Rifamycins
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This document provides information on rifamycins, a class of antibiotics used to treat tuberculosis, leprosy, and mycobacterium avium complex. It discusses that rifamycins are naturally produced by Streptomyces mediterranei, are bactericidal, and are particularly effective against mycobacteria. It also describes the classification, mechanisms of action inhibiting bacterial RNA polymerase, antimicrobial spectrum, pharmacokinetics of absorption, distribution, metabolism and excretion, adverse effects, drug interactions, contraindications, and clinical uses of rifamycins.
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HOD .,
Vignan Pharmacy college
vadlamudi- Guntur-A.P, India.
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I antigen expressed on tubular epithelium through which immune complexes lead to tubular cell destruction
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This document discusses various classes of antibiotics - polyenes and polypeptides. It provides details about Amphotericin B, Nystatin, Hamycin in the polyene class and Bacitracin, Polymyxin-B, Colistin/Polymyxin-E, and Dactinomycin/Actinomycin-D in the polypeptide class. It describes their origins, mechanisms of action, therapeutic uses, dosages and adverse effects.
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Adverse Events among HIV/MDR-TB Co-Infected Patients Receiving Antiretroviral...
Abstract
Background
Significant adverse events (AE) have been reported in patients receiving medications for multidrug- and extensively-drug-resistant tuberculosis (MDR-TB & XDR-TB). However, there is little prospective data on AE in MDR- or XDR-TB/HIV co-infected patients on antituberculosis and antiretroviral therapy (ART) in programmatic settings.
Methods
Médecins Sans Frontières (MSF) is supporting a community-based treatment program for drug-resistant tuberculosis in HIV-infected patients in a slum setting in Mumbai, India since 2007. Patients are being treated for both diseases and the management of AE is done on an outpatient basis whenever possible. Prospective data were analysed to determine the occurrence and nature of AE.
Results
Between May 2007 and September 2011, 67 HIV/MDR-TB co-infected patients were being treated with anti-TB treatment and ART; 43.3% were female, median age was 35.5 years (Interquartile Range: 30.5–42) and the median duration of anti-TB treatment was 10 months (range 0.5–30). Overall, AE were common in this cohort: 71%, 63% and 40% of patients experienced one or more mild, moderate or severe AE, respectively. However, they were rarely life-threatening or debilitating. AE occurring most frequently included gastrointestinal symptoms (45% of patients), peripheral neuropathy (38%), hypothyroidism (32%), psychiatric symptoms (29%) and hypokalaemia (23%). Eleven patients were hospitalized for AE and one or more suspect drugs had to be permanently discontinued in 27 (40%). No AE led to indefinite suspension of an entire MDR-TB or ART regimen.
Conclusions
AE occurred frequently in this Mumbai HIV/MDR-TB cohort but not more frequently than in non-HIV patients on similar anti-TB treatment. Most AE can be successfully managed on an outpatient basis through a community-based treatment program, even in a resource-limited setting. Concerns about severe AE in the management of co-infected patients are justified, however, they should not cause delays in the urgently needed rapid scale-up of antiretroviral therapy and second-line anti-TB treatment
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NANOTECHNOLOGY IN TUBERCULOSIS
This document summarizes a seminar presentation on nanogels for drug delivery. It discusses various types of nanogels such as chitosan-polylactic acid nanogels for encapsulating rifampicin. It also describes a study where rifampicin-loaded PLGA nanoparticles were incorporated into mannitol microspheres to enhance macrophage uptake and lung delivery. Overall, the presentation evaluates nanogels as a promising drug delivery system and discusses their ability to provide sustained and targeted drug release.
Rifampicin Induced Thrombocytopenia Ppt
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Rifamycins
- 1. RIFAMYCINS A PRESENTAION ON PRESENTING BY BIBEK GC (O5)
- 2. INTRODUCTION Complex macrocyclic antibiotics. Naturally produce by Streptomyces mediterranei. Bactericidal drug (intracellular and extracellular). Particulary effective against Mycobacteria. Used to treat TB, Leprosy and mycobacterium avium complex.
- 3. CLASSSIFICATION Based on production a) Natural rifamycins e.g. rifamycins B,O,SV and x. b) Semi-synthetic rifamycins derivatives e.g. rifampicin, rifabutin, rifaximin and rifapentine
- 4. MECHANISM OF ACTION • Inhibits bacterial DNA-dependent RNA synthesis by inhibiting bacterial DNA- dependent RNA polymerase. • Halts initiation of mRNA transcription • Prevention of translation of polypeptides
- 5. SELECTIVITY • Inhibits only prokaryotic DNA-primed RNA polymerase • In normal concentration-does not inhibit mammalian enzyme.
- 6. ANTIMICROBIAL SPECTRUM • High activity against gram +ve and mycobacteria. • Suceptible organisms: Stayphylococcus, Nesseria, Chlamydia, Mycobacterium sps etc. • Some activity against a few gram –ve; Brucella and vaccinia virus
- 7. BACTERIAL RESISTANCE • Natural resistance in gram –ve(due to failure to penetrate organism) • Resistance quickly when use sole. • Alteration in DNA dependent RNA polymerase.
- 8. PHARMACOKINETICS ABSORBTION • Well absorbed (40-70%) from GI tract in oral administration • I/m injection site – rapid absorption.
- 9. PHARMACOKINETICS DISTRIBUTION • Rapidly distributed to body tissues & fluids. • Enters into the cell. • Effective concentration reaches to many organs and body fluid including CSF. • Also penetrate abscess and caseous material.
- 10. PHARMACOKINETICS METABOLISM • In liver by deacetylated. EXCRETION • Mainly in bile(60-65%) and to a lesser extent to urine(30%)
- 11. ADVERSE EFFECT • Hepatitis • GI disturbances- nausea, vomiting, abdominal cramps with or without diarrhoea • CNS effects- headache, drowsiness, ataxia, and confusion
- 12. ADVERSE EFFECT • Myelosuppression • Respiratory – breathlessness • Cutaneous - flushing, pruritus, rash, redness and watering of eyes • Hypersensitivity reactions
- 13. CONTRAINDIACATION/PRECAUTION • Patient with Hypersensitivity to rifamycins. • Cautiously use in patient with pre-existing hepatic dysfunction. • Use carefully in pregnant animal, although significant teratogenicity has not been reported
- 14. Drug interaction Help in the metabolism/elimination of DRUGS • digitalis, coticosteriods, • quinidine, barbiturates, • ketoconazole, propranolol, • verapamil and oral anticoagulant (Effective liver enzyme inducer-hepatic cytochrome P450)
- 15. Drug interaction • Synergism with amphotericin B • Drugs Increasing toxicity of rifamycins azoles protease inhibitors The macrolide Clarithromycin Nonnucleoside reverse transcriptase inhibitors (increase levels of rifamycins by inhibiting CYP450 enzymes )
- 16. CLINICAL USES • TB • LEPROSY • MYCOBACTERIUM AVIUM COMPLEX
- 17. THANK YOU
Editor's Notes
- r
- tive