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Anti- Leprosy Drugs

  1. Dapsone
    1. Antifolate drug (DHFR)                  
    2. Bacteristatic         
    3. Long acting                          
    4. Half life 24 hours          
    5. Food increases absorption                    
    6. Undergoes entero-hepatic circulation
    7. Concentrates in stratum corneum

DOC

  1. Leprosy
  2. Also used in
    1. Dermatitis herpetiformis
    2. Herpes gestation (gestational herpes)
    3. Actinomycetes
    4. Malaria (Daraprim, malaprim)

Side effects

  1. MC-hemolysis, resulting in anemia                
  2. Sulpha allergy      
  3. ‘Solfone syndrome’                                
  4. Toxic epidermal necrolysis           
  5. Steven Johanson syndrome                  
  6. Agranulocytosis                            
  7. Megaloblastic anemia                    
  8. Fixed drug eruption                      
  9. Renal stones                        
  10. Methemoglobinemia 

2. Clofazamine

  1. Dye with leprastatic property
  2. Anti-inflammatory & analgesic property
  3. Long acting; cumulative
  4. Half life 70 days
  5. Accumulates in skin
  6. Side effects; blue grey discolouration of skin-can be permanent
  7. Used in lepra reaction (type-1) 

3. Lepra reactions

  1. Type-1
    1. Rx-Corticosterioids DOC
    2. Alternative drugs; NSAIDS, chloroquine, clofazamine  
  2. Type-2
     
    i. Corticosteroids initial DOC, resistant cases treated by thalidomide





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