Leprosy Flashcards
Where does leprosy infect?
Bacterium distributes from blood to tissue, especially body parts with cooler temperatures
How do you treat leprosy?
12 months:
Dapsone
Rifampin
Clofazimine
What do you use as initial treatment with single lesion?
Rifampicin
Ofloxacin
Minocycline
How does Dapsone work?
Inhibits mycobacteria folic acid synthesis (related to PABA inhibits dihydropteroate synthase)
Why do you slowly increase dose of Dapsone?
It accumulates in the skin, kidney, liver
Why does resistance occur with Dapsone?
2-40% resistance due to changes in enzyme on long term use
What drug is used in Pneumocystis Jerovecii pneumonia in AIDs patients?
Dapsone
What drug can also be used in lupus? Why?
Dapsone
It has some immunosuppressive activity
What are adverse effects of Dapsone?
Hemolysis (Glucose-6-phosphate deficiency) GI disturbances Insomnia, nervousness, headache Blurred vision, neuronal neuropathy Fever Rash, pruiritis
How does Clofazimine work?
Membrane disruption Inhibits mycobacterial phospholipase A2 Inhibits microbial K+ transport Generates H2O2 Interferes with electron chain transport
What is the half life of Clofazimine? Why?
Long half life of 70 days
It accumulates in the fat, excreted in the bile
What adverse effects are there with clofazimine?
Can turn lesions red or black; patients don’t want to take it bc then everyone knows they have leprosy
When do you use Amithiazone?
When dapsone resistance occurs
When do you use Thalidomide?
For resistant tuberculosis and leprosy
Use also to treat type 2 leprosy reactions
What is the Leprosy reaction?
Immune mediated 50% of patients have immune response to the dead bacteria
It means the therapy is working! DO NOT WITHDRAW.
Type 1 - lesions swell, edematous, ulcerate
Type 2 - Nodular rash, high fever, arthritis, nephritis, lymph nodes (Treat with thalidomide)
