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Dapsone (dr samiullah khalil )


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dr samiullah khalil peshawar pakistan

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Dapsone (dr samiullah khalil )

  1. 1. Dr samiullah khalil Fcps (II) Trainee Dermatology
  2. 2.  In the early 20th century, it is invented by the German chemist Paul Ehrlich while working on selective toxicity . Dapsone (diamino-diphenyl sulfone)is a medication most commonly usedin combination with rifampicin andclofazimine as multidrug therapy(MDT) for the treatment ofMycobacterium leprae infections (leprosy). Official in IP,BP,USP.
  3. 3. 4,4’-diaminodiphenylsulfone
  4. 4. 1. Absorption It is completely absorbed after oral administration2. Distribution Approximately 70% bound to plasma protein. The main metabolite, monoacetyl dapsone, is nearly 100% protein bound.
  5. 5.  After oral administration the drug is mainly eliminated by kidney.20 percent is excreted unchanged while 80 percent as derivatives. Only minor amount is excreted in faeces . Bile: 10% of an oral dose was found in the bile Breast-milk: Dapsone is excreted in breast milk
  6. 6.  Plasma concentration of Dapsone is reduced by Rafampicin. Plasma concentration of both drugs may increase when Dapsone given with Trimethoprim. This medication may decrease the effectiveness of combination- type birth control pills.This can result in pregnancy.
  7. 7.  Mycobacterium leprae infections (leprosy)./hansen’s disease Linear Ig A Bullous disease Acne. Vasculitis Sweet syndrome Mycetoma
  8. 8.  Pyoderma Gangrenosum Apthous ulceration Granuloma Annulare Pneumocystis pneumonia. Dermatitis Herpetiformis. Toxoplasmosis - Prophylaxis
  9. 9. DISEASE ADULT CHILDREN DAYS Leprosy - Lepromatous 50-100 mg/day 6-10 mg/day 2-5 years Leprosy - Tuberculoid 100 mg/day NA 6 months Dermatitis Herpetiformis 50-300 mg/day NA Life long basis Pneumocystis Pneumonia 100 mg/day 2 mg/kg/day 14-21 days Pneumocystis Pneumonia 100 mg/day 2 mg/kg/day Life long basis ProphylaxisToxoplasmosis - Prophylaxis 100 mg/day 2 mg/kg/day Life long basis
  10. 10. TRANSDERMAL DOSE Administered transdermally As a gel 5% topical acne medication available in 3-, 30-, and 60-gram tubes. In normal use, 0.5 grams should be administered to the face per application twice a day.
  11. 11.  Mild haemolytic anaemia (decreases with use of Vit C or Vit E ). Gastric intolerance-nausea & anorexia Methaemoglobinaemia (treated with Cemitidine) , headache, paresthesias, mental symptoms & drug fever allergic rashes, fixed drug eruption, hypermelanosis, phototoxicity& rarely exfoliative dermatitis, steven Jhonsen syndrome. Hepatitis & agranulocytosis
  12. 12.  Uncommonly weakness of the feet and hands muscles with dose greater then 100 mg/day It is tested by ability to walk on toes tip and to test Hand grip. Leucopenia presents with fever ,sore throat ,skin infections and other common infections. Bluish discoloration of lips and finger tips Dapsone reaction/sulfone syndrome
  13. 13.  Hypersensitivity more frequent in patients receiving multiple-drug therapy. The reaction involves a rash and may also include fever, jaundice, and eosinophilia. Swollen lymph glands and internal organ failure (Liver , Lungs , Heart and Kidney). In general, these symptoms will occur within the first six weeks of therapy or not at all, and may be treated by corticosteroid therapy.
  14. 14.  Allergic to sulphur containing antibiotics G6PD deficiency Heart diseases Lung diseases Breast feeding Pregnancy Porphyria
  15. 15.  FBC before the start of the therapy Then at 1 week Then once monthly