Antituberculosis and Antileprosy Drugs
These drugs target Mycobacterium tuberculosis (TB) and Mycobacterium leprae (leprosy). Due to the slow-growing nature of mycobacteria and their unique cell walls, treatment requires multiple drugs over a long duration.
Classification / Examples
- First-line Anti-TB Drugs:
- Isoniazid (INH), Rifampicin (RIF), Pyrazinamide (PZA), Ethambutol (EMB)
- Second-line Anti-TB Drugs:
- Aminoglycosides (e.g. streptomycin)
- Fluoroquinolones (e.g. levofloxacin, moxifloxacin)
- Macrolides (e.g. clarithromycin)
- Antileprosy Drugs:
- Dapsone, Clofazimine, Rifampicin
Side Effects
- Common: GI upset (nausea, vomiting, anorexia), skin rashes, pruritus
- Hepatotoxicity: INH, RIF, PZA
- Ototoxicity: Streptomycin → hearing loss
- Nephrotoxicity: Aminoglycosides
- Discoloration:
- Rifampicin: red-orange urine, sweat, tears
- Clofazimine: red-brown skin discoloration
- Other:
- Dapsone → hemolysis in G6PD deficiency
- Ethambutol → optic neuritis (↓ visual acuity, red-green color blindness)
Therapeutic Uses
- Anti-TB drugs:
- Treatment of active TB, latent TB, and multidrug-resistant TB
- Standard initial regimen (2 months): INH + RIF + PZA + EMB
- Continuation (4 months): INH + RIF
- Antileprosy drugs (Multidrug therapy):
- Paucibacillary (≤5 skin lesions): Dapsone + Rifampicin (6 months)
- Multibacillary (>5 lesions): Dapsone + Rifampicin + Clofazimine (12 months)