9/2/20121© 2010 Delmar, Cengage Learning1By- Jitendra BhangaleAssistant Professor & Head,Department of Pharmacology,Smt N....
9/2/20122© 2010 Delmar, Cengage Learning3By J. O. Bhangale, Head, Dept of Pharmacology, Smt N. M. Padalia Pharmacy College...
9/2/20123© 2010 Delmar, Cengage Learning5By J. O. Bhangale, Head, Dept of Pharmacology, Smt N. M. Padalia Pharmacy College...
9/2/20124© 2010 Delmar, Cengage Learning7By J. O. Bhangale, Head, Dept of Pharmacology, Smt N. M. Padalia Pharmacy College...
9/2/20125© 2010 Delmar, Cengage Learning9By J. O. Bhangale, Head, Dept of Pharmacology, Smt N. M. Padalia Pharmacy College...
9/2/20126© 2010 Delmar, Cengage Learning11By J. O. Bhangale, Head, Dept of Pharmacology, Smt N. M. Padalia Pharmacy Colleg...
9/2/20127© 2010 Delmar, Cengage Learning13By J. O. Bhangale, Head, Dept of Pharmacology, Smt N. M. Padalia Pharmacy Colleg...
9/2/20128© 2010 Delmar, Cengage Learning15By J. O. Bhangale, Head, Dept of Pharmacology, Smt N. M. Padalia Pharmacy Colleg...
9/2/20129© 2010 Delmar, Cengage Learning17By J. O. Bhangale, Head, Dept of Pharmacology, Smt N. M. Padalia Pharmacy Colleg...
9/2/201210© 2010 Delmar, Cengage Learning19By J. O. Bhangale, Head, Dept of Pharmacology, Smt N. M. Padalia Pharmacy Colle...
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Leprosy 120902115234-phpapp02

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Leprosy in modern times

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Leprosy 120902115234-phpapp02

