Antimycobacterials

ANTIMYCOBACTERIALS
BY
SAMINATHAN KAYAROHANAM M.PHARM.(PhD), M.B.A .(PhD)
Allianze University College of Medical Sciences
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CONTENT INTRODUCTION TO MYCOBACTERIUM MYCOBACTERIUM TUBERCULOSIS COMPLEX

INTRODUCTION TO TUBERCULOSIS TUBERCULOSIS-PREVALENCE(WHO-2009) SYMPTOMS OF TUBERCULOSIS CHEMOTHERAPY FOR TUBERCULOSIS INTRODUCTION TO LEPROSY LEPROSY-PREVALENCE(WHO-2004) CHEMOTHERAPY FOR LEPROSY CLASSIFICATION OF ANTIMYCOBACTERIALS MECHANISM OF ANTIMYCOBACTERIALS MECHANISM OF ISONIAZID MECHANISM OF RIFAMYCINS SOME CHARACTERISTICS OF FIRST-LINE DRUGS USED IN TREATING TUBERCULOSIS
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1. INTRODUCTION TO MYCOBACTERIUM
Mycobacterium is a genus of Actinobacteria, given its own family, the Mycobacteriaceae.To cause serious diseases in mammals. 1. Tuberculosis (Mycobacterium Tuberculosis) 2. Leprosy
(Mycobacterium Leprae, Mycobacterium lepromatosis) Mycobacteria are aerobic and nonmotile bacteria
(except for the species mycobacterium marinum)
That are characteristically acid-alcohol-fast.
Usually considered gram-positive.

SAMINATHAN KAYAROHANAM M.Pharm ( PhD) , M.B.A. ( PhD) Allianze university college of medical sciences
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2.MYCOBACTERIUM TUBERCULOSIS COMPLEX Mycobacterium tuberculosis complex refers to a group of Mycobacterium species that can cause tuberculosis in humans. Mycobacterium tuberculosis Mycobacterium africanum Mycobacterium bovis
Mycobacterium microti
Mycobacterium canettii Mycobacterium caprae
Mycobacterium pinnipedii
Mycobacterium mungi
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3.INTRODUCTION TO TUBERCULOSIS
Tuberculosis, or TB, is an infectious bacterial disease caused by Mycobacterium tuberculosis, which most commonly affects the lungs.
It is transmitted from person to person via droplets from the throat and lungs of people with the active respiratory disease. Today, these new and dangerous forms of the disease -- resistant to some of the commonly used drug treatments -- have created a public health crisis in many large cities worldwide
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4.TUBERCULOSIS-PREVALENCE(WHO-2009)
5.SYMPTOMS OF TUBERCULOSIS
6.CHEMOTHERAPY FOR TUBERCULOSIS
Mycobacterium tuberculosis, one of a number of mycobacteria, can lead to serious infections of the lungs, genitourinary tract, skeleton, and meninges. Treating tuberculosis as well as other mycobacterial infections presents therapeutic problems.
The organism grows slowly; thus, the disease may have to be treated for 6 months to 2 years. Resistant organisms readily emerge, particularly in patients who have had prior therapy or who fail to adhere to the treatment protocol. It is currently estimated that about one-third of the world's population is infected with M. tuberculosis, with 30 million people having active disease. Worldwide, 8 million new cases occur, and approximately 2 million people die of the disease each year.
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7.INTRODUCTION TO LEPROSY
Leprosy, also known as Hansen's disease (HD), is a chronic infection caused by the bacterium Mycobacterium leprae and Mycobacterium lepromatosis. Leprosy takes its name from the Latin word Lepra, which means "scaly", while the term "Hansen's disease" is named after thephysician Gerhard Armauer Hansen. It is primarily a granulomatous disease of the peripheral nerves and mucosa of the upper respiratory tract; skin lesions are the primary external sign. Left untreated, leprosy can be progressive, causing permanent damage to the skin, nerves, limbs and eyes. Contrary to folklore, leprosy does not cause body parts to fall off, although they can become numb or diseased as a result of secondary infections; these occur as a result of the body's defenses being compromised by the primary disease.
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8. LEPROSY-PREVALENCE(WHO-2004)
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9.CHEMOTHERAPY FOR LEPROSY

Leprosy (or, as it is specified by the U.S. Public Health Service, Hansen's disease) is rare in the United States, but a small number of cases, both imported and domestically acquired, are reported each year. Worldwide, it is a much larger problem. Approximately 70 percent of all cases in the world are located in India. Bacilli from skin lesions or nasal discharges of infected patients enter susceptible individuals via abraded skin or the respiratory tract. The World Health Organization recommends the tripledrug regimen of dapsone, clofazimine, and rifampin for 6 to 24 months. Figure 34.13 shows the effects of multidrug therapy.
Leprosy patient. A. Before therapy. B. After 6 months of multidrug therapy
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10. CLASSIFICATION OF ANTIMYCOBACTERIALS
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10CLASSIFICATION OF ANTIMYCOBACTERIALS
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11. MECHANISM OF ANTIMYCOBACTERIALS
120 100 80 60 40 20 0
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12.MECHANISM OF ISONIAZID Isoniazid, the hydrazide of isonicotinic acid, is a synthetic analog of pyridoxine. Isoniazid, often referred to as INH, is a prodrug that is activated by a mycobacterial catalase-peroxidase (KatG). Genetic and biochemical evidence has implicated at least two different target enzymes for isoniazid within the unique Type II fatty acid synthase system involved in the production of mycolic acids.
The targeted enzymes are enoyl acyl carrier protein reductase (InhA) and a ketoacyl-ACP synthase (KasA). The activated drug covalently binds to and inhibits these enzymes, which are essential for the synthesis of mycolic acid.
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13. MECHANISM OF RIFAMYCINS
Rifampin, rifabutin, and rifapentine are all considered to be rifamycins, a group of structurally similar macrocyclic antibiotics, which are first-line drugs for tuberculosis. Any of these rifamycins must always be used in conjunction with at least one other antituberculosis drug to which the isolate is susceptible.
Rifampin blocks transcription by interacting with the subunit of bacterial but not human DNA-dependent RNA polymerase. [Note: The drug is thus specific for prokaryotes.] Rifampin inhibits mRNA synthesis by suppressing the initiation step.
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14. SOME CHARACTERISTICS OF FIRST-LINE DRUGS USED IN TREATING TUBERCULOSIS
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Antimycobacterials

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ANTIMYCOBACTERIALS

CONTENT INTRODUCTION TO MYCOBACTERIUM MYCOBACTERIUM TUBERCULOSIS COMPLEX

That are characteristically acid-alcohol-fast.

Usually considered gram-positive.

6.CHEMOTHERAPY FOR TUBERCULOSIS

9.CHEMOTHERAPY FOR LEPROSY

10. CLASSIFICATION OF ANTIMYCOBACTERIALS

11. MECHANISM OF ANTIMYCOBACTERIALS

13. MECHANISM OF RIFAMYCINS

14. SOME CHARACTERISTICS OF FIRST-LINE DRUGS USED IN TREATING TUBERCULOSIS

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