2. Chronic granulomatous disease caused
by Mycobacterium tuberculosis.
Tuberculosis typically attacks the
lungs, but can also affect other parts of
the body.
It is spread through the air when people
who have an active TB infection
cough, sneeze, or otherwise transmit
respiratory fluids through the air.
8. Most effective and cheapest primary
anti tubercular drug.
Effective in both acidic and alkaline
medium
Tuberculocidal for rapidly
multiplying bacilli
Tuberculostatic for resting
bacilli
11. Semisynthetic derivative of rifamycin
, am anitibiotic obtained from
streptomyces mediterranei.
Highly effective tuberculocidal
Acts on both intra
and extracellular
organisms.
It is called a sterilizing
agent.
12. Rifampicin binds to beta subunit of DNA
dependant RNA polymerase and inhibits
RNA synthesis in bacteria.
It cannot bind to human RNA
polymerase, thus selectively destroying
the bacteria.
15. Analog of nicotinamide
Tuberculocidal
Requires acidic pH for
its activity
Mechanism of action
not clearly known.
HEPATOTOXICITY is the
Most common adverse
effect
May inhibit
synthesis of
mycolic
acids
16. Tuberculocidal
Acts only against extracellular organisms
Has to be given IM
When used alone
resistance develops.
Least preferred first
line drug.
17. Tuberculostatic
Also effective against
atypical mycobacteria.
Well absorbed on oral administration
Dose should be reduced in renal failure
Optic neuritis is an important adverse effect
which needs withdrawal of the drug.
It decreases the renal excretion of uric acid
and enhances plasma urate levels.
18. INH: potent bactericidal
Rifampicin: potent bactericidal
Pyrazinamide: weak bactericidal
Ethambutol: bacteriostatic
Streptomycin: bactericidal
Synergistic
effect
NEVER USE A SINGLE DRUG FOR CHEMOTHERAPY IN
TUBERCULOSIS, A COMBINATION OF 2 OR MORE IS
ALWAYS BETTER
19. Less effective
More toxic
Used only if organism is resistant to first
line drugs
Ethionamide , PAS, cycloserine :
bacteriostatic
Amikacin, capromycin, fluoroquinolones
are used in Multi Drug Resistant TB
20. Phase I
•1-3 months
•Rapidly kills
bacilli
•Symptomatic
relief
Phase II
•4-6 months
•Eliminates
remaining
bacilli
•Prevents
relapse
21. 1. INH+S+T daily for 2 months
2. INH+T daily for 10 months
INH – isoniazid
S – Streptomycin
T - Thiacetazone
22. 1. INH+R+Z+E/S daily or thrice a week for 2
months followed by:
2. INH+R daily or thrice a week for 4
months
3. INH+R+Z trice a week for 2 months
followed by
4. INH+R daily for 7 months.