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PREPARED BY: PUNIT PATEL
Leprosy is a chronic granulomatous
infectious disease that attacks the nervous
system caused by acid fast bacilli
Mycobac...
3
Leprosy attacks the different parts of the body
Leprosy destroys neurons in these areas, taking
feeling away from them
...
Infection usually transmitted from person to person
due to shedding of bacilli
To avoid leprosy, avoid close contact wit...
In the first stages of Leprosy, people’s lives are
not very affected, but eventually, people lose
their fingers and toes ...
Nerve is
damaged and
broken by
leprosy
infection.
Large bumps (legions)
on the skin that do not
heel and cannot feel
pain....
Examine skin
Check for patches
Count the number of patches
Test for sensation
Check for damage to nerves
8
Pale or slightly reddish patch
Loss of sensation in the patch
Signs of damage to nerves
Loss of sensation in hands/fee...
The diagnosis is made based on finding definite
loss of sensation in one or more patches.
1-5 patches is paucibacillary ...
 Sulfones
 Dapsone, Sulfoxone, Acedapsone
 Phenazine derivative
 Clofazimine
Antitubercular drug
 Rifampicin
Antibi...
 M.O.A.
 Inhibition of bacterial folic acid synthesis
 Dapsone acts against bacteria and protozoa in the
same way as su...
13
 Pharmacokinetics
 Well absorbed orally
 widely distributed throughout the body fluids and tissues
 acetylated in live...
 Uses
 In treatment and prevention of Pneumocystis carinii
pneumonia in AIDS patient
15
 Side effect
 During treatment of lepromatous laprosy some reactive
episodes may occur called as lepra reactions
 (1)Ty...
 Adverse effects
 Nonhaemolytic anaemia and methaemoglobinaemia in
G6PD deficient
 Mild – nausea
 loss of appetite
 p...
 M.O.A.
 Phenazine dye which binds with mycobacterial DNA &
Inhibit mycobacterial growth
 Leprostatic with anti-inflamm...
 Pharmacokinetics-
 Oral absorption variable
 excreted in feces
 plasma half life 60-70hrs
19
 Side effect
 Red brown discolouration of skin
 Abdominal pain with loose stools due to deposition of
crystals in intes...
 MOA-
 It binds to and inhibits bacterial DNA dependent RNA polymerase
so that it can not synthesize new RNA
 Mammalian...
 Side effect
 Hepatitis –major adverse effect
 Ocasionally- rashes, Gi disturbances, dizziness &
fatigue.
 Flu like sy...
Category and
Type of patient
Duration of
Treatment
Drug regimen
Multibacillary
Leprosy
(Lepromatous)
For 24 months
If RMP
...
• Red coloured urine
• Darkening of skin
• Severe itching of skin
• This is due to rifampicin. Lasts
only for few hours Re...
25
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Leprosy

  1. 1. 1 PREPARED BY: PUNIT PATEL
  2. 2. Leprosy is a chronic granulomatous infectious disease that attacks the nervous system caused by acid fast bacilli Mycobacterium leprae M. leprae lies within the macrophages and remain dormant Leprosy cause deficiency in cell mediated immunity 2
  3. 3. 3
  4. 4. Leprosy attacks the different parts of the body Leprosy destroys neurons in these areas, taking feeling away from them Leprosy also causes cartilage in those areas to get absorbed back into the body, causing fingers, toes, ears and nose to disappear Leprosy also causes large bumps in the skin that do not feel pain and do not heal 4
  5. 5. Infection usually transmitted from person to person due to shedding of bacilli To avoid leprosy, avoid close contact with someone who has untreated leprosy 5
  6. 6. In the first stages of Leprosy, people’s lives are not very affected, but eventually, people lose their fingers and toes and become disfigured Not only are the victims of Leprosy physically disabled, but emotionally as well In the later stages of leprosy, people lose their sight, as well as most of the feeling in their body 6
  7. 7. Nerve is damaged and broken by leprosy infection. Large bumps (legions) on the skin that do not heel and cannot feel pain. Nerve Leprosy infection 7
  8. 8. Examine skin Check for patches Count the number of patches Test for sensation Check for damage to nerves 8
  9. 9. Pale or slightly reddish patch Loss of sensation in the patch Signs of damage to nerves Loss of sensation in hands/feet weakness of muscles of hands/feet/face visible deformity of hands/feet/face 9
