Question
Classify the drugs used in Chemotherapy of Tuberculosis. Write the mechanism of
action, therapeutic uses and adverse effects of Rifampicin (3+3)
Q1 6 marks Essays ★ ✓
Answer
Classification of antitubercular drugs
Line Drugs First-line Isoniazid, Rifampicin, Pyrazinamide, Ethambutol, Streptomycin Second-line Fluoroquinolones (Levofloxacin, Moxifloxacin), Aminoglycosides (Kanamycin, Amikacin), Ethionamide, Cycloserine, Para-aminosalicylic acid (PAS), Bedaquiline, Linezolid
Rifampicin — mechanism, uses, adverse effects
Mechanism : rifampicin → inhibits bacterial DNA-dependent RNA polymerase → blocks mRNA synthesis → bactericidal against both actively dividing and semi-dormant organisms (broader-population activity than isoniazid).Uses : tuberculosis (both intensive and continuation phase), leprosy (combination therapy), chemoprophylaxis for close contacts of meningococcal meningitis.Adverse effects : hepatotoxicity (additive with isoniazid), harmless orange-red discoloration of body fluids (urine, tears, sweat — important to pre-counsel patients about), and potent, broad-spectrum hepatic CYP450 induction — accelerating metabolism of oral contraceptives (contraceptive-failure risk), warfarin, and numerous other co-administered drugs.
1 Quinolones
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