3. ISONIAZID
DESCRIPTION:
It is synthetic anti- TB drug introduced in 1950
Chemically, it is isonicotinic acid derivative – combination
of isonicotinic acid and hydrazine (Hydrazide)
Chemical formula: C6H7N3O
It is a prodrug; in body in converted into electrophilic
species which inhibit the synthesis of mycolic acid
It is effective against rapidly dividing MTB but less
effective against dormant and semi dormant MTB.
Pregnancy category “C”
5. CHEMISTRY:
Isoniazid is a chemical synthetic molecule.
It s pyridine derivative of nicotinamide OR it is a hydrazide of
nicotinic acid.
CHEMICAL NAME:
1. 4-pyridinecarboxyhydrazide 2. Isonicotinohydrazide
3. Isonicotinic acid hydrazide
MOLECULAR FORMULA: C6H7N3O
MELTING POINT: 170 – 173
SOLUBILITY:
Soluble in water, alcohol
Slightly soluble in chloroform and ether.
6. SYNTHESIS OF ISONIAZID:
METHOD 1:
Basic hydrolysis of 4-cyano pyridine converts cyano / nitrile
group to an amide- isonicotinamide.Which then reacts with
hydrazine to produce isoniazid.
8. SAR OF ISONIAZID:
Pyridine ring, if replaced with piperidine then the biological
activity lost.
Hydrazide linkage when converted into hydrazine derivatives, a
series of active compounds are produced.
If hydrazide is shifted to position 2 or 3 instead of 4 then the
compound is less active.
Carbonyl hydrazide at position no. 4 is essential for biological
activity.
INH contains 2 nitrogen atoms, when alkyl group is introduced
then:
1. If N1= compound became inactive
2. If N2= active compounds but less than orignal
9. Replacement of hydrazide group with another amide or ester
group results in loss of activity.
Oxidation of pyridine nitrogen results in loss of activity.
For anti-tubercular activity terminal nitrogen is must
N2- alkyl derivative ( N2-isopropyl derivative) is essential for
anti- tubercular activity.
Dialkyl derivative ( O=C-NH-NR2) show high activity.
When isopropyl group is attached to terminal nitrogen, the
compound show similar activity as INH.
10. Mechanism of action:
In small doses it is act as bacteriostatic and in large doses it is
bacteriocidal
Mycolic acid is the essential component of mycobacterial cell
wall ,The drug (isoniazid) inhibit the synthesis of the Mycolic
acid and as a result the cell wall become thin and inhibit the
growth of bacteria.
Mechanism :
Isoniazid is a prodrug activated by mycobacterial catalase-
peroxidase (KatG)
It targets the enzyme acyl carrier protein reductase (InhA) and
b-ketoacyl-ACP synthetase
11. •Under the influence of KatG gene, INH is
converted into;
1. Isonicotinic aldehyde
2. Isonicotinic acid
3. Isonicotinamide
12. • From these compounds, highly reactive
electrophile species such as isonicotinyl
radical and isonicotinyl peroxy radical are
formed
13. These radical acylate NADPH dependent beta-ketoacyl carrier
protein reductase, involved in the elongation of mycolic acid. It
results in the inhibition of cell wall leading to cell death.
This enzyme selectively acts on fatty acids( more than 26
carbon). Mycolic acid is a alpha branched fatty acids having
short arm of 20 – 24 and long arm of 26 – 50 carbon.
14. Therapeutic uses:
It is the first line drug in the treatment of pulmonary tuberculosis.
It is active against extracellular and intracellular organisms Used for
prophylaxis against TB in individuals who are at great risk as very
young or immunocompromised patients.
Latent tuberculosis in patients with positive tubercullin test
It is used in tuberculo meningitis
It is also used in the treatment of acute leukemia.
Side effects:
Peripheral neuritis, Optic neuritis,Allergic
reactions,Hepatotoxicity,Gastric upset,Haemolytic
anaemia,CNS toxicity,Thrombocytopenia,Agranulocytosis and
Fever.