Anti TB Anti Malarial Flashcards
Classify anti tubercular drugs
1ST LINE
Rifampicin
Isoniazid
Pyrazinamide
Ethambutol
Streptomycin ( only injectable )
2nd LINE
Kanamycin/ Amikacin
Ciprofloxacun / Ofloxacin
Para amino salicylic acid
Cycloserin
Thioacetazone , Capreomycin
Ethionamide
Treatment regimen of PTB
6 Months regimen of PTB
1) Initial phase = 1st two months
R I P E
2) Continuation phase = next four months
R I
Tab pyridoxine , for prevention of peripheral neuropathy because INH causes peripheral neuropathy
M/A of Rifampicin
Binds with beta subunit bacterial DNA dependent RNA polymerase enzyme
Inhibit RNA synthesis
No protein synthesis
No growth and multiplication of bacteria
M/ A of isoniazide
Prodrug activated by MB catalase peroxidase
Activated form of INH forms covalent complex with acyl carrier protein and Beta keto acyl carrier protein
Complex blocks myocolic acid synthesis
Cell wall of bacteria disrupted
Bacterium cell death
Role of INZ in PTB
It penetrates the macrophage
It kills both intracellular and extracellular bacilli
It is bactericidal for growing bacilli
It is bacteriostatic for resting Bacteria
Role of Rifampicin
It kills both extracellular and intracellular bacteria
Role of pyrazindamide in PTB
It kills dormant bacilli
It kills intracellular bacilli
It decreases total treatment duration from 9 months to 6 months
Prevents relapse and oppose treatment failure
Combination of drugs for anti TB
To increase the synergistic effects / efficacy
To boarder the spectrum of activity
To kill intracellular and extracellular and dormant bacilli
To act against large granuloma
To decrease the dose of individual drug
To decrease total treatment duration from 9 months to 6 months
To decrease adverse effects of one another
To decrease chance of drug resistance
MDR
MDR Tb us defined as the condition of resistance to at least isoniazide Rifampicin
Confirmed by Sputum AFB culture and sensitivity test
Treatment
MDR = specially designed drug regimen and specialised hospital
1) at first drug sensitivity test is done
2). Treated with 5-6. Drugs including which were not used in past as per DST report
Drugs are = 2nd line
3) treatment should be continued for 18-24 months or treatment should be continued for 6 months after last negative culture report of sputum
DOTS
Directly observed treatment shortcourse
Are comprehensive strategy for Tb cure with short course chemotherapy
CAT1 for 6M and CAT2 for 8 M
It includes appropriate diagnosis by sputum Microscopy
Regular adequate drug supply
Proper monitoring recording and reporting
Providing in front of health worker / any responsible person
Sucessful rate more than 95%
Drugs are 1st line anti TB drugs
Government commitment
What are the principles of anti TB therapy
To cure Tb
To make the patient non infective as early as possible
To prevent the spread of infection to others
To eradicate tubercular bacilli from infected tissue
To see the bacteria doesn’t become resistance
To prevent relapse
Adverse effects of
1) INH = PERIPHERAL NEUROPATHY ( slow acylator ) HYPERSENSITIVITY, HEPATOTOXICITY ( rapid acetylator )
2) Rifampicin = harmless red colouration or saliva , urine , tear sweat
Hepatotoxicity jaundice hypersensitivity
3) Ethambutol = OPTIC NEURITIS RETROBULBULAR NEURITIS
Hypersensitivity
4) Pyrazinamide = GOUTY ATTACK , Arthalgia , GIT upset
5) Streptomycin = OTOTOXICITY
Classification of anti malarial drugs Acc to stage of lifecycle
BLOOD SCHIZONTOCIDES :
1 st group = rapid acting = Chloroquine , Quinine , Melfoquinie , Lomefanthrine , Artemisinin
2nd group = slow acting = Proguail, Pyramethamine , Tetracycline , Doxicycline
TISSUE SCHIZONTOCIDES
Proguanil, pyramethamine , primaquine
GAMETOCYCTOCIDES
Primaquine , Chloroquine
SPORONOTOCIDES
Primaquine , Proguanil , pyramethamine
Antimalarial drugs are
Chloroquine
Quinine
Mefloquine
Proguanil
Primaquine
Fansider
Pyramethamine
Doxycycline
Tetracycline
Lumofontide
Pharmacological action of Choloroquine
Antimalaria action
Anti amoebic action
Anti inflammatory action
Quinidine like action
