0114
 UNIQUE IDENTIFIER        DRG-0133
 NAME OF SUBSTANCE        Tuberculin Purified Protein Derivative [PDR
                          1995]
 REGISTRY NUMBER          92129-86-7
 SYNONYMS                 PPD [Merck Index 1989]
 SYNONYMS                 Purified Protein Derivative [Merck Index
                          1989]
 SYNONYMS                 Aplisol [USAN 1996]
 SYNONYMS                 Aplitest [USAN 1996]
 SYNONYMS                 Tuberculin PPD [PDR 1995]
 PROTOCOL ID NUMBERS      NIAID CPCRA 008
 SECONDARY SOURCE ID      DRG
 PHARMACOLOGICAL ACTION   MECHANISM OF ACTION:  The accuracy of skin
                          tests with tuberculin purified protein
                          derivative (PPD) is dependent upon the
                          patient's ability to mount a delayed-type
                          hypersensitivity reaction. The reaction to a
                          0.1 ml (5 TU) dose of PPD injected
                          intradermally into the forearm (Mantoux test)
                          is measured quantitatively 48-72 hours
                          following administration of the test. An
                          induration (or small hard knot beneath the
                          skin) of less than 5 mm indicates a negative
                          response. In the HIV-infected population, an
                          induration of 5 mm or greater is considered
                          positive for TB infection. In the general
                          population, an induration of 5-9 mm indicates
                          a possible but not definite tuberculosis (TB)
                          infection within the body, and an induration
                          of 10 mm or greater indicates a positive
                          response to a past or present TB infection.
                          [NIAID CPCRA 008] [AHFS Drug Information
                          1995]
 DISEASES STUDIED/TREATED Diagnostic aid to detect Mycobacterium
                          tuberculosis [AHFS Drug Information 1995]
 CLASSIFICATION CODE      Diagnostic Aid [Merck Index 1989]
 OTHER MAJOR USES         Diagnostic aid to detect Mycobacterium
                          tuberculosis [AHFS Drug Information 1995]
 SUBSTANCE INTERACTIONS   Reactivity to the test may be suppressed by
                          corticosteroids or immuno-suppressants, or by
                          live virus vaccines. [PDR 1995]
 ADVERSE EFFECTS          In highly sensitive individuals, strongly
                          positive  reactions including vesiculation,
                          ulceration, or necrosis may occur at the test
                          site. Strongly positive test reactions may
                          result in scarring at the test site.
                          Immediate erythematous or other reactions may
                          occur at the injection site. [PDR 1995] [AHFS
                          Drug Information 1995]
 CONTRAINDICATIONS        Contraindicated in persons who are known
                          tuberculin-positive reactors. [PDR 1993]
 CHEMICAL/PHYSICAL DATA   DRUG DESCRIPTION: Purified protein fraction
                          isolated from culture filtrates of human type
                          strains of Mycobacterium tuberculosis [AHFS
                          Drug Information 1995]
 CHEMICAL/PHYSICAL DATA   PHYSICAL DESCRIPTION: Sterile aqueous
                          solution or multiple puncture device [AHFS
                          Drug Information 1995]
 SUBSTANCE DELIVERY DATA  DOSAGE FORM: Multiple puncture device and
                          solution. [AHFS Drug Information 1995]
 SUBSTANCE DELIVERY DATA  MODE OF DELIVERY: Intradermal, multiple
                          puncture devices. [AHFS Drug Information
                          1995]
 SUBSTANCE DELIVERY DATA  STORAGE: Solutions should be stored at 2-8 C,
                          multiple puncture devices should be stored
                          unrefrigerated at temperatures not exceeding
                          30 C. [AHFS Drug Information 1995]
 MANUFACTURERS            Warner-Lambert Parke-Davis
 REFERENCES               Antonucci G, Girardi E, Raviglione MC,
                          Ippolito G. Risk factors for tuberculosis in
                          HIV-infected persons. A prospective cohort
                          study. The Gruppo Italiano di Studio
                          Tubercolosi e AIDS (GISTA). JAMA. 1995 Jul
                          12;274(2):143-8.
 REFERENCES               Wright PW, Crutcher JE, Holiday DB. Selection
                          of skin test antigens to evaluate PPD anergy.
                          J Fam Pract. 1995 Jul;41(1):59-64.
 REFERENCES               Johnsen C. Evaluation of two-step tuberculin
                          testing in a Massachusetts correctional
                          facility. Am J Infect Control. 1995
                          Jun;23(3):209-12.
 REFERENCES               Pickwell SM. Positive PPD and
                          chemoprophylaxis for tuberculosis infection.
                          Am Fam Physician. 1995 Jun;51(8):1929-34,
                          1937-8.
 REFERENCES               Nagy AS, Conney E. Effect of interleukin-12
                          on the in vitro cellular immune response to
                          PPD in HIV infection. Natl Conf Hum
                          Retroviruses Relat Infect (2nd). 1995 Jan
                          29-Feb 2;:86.
 REFERENCES               Gourevitch MN, Hartel D, Schoenbaum EE, Klein
                          RS. Similar induration sizes in HIV (+) and
                          HIV (-) PPD reactors. Natl Conf Hum
                          Retroviruses Relat Infect (2nd). 1995 Jan
                          29-Feb 2;:73
 REFERENCES               Gorevitch MN, Hartel D, Schoenbaum EE, Klein
                          RS. Sensitivity and specificity of tuberculin
                          antigen of multitest CMI(R) device. Natl Conf
                          Hum Retroviruses Relat Infect (2nd). 1995 Jan
                          29-Feb 2;73.
 REFERENCES               Manoff SB, Farzadegan H, Astemborski JA,
                          Vlahov D, Bonds MB, Rizzo RT, Graham NMH. PPD
                          response and HIV viral burden among
                          HIV-infected IDUs. Natl Conf Hum Retroviruses
                          Relat Infect (2nd). 1995 Jan 29-Feb 2;:73.
 REFERENCES               Raszka WV, Moriarty RA, Waecker NJ, Ascher
                          DP, Ottolini MG, Cieslak TS, Birx D, Robb ML.
                          Delayed type hypersensitivity (DTH) skin
                          testing in HIV infected (HIV+) children.
                          American Pediatric Society 104th annual
                          meeting and Society for Pediatric Research
                          63rd annual meeting; 1994 May 2-5; Seattle.
                          Pediatr AIDS HIV Infect. 1994 Oct; 5(5):320
                          (unnumbered abstract).
 REFERENCES               Lifson AR, Watters JK, Thompson S, Crane CM,
                          Wise F. Discrepancies in tuberculin skin test
                          results with two commercial products in a
                          population of intravenous drug users. J
                          Infect Dis. 1993 Oct;168(4):1048-51.
 ENTRY MONTH              9201
 LAST REVISION DATE       960129
 

SOURCE: National Library of Medicine, Bethesda, MD.  Distributed by AEGIS.
