Leprosy Flashcards
What drugs do you give to leprosy patients if they can’t tolerate clofazimine?
clarithomycin, minocyclin, and oxfloacin
MOA of Dapsone
folate antagonist; inhibits dihydropteroate synthetase; inhibits 2nd messenger pathways involved in PMN chemotaxis
Dapsone Metabolism
- metabolized to hydroxylamine –> methemoglobinemia and hemolysis
- interaction w/ rifampin –> increases toxicity
- cimetidine and omeprazole decrease toxicity
- Trimethoprim increases serum levels of both drugs
- Renal elimination
- interaction w/ probenecid decreases clearance
adverse effects of Dapsone
hemolysis, methemoglobinemia, hepatitis, cholestatic jaundice, peripheral neuropathy, severe hypoalbunemia, psychosis, leukopenia, agranulocytosis, rash can extend to SJS
MOA of rifampin
inhibits beta subunit of DpRp
adverse effect of rifampin
transient increases in hepatic enzymes, sometimes liver toxicity, makes management of DM difficult, discolors bodily fluids,
MOA of clofazmine
perferential binding to mycobacterial guanine in DNA
adverse effects of clofazimine
dose dependent anti-inflammatory and immunosuppressive effects, hepatitis, jaundice, stains body/bodily fluids/ and suckling infants, feces may appear black or tarry, skin discoloration
where in the body does clofazimine stay for in months
fatty tissues and RES b/c it’s highly lipophilic
MOA of thalidomine
inhibits NFkB mediated transcriptional upregulation and TNF alpha production, blocks leukocyte migration; also has anti-angiogenic activity
adverse effect of thalidomine
TERATOGEN, increases plasma HIV viral load, rarely peripheral neuropathy
why are corticosteroids used?
For Type 1 Reactions: treats red patchy skin lesion, erythema, swollen hands/feet, joint pain.
For Type 2 Reactions (erythema nodosum leprosum) - treats sudden eruption of numerous, painful, nodules, neuritis
