Drugs Used In Tuberculosis - Introduction

on 19.1.08 with 0 comments



Brief History:

  • Upto 1940's : No effective chemotherapeutic agents, Sanatoriums
  • 1947: Streptomycin discovered to have activity against Mycobacterium Tuberculosis
  • 1950's: INH and PAS synthesized
  • 1960's: Ethambutol and domicilliary treatment started
  • !970's: Discovery of Rifampicin and pyrazinamide. Introduction of short course chemotherapy.
  • At present: Newer agents with activity against tuberculosis bacilli such as Fluoroquinolones,Newer macrolides, Rifabutin and Rifapentine developed.
    • These are second line agents
    • Used in Multi Drug Resistant Tuberculosis.

Classification:

  1. First line Anti-tubercular agents (Standard or Primary Agents)
    • Isoniazid (H)
    • Pyrazinamide (Z)
    • Rifampicin (R)
    • Ethambutol (E)
    • Streptomycin (S)
  2. Second line Anti-tubercular agents (Reserve or secondary)
    • Para Amino Salicylic Aceid (PAS)
    • Thioacetazone
    • Cycloserine
    • Ethionamide
    • Kanamycin
    • Amikacin
    • Capreomycin
  3. Newer Agents
    • Ciprofloxacin
    • Moxifloxacin
    • Clarithromycin
    • Azithromycin
    • Rifabutin
    • Rifapentin

Based on Action
  • Active on Extracellular Bacilli: Most antitubercular Agents
  • Active on Intracellular Bacilli: Isoniazid,Rifampicin,Pyrazinamide
  • Active against Dormant/Persisters: Rifampicin

Category: Pharmacology Notes

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