ANTILEPROTIC DRUGS

Views:
 
Category: Education
     
 

Presentation Description

No description available.

Comments

Presentation Transcript

ANTILEPROTIC DRUGS:

ANTILEPROTIC DRUGS Dr S.P. Dhanya Assistant Professor Pharmacology

PowerPoint Presentation:

Tuberculoid

PowerPoint Presentation:

Lepromatous

Types:

Types Paucibacillary Leprosy - Indeterminate TT BT Multibacillary Leprosy – BB BL LL

Paucibacillary Leprosy :

Paucibacillary Leprosy <5 Hypoanesthetic skin lesions Normal/partially deficient CMI Bacilli rarely found Lepromin test +ve Prolonged remissions with periodic exacerbations

Multibacillary Leprosy :

Multibacillary Leprosy >5 Hypoanesthetic skin lesions mucus membrane involvement CMI deficient Bacilli numerous Lepromin test -ve

ANTILEPROTIC DRUGS :

ANTILEPROTIC DRUGS Sulfones-Dapsone( DDS) Phenazine derivative -Clofazimine ATT drugs - Rifampicin, Ethionamide

Newer drugs:

Newer drugs Fluroquinolones- Pefloxacin,Ofloxacin,Sparfloxacin Minocycline Roxithromycin,Clarithromycin, Telithromycin Rifapentine Bromidoprim Deoxyfructose serotonin

DAPSONE :

DAPSONE Oldest and cheapest Related to Sulfonamide 4-4diamino diphenyl sulfone MOA Inhibits incorporation of PABA Bacteriostatic Dose-100mg/day

KINETICS :

KINETICS Complete oral absorption Undergoes enterohepatic circulation Wide distribution in body Poor CNS penetration Concentrated in skin,muscle,kidney,liver Metabolised by acetylation-- ACEDAPSONE

Adverse drug reaction :

Adverse drug reaction Mild hemolytic anemia-dose related G-6PD deficient patients—Severe hemolytic anemia Gastric - intolerance, nausea, gastritis CNS -wooly headedness-Headache, mental symptoms-psychosis

PowerPoint Presentation:

Peripheral neuropathy Methhemoglobinemia,agranulocytosis -rare Hepatotoxicity Nephrotoxicity Cutaneous-rash,photosensitivity,SJS,TEN

Dapsone syndrome:

Dapsone syndrome Maculopapular skin rash Exfoliative dermatitis Generalised lymphadenopathy Fever Jaundice Occurs within 6 weeks of starting therapy Stop dapsone

Uses:

Uses Leprosy Dermatitis herpetiformis Pneumocystitis carni pneumonia Rhinosporidiosis Pustular psoariasis Nodulocystic acne Brown recluse spider bite

Rifampicin:

Rifampicin Source-Str. mediterranei Spectrum-bactericidal MOA-Inhibit DNA dependent RNA polymerase Rapidly renders non infectious MIC-0.3µg/ml Component of multi drug treatment DOSE -600mg/month

Uses:

Uses TB Leprosy MAIC infection Meningococcal and H. influenza meningitis MRSA Diphtheria, Legionella Brucellosis Leishmaniasis

CLOFAZIMINE :

CLOFAZIMINE Phenazine dye Antileprotic, Antiinflammatory--high dose Bacteriostatic MOA Binds preferentially to mycobacterial DNA interferes with template function DOSE-100mg/day orally

Repository drug- :

Repository drug- Accumulated in fat and reticuloenothelial system Poor CSF penetration T1/2=70 days

ADR :

ADR Reversible discolouration (Reddish brown) of skin ,hair ,conjunctiva ,cornea, secretions Dreaded-Enteritis Abd pain with loose stools Deposition of clofazimine crystals in intestinal mucosa Icthyosis, Acne like lesions Photo toxicity Contraindicated in Pregnancy Hepatic ,renal impairment

Other drugs:

Other drugs OFLOXACIN Rifampicin resistance Dose 400mg/day PEFLOXACIN 400mg/day SPARFLOXACIN 400mg/day

PowerPoint Presentation:

MINOCYCLINE 100mg/day CLARITHROMYCIN 500 mg/day

PowerPoint Presentation:

Treatment of Leprosy

Treatment of PBL :

Treatment of PBL Dapsone -- 100mg/day self Rifampicin – 600mg/month- supervised Duration --- 6 months

Treatment of MBL :

Treatment of MBL Dapsone - 100mg daily - self administered Rifampicin – 600mg once a month-supervised Clofazimine- 50mg daily self 300mg once a month-supervised Duration of treatment - 12 months

Alternative regimens of MBL :

Alternative regimens of MBL Clofazimine 50mg/day+ Ofloxacin 400mg/day+ Minocycline 100mg/day OR Dapsone 100mg/day+ Ofloxacin 400mg/day+ Rifampicin 600mg/month

PBL with single lesion:

PBL with single lesion Earlier used ROM regimen R RIFAMPICIN 600mg+ O OFLOXACIN 400mg+ M MINOCYCLINE 100mg

LEPRA REACTIONS:

LEPRA REACTIONS Immunologically mediated Episodes of acute /subacute inflammation Occurs during the course of leprosy Precipitated by malaise, anxiety,acute infection

Type I Type II :

Type I Type II Erythema Nodosum Leprosum-Relapse In lepromatous Type III HSR Slow and insiduous New crops of nodules Glomerulonephritis, Hepatitis,Conjunctivitis Keratitis,fever No tenderness Reversal/Upgrading or Downgrading In tuberculoid Type IV HSR Abrupt and sudden Existing lesion-Edema,erythema Tenderness

Type I Type II :

Ulceration+ Multiple nerve Precipitated by drug Main treatment-steroids Ulceration- Single nerve Due to high bacterial load Main Steroids Type I Type II

Type 1 :

Type 1 Mild analgesics Moderate to severe-Steroids 60 mg/day-Prednisolone Taper off in 6-12 months Clofazimine Azathioprine Cyclosporine

Type II:

Type II Steroids-1 mg/kg/day-taper off in 12 weeks Clofazimine-300mg/day Thalidomide-300-400mg/day Colchicine Pentoxyfylline Zinc Antimony compound Chloroquine

Thalidomide:

Thalidomide Immunomodulatory MOA----Inhibit TNF α ,Modulate IL,lysosomal membrane stabilisation Controls-Neuritis, Relieve pain Improve renal function

USES:

USES ENL Aphthous stomatitis in HIV patient Behcet’s disease TB,Sarcoidosis GVHD IBD Sjogren’s syndrome,DLE/SLE Multiple myeloma

Adverse effects:

Adverse effects Teratogenicity-Phocomelia

ADR:

ADR Painful peripheral neuropathy Eosinophilia Drowsiness Allergic drug reactions Dose-100 mg---3 to 4 times daily

PowerPoint Presentation:

Thank You

authorStream Live Help