The treatment must contain multiple drugs to which the organisms are susceptible. This is called as multi drug therapy (MDT).

1. E. Udaya Rajitha
IV B. Pharmacy
V. V. Institute of Pharmaceutical Sciences, Gudlavalleru.

2. CONTENTS :
 What is tuberculosis?
 Site of infection
 Types of Tuberculosis
 Symptoms
 Mode of transmission
 Treatment
V. V. Institute of Pharmaceutical Sciences, Gudlavalleru.

3. TUBERCULOSIS (TB):
V. V. Institute of Pharmaceutical Sciences, Gudlavalleru.
• It is an infectious disease caused by a single
infectious agent Mycobacterium tuberculosis.
• world wide it is a leading killer disease.

4. SITE OF INFECTION:
V. V. Institute of Pharmaceutical Sciences, Gudlavalleru.
• The common site of infection for tuberculosis is
lungs.
• Also affect the central nervous system, lymphatic
system, liver, kidney, genitourinary tract, bones
and joints.

5. TYPES OF TUBERCULOSIS:
V. V. Institute of Pharmaceutical Sciences, Gudlavalleru.
• Depending upon the site of infection,
tuberculosis is of different types:
- Pulmonary tuberculosis.
- Genitourinary tuberculosis.
- Tuberculosis meningitis.
- Miliary tuberculosis.

6. SYMPTOMS :
V. V. Institute of Pharmaceutical Sciences, Gudlavalleru.

7. SPREAD OF DISEASE :
V. V. Institute of Pharmaceutical Sciences, Gudlavalleru.
• By droplet infection

8. TREATMENT:
• Administration of single drug leads to the
development of bacterial population resistant to
the drug.
• So, the treatment must contain multiple drugs to
which the organisms are susceptible.
• This is called as multi drug therapy (MDT).
V. V. Institute of Pharmaceutical Sciences, Gudlavalleru.

9. V. V. Institute of Pharmaceutical Sciences, Gudlavalleru.
FIRST LINE DRUGS SECOND LINE DRUGS
Isoniazid Ethionamide
Ethambutol Para amino salicylic acid
Pyrazinamide Cycloserine
Rifampicin Amikacin
Streptomycin Capreomycin
CLASSIFICATION:

10. • In majority of patients first line drugs shows
excellent effects.
• It is a 6 months course
Isoniazid+Rifampicin+Pyrazinamide for 2 months
Isoniazid+Rifampicin for 4 months
• Second line drugs are mainly used to treat the multi
resistant M.tuberculosis infections.
V. V. Institute of Pharmaceutical Sciences, Gudlavalleru.

11. V. V. Institute of Pharmaceutical Sciences, Gudlavalleru.
Rifampicin:
Adverse effects: Hepato toxicity, GIT distrubances, Leg cramps,
Rashes.
Mechanism of action: Acts by inhibiting the RNA synthesis.

12. V. V. Institute of Pharmaceutical Sciences, Gudlavalleru.
Isoniazid:
Adverse effects: Fever, Jaundice, Peripheral neuritis.
Mechanism of action:
Acts by inhibiting the synthesis of mycolic acid.

13. V. V. Institute of Pharmaceutical Sciences, Gudlavalleru.
Pyrazinamide:
Adverse effects: Hepato toxicity, Jaundice, Gout, Hyper uricemia,
GIT upsets.
Mechanism of action:
Acts as bactericidal at high concentrations.

14. Ethambutol:
V. V. Institute of Pharmaceutical Sciences, Gudlavalleru.
Mechanism of action:
Acts by inhibiting the synthesis of mycolic acid.
Adverse effects: Visual distrubances, Dose dependent
neuritis.

15. V. V. Institute of Pharmaceutical Sciences, Gudlavalleru.
P-amino salicylic acid:
Adverse effects: GIT problems, Anorexia, Nausea, Diarrhoea.
Mechanism of action:
Act by inhibiting the pteroate synthetase enzyme.

16. V. V. Institute of Pharmaceutical Sciences, Gudlavalleru.
Cycloserine:
Mechanism of action:
Acts by inhibiting the synthesis of cell wall
Adverse effects: Neuro toxicity, Nausea, Seizures

17. V. V. Institute of Pharmaceutical Sciences, Gudlavalleru.
Ethionamide:
Mechanism of action:
Inhibits the mycolic acid synthesis

18. V. V. Institute of Pharmaceutical Sciences, Gudlavalleru.
CONCLUSION

19. • Wilson & Gisvold Text book of Organic Medicinal and
Pharmaceutical Chemistry.
• Essentials of medical pharmacology by KD. Tripathi
Chapter 55:( anti tubercular drugs); page no. 740-750).
REFERENCES

20. THANK YOU