ANTI-

LEPROTIC
DRUGS
 Anti-leprosy drugs have multiple
targets in the leprosy bacillus, making
a combination therapy, such as the
WHO-recommended MDT combination
of rifampicin, clofazimine and dapsone
for MB leprosy patients and rifampicin
and dapsone for PB leprosy patients
 RIFAMPICIN MECHANISM OF ACTION
Crystal structure data and biochemical data suggest
that rifampicin binds to the pocket of the RNA
polymerase β subunit within the DNA/RNA channel,
but away from the active site. The inhibitor prevents
RNA synthesis by physically blocking elongation, and
thus preventing synthesis of host bacterial proteins.
By this "steric-occlusion" mechanism, rifampicin
blocks synthesis of the second or third
phosphodiester bond between the nucleotides in the
RNA backbone, preventing elongation of the 5' end of
the RNA transcript past more than 2 or 3 nucleotides.

Rifampin acts via the inhibition of DNA-dependent

RNA polymerase, leading to a suppression of RNA
synthesis and cell death.
 RIFAMPICIN NURSING
CONSIDERATION
 Monitorhepatic function, hematopoietic
studies and uric acid levels. Drug may
cause hemorrhage in neonates of
rifampicin-treated mothers
 Takedrugs with meals to reduce upset
stomach Warn patient that may feel
drowsy and that urine, feces, saliva,
sweat, sputum and tears may turn red-
orange
CLOFAZIMINE MECHANISM
OF ACTION
Clofazimine works by binding to the
guanine bases of bacterial DNA, thereby
blocking the template function of the DNA
and inhibiting bacterial proliferation.
It also increases activity of bacterial
phospholipase A2, leading to release and
accumulation of lysophospholipids, which
are toxic and inhibit bacterial
proliferation.
 CLOFAZIMINE NURSING
CONSIDERATION
 Emphasize to patient that Clofazimine may
cause pink or red to brownish-black
discoloration of the skin within a few weeks
after you start taking it.
 may cause some people to become dizzy,
drowsy, or less alert than they are normally.
Make sure you know how you react to
clofazimine before you drive, use machines, or
do anything else that could be dangerous if you
are dizzy or are not alert or able to see well.
DAPSONE MECHANISM OF ACTION
 Dapsone acts against bacteria and protozoa
in the same way as sulphonamides, that is
by inhibiting the synthesis of dihydrofolic
acid through competition with para-amino-
benzoate for the active site of
dihydropteroate synthetase during the
bacterial synthesis of tetrahyrofolic acid
 Inhibition of tetrahydrifolic acid prod.
leads to deacreased level of purines and
nucleic acid which is necessary for the
synthesis of the proteins by the bacteria.
Hence, exerts a bacteriostatic action on M.
Leprae and acts as a antileprotic.
 DAPSONE NURSING CONSIDERATION
 Obtain baseline CBC. Monitor weekly for first month ,
monthly for 6 months then semiannually
 Reduce or temporarily stop dapsone if Hgb level falls
below 9g/dl, WBC count falls below 5000/mm3 or
remains low If generalized diffuse dermatitis occurs,
notify prescriber and prepare to stop the drug
 Give antihistamines to combat allergic dermatitis
 Watch for signs and symptoms of erythema nodosum
reaction, such as malaise, fever, painful inflammatory
irritation in skin and mucos, iritis, and neuritis which
may occur during therapy as a result of M. Leprae
bacilli.
 Tell patient drug may be taken with food to upset
reduce stomach