Antileprosy Drugs
ANTILEPROSY DRUGS
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Introduction
· Leprosy, also known
as Hansen's disease, is a chronic infectious disease caused by Mycobacterium
leprae.
· It primarily affects
the skin, peripheral nerves, upper respiratory tract, and eyes.
· Antileprosy drugs are
essential for treating this disease, preventing complications, and reducing
transmission.
Definition
· Antileprosy drugs are
medications used to treat leprosy by killing the causative organism,
Mycobacterium leprae, and managing the symptoms and complications of the
disease.
Classification
Antileprosy drugs can be classified
into the following categories:
1.
Primary Drugs
o
Dapsone: The most commonly used drug in
leprosy treatment.
o
Rifampicin: A potent bactericidal drug often used
in combination therapy.
o
Clofazimine: Used for its anti-inflammatory and
bactericidal properties.
2.
Secondary Drugs
o
Ofloxacin: An antibiotic used in some cases.
o
Minocycline: Another antibiotic with efficacy
against Mycobacterium leprae.
o
Clarithromycin: Sometimes used in combination with
other drugs.
Pharmacokinetics
1.
Dapsone
o
Absorption: Well absorbed from the
gastrointestinal tract.
o
Distribution: Widely distributed in tissues, with
high concentrations in the skin.
o
Metabolism: Metabolized in the liver.
o
Excretion: Excreted in urine, both as
metabolites and unchanged drug.
2.
Rifampicin
o
Absorption: Well absorbed orally.
o
Distribution: Widely distributed in body tissues
and fluids.
o
Metabolism: Metabolized in the liver.
o
Excretion: Primarily excreted in bile and feces.
3.
Clofazimine
o
Absorption: Variable absorption from the
gastrointestinal tract.
o
Distribution: Deposited in fatty tissues and skin.
o
Metabolism: Metabolized in the liver.
o
Excretion: Excreted mainly in feces.
Mechanism of Action
1.
Dapsone: Inhibits dihydropteroate synthase in
the folic acid synthesis pathway of bacteria, leading to bacteriostatic
effects.
2.
Rifampicin: Inhibits DNA-dependent RNA polymerase
in bacterial cells, preventing RNA synthesis and thus killing the bacteria.
3.
Clofazimine: Binds to mycobacterial DNA and
interferes with growth and replication. It also has anti-inflammatory
properties.
Uses
·
Leprosy (Hansen's disease): The primary use of
these drugs is in treating different forms of leprosy.
·
Combination Therapy: Multidrug therapy
(MDT) with dapsone, rifampicin, and clofazimine is the standard treatment to
prevent resistance.
·
Other Uses: Clofazimine is also used in treating
certain skin conditions and as a part of the treatment regimen for
multidrug-resistant tuberculosis (MDR-TB).
Adverse Effects
1.
Dapsone: Hemolysis (especially in patients
with G6PD deficiency), methemoglobinemia, skin rashes, and neuropathy.
2.
Rifampicin: Hepatotoxicity, red-orange
discoloration of bodily fluids, gastrointestinal disturbances, and
hypersensitivity reactions.
3.
Clofazimine: Skin discoloration, gastrointestinal
disturbances, and photosensitivity.
Contraindications
1.
Dapsone: Severe anemia, hypersensitivity to
sulfonamides, and G6PD deficiency.
2.
Rifampicin: Liver disease, hypersensitivity to
rifamycins.
3.
Clofazimine: Hypersensitivity to clofazimine or
any component of the formulation.
Role of Nurse
·
Patient Education: Educating patients about leprosy, the
importance of adherence to treatment, and potential side effects.
·
Administration of Medications: Ensuring the
correct administration of medications and observing for adverse reactions.
·
Monitoring: Regular monitoring of patient’s
progress, including checking for side effects and managing complications.
·
Support: Providing emotional and psychological
support to patients, as leprosy can be a stigmatizing condition.
·
Infection Control: Implementing and promoting infection
control practices to reduce the spread of leprosy.
·
Follow-up Care: Ensuring regular follow-ups and
coordinating with healthcare providers for comprehensive care.
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