  10. 10. The diagnosis is made based on finding definite loss of sensation in one or more patches. 1-5 patches is paucibacillary (PB), more than 5 patches is multibacillary (MB) leprosy 10
  11. 11.  Sulfones  Dapsone, Sulfoxone, Acedapsone  Phenazine derivative  Clofazimine Antitubercular drug  Rifampicin Antibiotics  Fluoroquinolones – Ofloxacin, Sparfloxacin  Macrolides – Clarithromycin  Tetracyclines - Minocycline 11
  12. 12.  M.O.A.  Inhibition of bacterial folic acid synthesis  Dapsone acts against bacteria and protozoa in the same way as sulphonamides.  That is by inhibiting the synthesis of dihydrofolic acid through competition with para-amino-benzoate for the active site of dihydropteroate synthetase  Has antiinflammatory properties 12
  13. 13. 13
  14. 14.  Pharmacokinetics  Well absorbed orally  widely distributed throughout the body fluids and tissues  acetylated in liver excreted in bile, undergoes enterohepatic circulation  It tends to remain in skin,muscle,kidney and liver up to the three weeks after the therapy is stopped  70% excreted through urine  Plasma half life 1-2 days 14
  15. 15.  Uses  In treatment and prevention of Pneumocystis carinii pneumonia in AIDS patient 15
  16. 16.  Side effect  During treatment of lepromatous laprosy some reactive episodes may occur called as lepra reactions  (1)Type 1 lepra reaction  (2)Type 2 lepra reactions(erythema nodosum leprosum)  Type 1 reactions delayed hypersensitivity reactions due to M leprae antigens [type 4 hypersensitivity reactions]  Type 2 reactions represent a humoral antibody response[type 3 hypersensitivity reaction] 16
  17. 17.  Adverse effects  Nonhaemolytic anaemia and methaemoglobinaemia in G6PD deficient  Mild – nausea  loss of appetite  pruritus  reversible neuropathy & hepatotoxicity  drug fever  Not given when hb% is below 7 17
  18. 18.  M.O.A.  Phenazine dye which binds with mycobacterial DNA & Inhibit mycobacterial growth  Leprostatic with anti-inflammatory action  It bind to mycobacterial DNA leading to disruption of the cell cycle and eventually prevents the growth of the bacterium. 18
  19. 19.  Pharmacokinetics-  Oral absorption variable  excreted in feces  plasma half life 60-70hrs 19
  20. 20.  Side effect  Red brown discolouration of skin  Abdominal pain with loose stools due to deposition of crystals in intestinal mucosa  Avoided in pregnancy  Mild – Conjunctival pigmentation & phototoxicity 20
  21. 21.  MOA-  It binds to and inhibits bacterial DNA dependent RNA polymerase so that it can not synthesize new RNA  Mammalian RNA does not binds with drug , host cells unaffected  The drug is bactericidal  Pharmacokinetics-  well absorbed on oral administration.  Penetrates all tissue, tubercular cavities, placenta & protein binding.  Excreted through liver into bile & undergo enterohepatic circulation. 21
  22. 22.  Side effect  Hepatitis –major adverse effect  Ocasionally- rashes, Gi disturbances, dizziness & fatigue.  Flu like syndromes- fever, chills,myalgias & thrombocytopenia.  Imparts harmless red colour urine.  Resistance devlop after prolong use 22
  23. 23. Category and Type of patient Duration of Treatment Drug regimen Multibacillary Leprosy (Lepromatous) For 24 months If RMP resistance Dapsone 100 mg daily + Clofazimine 50 mg daily with 300 mg once a month + Rifampicin 600 mg once a month Clofazimine 50 mg daily + Ofloxacin 400 mg daily + Minocycline 100 mg daily for 6 m Then Clofazimine + Ofloxacin for 18 months Paucibacillary Leprosy (Tuberculoid) 6 months If Dapsone not tolerated Dapsone 100 mg daily + Rifampicin 600 mg once a month Clofazimine 50 mg daily and 300 mg once a month may be substituted in place of Dapsone23
  24. 24. • Red coloured urine • Darkening of skin • Severe itching of skin • This is due to rifampicin. Lasts only for few hours Reassure the patient that this is harmless • This is due to clofazimine. Reassure the patient that this will disappear after treatment is completed • This is due to allergy to one of the drugs (commonly to dapsone). Stop all medicines and refer to hospital 24
  25. 25. 25
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