This document summarizes information about anti-tuberculosis drugs. It first defines tuberculosis as an infectious bacterial disease caused by Mycobacterium tuberculosis that commonly affects the lungs. It then discusses risk factors for tuberculosis, why it affects the lungs, the etiology and types of tuberculosis infection, transmission, symptoms, and management. For management, it outlines first-line therapy drugs including isoniazid, rifampicin, pyrazinamide, and ethambutol. It also discusses the mechanisms of action of these drugs and DOTS strategy for tuberculosis control.

1. Anti Tuberculosis drugs
Presented by : Sonali Hiranwar
J.L Chaturvedi college of pharmacy Nagpur

2. • Tuberculosis is granulomatous disease and major health problem in developing
countries.
• As per “WHO” Tuberculosis also call “TB” Is An Infectious Bacterial Disease
Caused By Mycobacterium Tuberculosis, Which Most Commonly Affects The
Lungs. It Is Transmitted From Person To Person Via Droplets From the Throat And
Lungs Of People With the Active Respiratory Disease. Tuberculosis ancient
disease remains a leading infectious killer of mankind.
• TB commonly was known as “consumption” because of the pronounced weight
loss that it caused Other common names included “wasting disease” and the
“white plague.”
• Introduction

3. • RISK FACTOR
• A healthy immune system can often successfully fight TB bacteria, but
your body can’t mount an effective defence if your resistance is low.
Diseases and medications can weaken your immune system, including :
• HIV/AIDS
• Diabetes
• Chemotherapy
• Malnutrition Advanced age Alcoholism
• Immunosuppressive medications
• Immigrant (From area with high TB incidence )

4. • WHY TB AFFECTS ONLY LUNGS ?
• M.tuberculi Enters Host cell Utilizes Cholesterol in cell
membrane (Highly oxygenases amount involved in metabolism
of cholesterol into)
• The concentrations of oxygenases greater in alveoli of lungs
.Hence Mycobacterium species majorly reside in alveoli of
lungs.
• And as it is strict aerobe strictly thrives best in tissues with high
Oxygen tension such as in the apex of the lung ATP.

5. • ETIOLOGY
• TB infection caused by tubercle bacilli, which belong genus to mycobacterium.
Mycobacterium, from the greek “mycos” refers to mycobacteria’s waxy
appearance, which due to highly lipid contain cell wall with slender shape
bacillus. Ziehl-neelson stain or the fluorochrome stain must be used instead gram
stain. Main species of mycobacterium cause tuberculosis.
• Typical mycobacteria
• Mycobacterium tuberculosis
• Mycobacterium hominis
• M ycobacterium bovine
• Atypical mycobacteria
• Saprophytic mycobacteria
• Mycobacterium avium

6. • TRANSMITTION
• Tuberculosis is tansmitted Mainly By Droplet Infection And Droplet Nuclei.
Generated By Sputum-positive Patient With Pulmonary Tuberculosis. To Transmit
Infection , The Particles Must Be Fresh Enough To Carry A Viable Organism.

7. • Type of tuberculosis infection
• Primary Tuberculosis : The infection of an individual who has not been
previously infected or immunized is called Primary tuberculosis or Ghon’s
complex or childhood tuberculosis. Lesions forming after infection is peripheral
and accompanied by hilar which may not be detectable on chest radiography.
• Secondary Tuberculosis : The infection that individual who has been previously
infected or sensitized is called secondary or post primary or reinfection or chronic
tuberculosis.

8. • SYMPTOMS OF TUBERCULOSIS

9. Management For Anti Tuberculosis drugs

10. Lines and Regimens Defined
.First-Line Therapy – Category I regimen for new patients
Category II regimen for re-treatment patients – Suspicion of resistance
to one anti-TB drug
Category III- New cases of smear –ve pulmonary TB with limitedNew
cases of smear –ve

11. • Isoniazid

12. • Rifampicin

13. • • Highly effective during 1st 2months • Active both intra &
extracellularly • Including Z in combination therapy –duration of
treatment is ↓ -It has potent sterilising action –Risk of relapse is
reduced • Good CSF Penetration
• Pyrazinamide Mycobacterial Pyrazinamidase pncA Pyrazinoic
Acid Inhibits Plasma membrane Synthesis
• ETHAMBUTOL(E)
• Tuberculostatic • Rapid Growers are more susceptible •
Hastens the rate of sputum conversion • Prevent the
emergence of Resistant bacilli
• 30. M.O.A Mycobacterial Arabinosyl Transferase Polymerisation
reaction of Arabinoglycan Essential component of Cell wall
PYRAZINAMIDE(Z)

16. • Ethionamide
• Inhibition of mycolic acid biosynthesis and consequent impairment of
cell-wall synthesis

17. • DOTS (directly observed treatment, short-
course),
• DOTS (directly observed treatment, short-course), is the name given to the World
Health Organization-recommended tuberculosis control strategy that combines
five components:
• 1. Government commitment (including both political will at all levels, and
establishing a centralized and prioritized system of TB monitoring, recording and
training)
2. Case detection by sputum smear microscopy
3. Standardized treatment regimen directly observed by a healthcare worker or
community health worker for at least the first two months
4. A regular drug supply
5. A standardized recording and reporting system that allows assessment of
treatment result

18. Thank you