 Chronic granulomatous disease caused
by Mycobacterium tuberculosis.
 Tuberculosis typically attacks the
lungs, but can ...
 Sites of
extra-pulmonary
tuberculosis
FirstlineSecondline
 Isoniazid
 Rifampicin
 Pyrazinamide
 Ethambutol
 Streptomycin
 Ethionamide
 Thiacetazone
 Par...
tuberculocidaltuberculostatic
 Isoniazid
 Streptomycin
 Capromycin
 Ciprofloxacin
 Rifampicin
 Pyrazinamide
 Kanamy...
 Most effective and cheapest primary
anti tubercular drug.
 Effective in both acidic and alkaline
medium
 Tuberculocida...
Mycolic
acids
synthesizes
Isoniazid
inhibits this
synthesis
 Peripheral neuritis
 Hepatitis
 Psychosis
 Seizures
 Anorexia
 GIT discomfort
 Fever
 Allergic reactions
Less
com...
 Semisynthetic derivative of rifamycin
, am anitibiotic obtained from
streptomyces mediterranei.
 Highly effective tuber...
 Rifampicin binds to beta subunit of DNA
dependant RNA polymerase and inhibits
RNA synthesis in bacteria.
 It cannot bin...
 Hepatotoxicity
 GIT disturbances
 Flu-like syndrome
 CNS symptoms – drowsiness, ataxia,
confusion, peripheral neuropa...
TB & atypical
mycobacterial
infections
Leprosy
Prophylaxis in
H. influenza
Resistant staph
infections
Brucellosis
Pneumoco...
 Analog of nicotinamide
 Tuberculocidal
 Requires acidic pH for
its activity
 Mechanism of action
not clearly known.
...
 Tuberculocidal
 Acts only against extracellular organisms
 Has to be given IM
 When used alone
resistance develops.
...
 Tuberculostatic
 Also effective against
atypical mycobacteria.
 Well absorbed on oral administration
 Dose should be ...
 INH: potent bactericidal
 Rifampicin: potent bactericidal
 Pyrazinamide: weak bactericidal
 Ethambutol: bacteriostati...
 Less effective
 More toxic
 Used only if organism is resistant to first
line drugs
 Ethionamide , PAS, cycloserine :
...
Phase I
•1-3 months
•Rapidly kills
bacilli
•Symptomatic
relief
Phase II
•4-6 months
•Eliminates
remaining
bacilli
•Prevent...
1. INH+S+T daily for 2 months
2. INH+T daily for 10 months
INH – isoniazid
S – Streptomycin
T - Thiacetazone
1. INH+R+Z+E/S daily or thrice a week for 2
months followed by:
2. INH+R daily or thrice a week for 4
months
3. INH+R+Z tr...
Anti tuberculosis drugs
Anti tuberculosis drugs
Anti tuberculosis drugs
Anti tuberculosis drugs
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Anti tuberculosis drugs

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Anti tuberculosis drugs

  1. 1.  Chronic granulomatous disease caused by Mycobacterium tuberculosis.  Tuberculosis typically attacks the lungs, but can also affect other parts of the body.  It is spread through the air when people who have an active TB infection cough, sneeze, or otherwise transmit respiratory fluids through the air.
  2. 2.  Sites of extra-pulmonary tuberculosis
  3. 3. FirstlineSecondline  Isoniazid  Rifampicin  Pyrazinamide  Ethambutol  Streptomycin  Ethionamide  Thiacetazone  Para Aminosalicylic acid (PAS)  Amikacin  Capreomycin  Cycloserine  Ciprofloxacin  Kanamycin  Rifabutin  Rifapentine
  4. 4. tuberculocidaltuberculostatic  Isoniazid  Streptomycin  Capromycin  Ciprofloxacin  Rifampicin  Pyrazinamide  Kanamycin  Ethambutol  Thiacetazone  PAS  Ethionamide  Cycloserine
  5. 5.  Most effective and cheapest primary anti tubercular drug.  Effective in both acidic and alkaline medium  Tuberculocidal for rapidly multiplying bacilli  Tuberculostatic for resting bacilli
  6. 6. Mycolic acids synthesizes Isoniazid inhibits this synthesis
  7. 7.  Peripheral neuritis  Hepatitis  Psychosis  Seizures  Anorexia  GIT discomfort  Fever  Allergic reactions Less common
  8. 8.  Semisynthetic derivative of rifamycin , am anitibiotic obtained from streptomyces mediterranei.  Highly effective tuberculocidal  Acts on both intra and extracellular organisms.  It is called a sterilizing agent.
  9. 9.  Rifampicin binds to beta subunit of DNA dependant RNA polymerase and inhibits RNA synthesis in bacteria.  It cannot bind to human RNA polymerase, thus selectively destroying the bacteria.
  10. 10.  Hepatotoxicity  GIT disturbances  Flu-like syndrome  CNS symptoms – drowsiness, ataxia, confusion, peripheral neuropathy etc  Hypersensitivity reactions  Staining of secretions
  11. 11. TB & atypical mycobacterial infections Leprosy Prophylaxis in H. influenza Resistant staph infections Brucellosis Pneumococcal meningitis To eradicate carrier state
  12. 12.  Analog of nicotinamide  Tuberculocidal  Requires acidic pH for its activity  Mechanism of action not clearly known.  HEPATOTOXICITY is the Most common adverse effect May inhibit synthesis of mycolic acids
  13. 13.  Tuberculocidal  Acts only against extracellular organisms  Has to be given IM  When used alone resistance develops.  Least preferred first line drug.
  14. 14.  Tuberculostatic  Also effective against atypical mycobacteria.  Well absorbed on oral administration  Dose should be reduced in renal failure  Optic neuritis is an important adverse effect which needs withdrawal of the drug.  It decreases the renal excretion of uric acid and enhances plasma urate levels.
  15. 15.  INH: potent bactericidal  Rifampicin: potent bactericidal  Pyrazinamide: weak bactericidal  Ethambutol: bacteriostatic  Streptomycin: bactericidal Synergistic effect NEVER USE A SINGLE DRUG FOR CHEMOTHERAPY IN TUBERCULOSIS, A COMBINATION OF 2 OR MORE IS ALWAYS BETTER
  16. 16.  Less effective  More toxic  Used only if organism is resistant to first line drugs  Ethionamide , PAS, cycloserine : bacteriostatic  Amikacin, capromycin, fluoroquinolones are used in Multi Drug Resistant TB
  17. 17. Phase I •1-3 months •Rapidly kills bacilli •Symptomatic relief Phase II •4-6 months •Eliminates remaining bacilli •Prevents relapse
  18. 18. 1. INH+S+T daily for 2 months 2. INH+T daily for 10 months INH – isoniazid S – Streptomycin T - Thiacetazone
  19. 19. 1. INH+R+Z+E/S daily or thrice a week for 2 months followed by: 2. INH+R daily or thrice a week for 4 months 3. INH+R+Z trice a week for 2 months followed by 4. INH+R daily for 7 months.
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