Anti-tubercular drugs

hello everybody this is dr. Mallory from Team MDS conquer now we'll have a short discussion err anti-tuberculosis so this is the classification of anti tubercular drugs basically tuberculosis is a granulomatous infection so this anti tubercular drugs are of two types that is first-line drugs and second-line drugs again this first-line drugs are of essential drugs and supplementary drugs first-line drugs which are essential includes HR jet a that means has been sized when he has it the farm person is our pyro cinema is Z whereas ether butyl is e we're a supplementary drugs include streptomycin reefer butan a reefer pen time and this second line of drugs includes Co a citizen para - salicylic acid eg an amide don't confuse between Ethan amide and Ethan butyl ether muta is the first line whereas Ethan amide is a second line then cyclo serine kanamycin an amicus and there are newer drugs like ciprofloxacin clarithromycin and you throw my sim rifabutin which is also used as a supplementary drug in the first line so these are the drugs which are most effective in mycobacteria rapidly-growing mycobacteria isin e as it is very effective in slow-growing mycobacteria piracy no mind is more effective and in sport is like within cases material rifampicin is more effective then first coming to the drug isoniazid this is very important drug because it is the move only and the most drug each is used in the prophylaxis of tuberculosis and here this is a pro drug which is activated by catalase peroxidase which is denoted by CAD G and the mechanism of action is it this ëismí acid will inhibit this keto enol reductase into mycolic acid synthesis and this mycolic acid is very important the cell wall component of my co bacterium and this entire crosses this oxygen demand dependent this isoniazid can be used as both static and cycle that is bacteriostatic and back to the side enjoy extra similar and it can be seen in CSF and the metabolization is through acetylation and these are the very important that was effects like peripheral neurotics which is treated by pyridoxine hemolysis in g6pd deficiency patient's marrow inhibition optic atrophy lupus like syndrome and gynecomastia then coming to the rifampicin and other type of drugs like rifampicin AR Rifa beauty 9 reefer pen tine remember the half-life of rifampicin is 3 to 5 hours and it is used as only Cyril drug and in empro action is through inhibiting DNA dependent RNA polymerase by it can be secret in the bile hence there is no adjustment in the renal failure patients you can see orange color discoloration of urine when the usage of this drug and even it can cause blood brain and placental barrier and adds both intra and extracellular and even it can be ax and leprosy also and this is the prophylactic dragon meningococcal and Staphylococcus infection but the treatment is Ruthven Zealand but prophylaxis is with rifampicin and it can cause lights in protein area and hyperlipidemia without as GPT elevations and these are the all drugs where you can see drug interactions with the rifampicin and remember this is a very important point that rifabutin can be used in tuberculosis patients with HIV that means in HIV patients with tuberculosis the rifabutin is used and if a patient is an oral contraceptive plus rifampicin you have to increase the dose of free oral contraceptive or change to the other modes of safety and this para- a second acid plus rifampicin should not be used and this patient is and warfarin then you have to ask the patients to change to a low molecular weight heparin if a patient is taking a rifampicin then it is the safest drug in pregnancy then other type of drugs like RIF personally for mutant and reefer Penton this reefer mutant has a longer half-life that is 45 hours and can be used in Clostridium difficile II associated diarrhea and it can call it can cause this this is adverse effects it can cause polymyalgia syndrome and pseudo jaundice which is important which causes ello discoloration of the skin then coming to the reefer pen type it is a leaf lipophilic and it cannot be used in HIV and this there is an other drug called as the facsimile this refax women can be used in a traveler's diarrhea treatment which is caused by a coli and also as in a hepatic encephalopathy along with anti-tuberculosis and the coming two other important drug that is Pyrus an amide resolves a bacterial Seidel and it will more acting effective on slowly replicating micro bacteria and more effective on acidic media and only intracellular micro bacteria it is effective and it can cause non go Tiare algea hyperuricemia qualify and photosensitivity these are the adverse effects if coming to the a computer this is starting drag I'm here there will be of inhibition of Araby no Galacta which is present in the cell wall and it cannot be seen in CSF it can cause optic neuritis because of this loss of ability you cannot see green or a red color and it will have an effect on amacrine and bipolar cells of retina this is very important and this cannot be used in children that is contraindicated in children it can cause hyper Insignia peripheral your itis i knew a weak a it needs and those i just amended renal failure and it is not hepatotoxic but it is a real and toxic then coming to the streptomycin it is a cyril drag and aurally it cannot be given only intramuscularly we can use ur streptomycin and it is only active again is the extracellular and not hepatotoxic and there are other amino glycosides used in 90 TBR Amica sync animation captain myosin and this streptomycin is contraindicated in pregnancy there are few other important drugs like he was in the zone which is a static drag and it in cost Steven Johnson syndrome and this is not used in the head IV because it causes hypersensitivity and there is a other drug param I know salicylic acid it is a static with a similar action to the sulfonamides then coming to ithi an amide it is a static and it can cause this optic neuritis hypothyroidism it is very important and it can be used in leprosy and here bacteria which are resistant to eyes Nia's it can also cross resistant to this ethan amide then coming to Caprio my sim this is an injectable polypeptide and it can cause hypokalemia and hypomagnesemia this is very important then Ajith Rama and clarithromycin are mostly used a non tubercular atypical mycobacteria treatment so this is the treatment regimen for anteater I mean tuberculosis there is a name called Dodds regimen that is devotee s that means directly observed treatment shortcodes this is for tuberculosis treatment which is given by 1995 by wh-wha that means single daily dose of first line of anti tubercular times are very effective and again this has been this treatment has been divided into four categories that is category 1 2 3 & 4 this category 1 patients include new untreated cases which are smear positive for tuberculosis and new untreated smear negative with tuberculosis and also the involvement of parenchyma and neo severe forms like meningitis and miliary tuberculosis then category 2 patients include smear positive failure relapse cases and interrupted cases and this is very important this category to have a greater risk of multidrug-resistant tuberculosis then category 3 include smear negative pulmonary to closest with limited parenchymal involvement then category for England chronic cases that is multi drug-resistant tuberculosis cases so these are the category of patients so this is the drugs which are given for category and these numbers includes in months and these are the doses which can be given weekly that is subscript and here these are these for category 1 this is the initial phase treatment a charger ES and this is a continuation phase will have that is HR Hetchy a total of 6 months whereas this a category to include HR JDS or 1 haytch rj d and in continuation phase for 5 months you have to use a char e and this are the HR e which are given the doses measly and it can be used for eight months then coming to the category 3 here there will be of hey char Z or for HR or 6 Hetchy in continuous phase and can be used for 6 or 8 months whereas in category 4 if pregnant patients will use any eyes on e acid they farm person Pyrus in a mite and whereas in prophylaxis we can use only eye sony acid whereas in Mac that is Mycobacterium avium complex that is in HIV we can use clarithromycin erythromycin plus e thumb util plus or minus rifabutin so that's all guys this is these are very important points regarding anti tubercular tracks stay tuned for more videos now learning with MDS panca thank you