  1. 1. 9/2/20121© 2010 Delmar, Cengage Learning1By- Jitendra BhangaleAssistant Professor & Head,Department of Pharmacology,Smt N. M. Padalia Pharmacy College,Ahmedabad© 2010 Delmar, Cengage Learning2By J. O. Bhangale, Head, Dept of Pharmacology, Smt N. M. Padalia Pharmacy College, A’badIt is a chronic infectious disease caused by M.leprae, anacid fast, rod shaped bacillus.It mainly affects the skin, peripheral nerves, and mucosa ofthe respiratory tract etc.,It has left behind a terrifying image in history and humanmemory of mutilation, rejection and exclusion from society.
  2. 2. 9/2/20122© 2010 Delmar, Cengage Learning3By J. O. Bhangale, Head, Dept of Pharmacology, Smt N. M. Padalia Pharmacy College, A’badCaused by a germ similar to thatwhich causes tuberculosis.It attacks the nerves of thehands, feet and face.If left untreated can take awaythe ability to move fingers, toesand eyelids.It can also destroy the ability tofeel pain so those affected areprone to injuries and burns.The longer the disease is leftundetected, the more likely it isthat the deformities, so oftenassociated with leprosy, will occur.© 2010 Delmar, Cengage Learning4By J. O. Bhangale, Head, Dept of Pharmacology, Smt N. M. Padalia Pharmacy College, A’badLepromatous: damages respiration, eyes, and skinTuberculoid: affects nerves in fingers and toes, andsurrounding skinBorderline: has effects of both types
  3. 3. 9/2/20123© 2010 Delmar, Cengage Learning5By J. O. Bhangale, Head, Dept of Pharmacology, Smt N. M. Padalia Pharmacy College, A’badExamine skinCheck for patchesTest for sensationCount the number of patchesLook for damage to nerves© 2010 Delmar, Cengage Learning6By J. O. Bhangale, Head, Dept of Pharmacology, Smt N. M. Padalia Pharmacy College, A’badTest for sensationTake a pointed soft object (feather, cotton wick)Lightly touch alternately the patch & normal skinAsk the person to point where they were touchedAsk them to close their eyes and repeat the procedureIn case of loss of sensation the person will be able topoint to where they were touched on the normal skin butnot on the patch
  4. 4. 9/2/20124© 2010 Delmar, Cengage Learning7By J. O. Bhangale, Head, Dept of Pharmacology, Smt N. M. Padalia Pharmacy College, A’badThe diagnosis is made based on finding definite loss ofsensation in one or more patches.When you have examined the whole body, count the numberof patches.1-5 patches is paucibacillary (PB), more than 5 patches ismultibacillary (MB) leprosy© 2010 Delmar, Cengage Learning8By J. O. Bhangale, Head, Dept of Pharmacology, Smt N. M. Padalia Pharmacy College, A’badPB Adult(6 blister packs)Rifampicin 600 mg once a monthDapsone 100 mg every dayMB Adult(12 blister packs)Rifampicin 600 mg once a monthClofazimine 300 mg once a monthClofazimine 50 mg and dapsone 100 mg every day
  5. 5. 9/2/20125© 2010 Delmar, Cengage Learning9By J. O. Bhangale, Head, Dept of Pharmacology, Smt N. M. Padalia Pharmacy College, A’bad© 2010 Delmar, Cengage Learning10By J. O. Bhangale, Head, Dept of Pharmacology, Smt N. M. Padalia Pharmacy College, A’bad
  6. 6. 9/2/20126© 2010 Delmar, Cengage Learning11By J. O. Bhangale, Head, Dept of Pharmacology, Smt N. M. Padalia Pharmacy College, A’badSulfonesDapsonePhenazine derivativeClofazimineAnti TB agentsRifampinEthionamideOtherOfloxacinMinocyclineClarithromycin© 2010 Delmar, Cengage Learning12By J. O. Bhangale, Head, Dept of Pharmacology, Smt N. M. Padalia Pharmacy College, A’badThe sulfones are derivatives of 4,4-diaminodiphenylsulfone(dapsone).Dapsone is bacteriostatic, but not bactericidal.Mechanism of action:-They are competitive inhibitors of dihydropteroate synthase andprevent the normal bacterial utilization of para-amino-benzoic acid.Both possess approximately the same range of antibacterial activityand both are antagonized by para-aminobenzoic acid.
  7. 7. 9/2/20127© 2010 Delmar, Cengage Learning13By J. O. Bhangale, Head, Dept of Pharmacology, Smt N. M. Padalia Pharmacy College, A’badUntoward EffectsMethemoglobinemia, Anorexia, nausea, and vomiting,headache, nervousness, insomnia, blurred vision,paresthesias, reversible peripheral neuropathy© 2010 Delmar, Cengage Learning14By J. O. Bhangale, Head, Dept of Pharmacology, Smt N. M. Padalia Pharmacy College, A’badThe rifamycins (rifampin, rifabutin, rifapentine) are a group ofstructurally similar, complex macrocyclic antibiotics produced byStreptomyces mediterranei .Antibacterial Activity:- Rifampin inhibits the growth of mostgram-positive bacteria as well as many gram-negativemicroorganisms such as Escherichia coli, Pseudomonas, indole-positive and indole-negative Proteus, and Klebsiella. Rifampin is veryactive against Staphylococcus aureus and coagulase-negativestaphylococci.
  8. 8. 9/2/20128© 2010 Delmar, Cengage Learning15By J. O. Bhangale, Head, Dept of Pharmacology, Smt N. M. Padalia Pharmacy College, A’badMechanism of Action:-Rifampin inhibits DNA-dependent RNA polymerase of mycobacteriaand other microorganisms by forming a stable drug-enzymecomplex, leading to suppression of initiation of chain formation inRNA synthesis.More specifically, the β subunit of this complex enzyme is the siteof action of the drug, although rifampin binds only to theholoenzyme.© 2010 Delmar, Cengage Learning16By J. O. Bhangale, Head, Dept of Pharmacology, Smt N. M. Padalia Pharmacy College, A’badNuclear RNA polymerases from a variety of eukaryotic cells do notbind rifampin, and RNA synthesis is correspondingly unaffected ineukaryotic cells.High concentrations of rifamycin antibiotics can inhibit RNAsynthesis in mammalian mitochondria, viral DNA-dependent RNApolymerases, and reverse transcriptases.Rifampin is bactericidal for both intracellular and extracellularmicroorganisms.
  9. 9. 9/2/20129© 2010 Delmar, Cengage Learning17By J. O. Bhangale, Head, Dept of Pharmacology, Smt N. M. Padalia Pharmacy College, A’badAdverse effect:-Hepatitis and deathsChronic liver diseaseAlcoholismRespiratory syndromeCutaneous syndromeFlu syndromeAbdominal syndrome© 2010 Delmar, Cengage Learning18By J. O. Bhangale, Head, Dept of Pharmacology, Smt N. M. Padalia Pharmacy College, A’badClofazimine appears to preferentially bind to GC-richmycobacterial DNA and also increase mycobacterialphospholipase A2 activity and inhibit microbial K+ transport.It is weakly bactericidal against M. intracellulare.The drug also exerts an antiinflammatory effect and prevents thedevelopment of erythema nodosum leprosum.The compound also is useful for treatment of chronic skin ulcersproduced by Mycobacterium ulcerans.
  10. 10. 9/2/201210© 2010 Delmar, Cengage Learning19By J. O. Bhangale, Head, Dept of Pharmacology, Smt N. M. Padalia Pharmacy College, A’badThalidomide has been shown effective for the treatment oferythema nodosum leprosum.It has immunomodulatory actions and inhibits tumor necrosisfactor-a.© 2010 Delmar, Cengage Learning20By Jitendra BhangaleAsst. Prof. Dept of Pharmacology, Smt N. M. Padalia Pharmacy College, Ahmedabad

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