Pharm-Leprosy Flashcards
Which drug is contraindicated in G6PD?
Dapsone
Dapsone AEs
methemoglobinemia and hemolysis
Dapsone Interactions
Rifampin - inc toxicity
cimetidine and omeprazole - toxicity up
trimethoprim - serum lvl up both
intx probenecid - dec clearance
Dapsone MOA
Folate antagonist same target as sulfa drugs
Also inhibit second messenger pathways involved in neutrophil chemotaxis
What is dapsone syndrome?
Maculopapular or exfoliativerash confined to either the upper limbs or the forehead; can also be disseminated
Sequence of symptoms–dermatitis, lymphadenopathy notably along the posterior border of the sternomastoid muscles and hepatitis – forms a particular pattern
liver enzyme elevation and blood methemoglobinemia etc
Rifampin AEs
Red body fluids liver liver liver! CYP induction Placenta, breast, bbb cross hepatic metab
rifampin
RNA synthesis inhibitor
Rapid and slow dividers effected
Clofazimine MOA
DNA binder, not intercalator
targets inc G and C bases in mycobacterium
dose-dependent anti-inflamm
Clofazimine AEs
long-lasting
Stain body and body fluids
Black feces
Skin discoloration - depression?
What kind of monitoring do you need to do with clofazimine?
CBC, LFTs, renal, G6PD
Ofloxacin MOA
bacterial DNA gyrase cidal
Describe the adverse reaction types (2)
Type 1: red patchy skin, erythema
tx: corticosteroids
Type 2: erythema nodosum leprosum
Sudden eruption of numerous painful nodules
tx: corticosteroids, clofazimine, thalidomide
Thalidomide MOA
Inhibit NfkB transcriptional upreg of TNF-alpha
Thalidomide AEs
Teratogen!
Inc plasma HIV viral load
Somnolence
What are the two types of leprosy and how do you treat each one?
Tuberculoid - dapsone and rifampin 12 months
Lepromatous - dapsone, rifampin, clofazimine, 24 months
