M. Sc. PPT

1. Tuesday, August 24, 2010 1 RIFAMPICIN INDUCED THROMBOCYTOPENIA(Rajiv Garg, V. Gupta, S. Mehra, R. Singh and R.Prasad)[Indian J Tuberc 2007] -Rishikesh H. Autade M.Sc. (IV Sem)

2. 2 “It happens every time! Doc. When I eat Anti-tubercular Drug, immediately develop this nasty rasher on all over my body. My wife thinks that I m Alien.”

3. 3 Tuberculosis Mycobacterium tuberculosis. Transmission. How does bacteria enters in to Macrophage? How lesions are formed? Symptoms.

4. 4 Treatment of Tuberculosis Isoniazid -Catalase oxidase Rifampicin -DNA dependent RNA polymerase. Streptomycin -30s Ribosome Ethanmbutanol -Bacterial cell wall Pyraziamide -DNA Replication.

5. 5 Rifampicin(1967) Amycolaptosis rifacolatopsis. Metabolism C43H58N4O12 Mycolic acid And Peptidoglycan How does bacteria get resistance to Rifampicin?

6. 6 Adverse Effect (Thrombocytopenia) Thrombocytopenia is the term used for a reduced platelet (Thrombocyte) count. 150 to 400 million/ml Platelet- Blood clotting What is the effect of reduced platelet count?

7. 7 Drug dependent Antibody Conf. Change in Glycoprotein Rifampicin Glycoprotein Platelet Platelet removed from blood How does rifampicin causes thrombocytopenia?

8. 8 Case Study Prpura means bleeding is seen on the skin in the form of tiny pin prick hemorrhages. 1st evidence of Rafampicin induced thrombocytopenia.

9. 9 Discussion Criteria's for Thrombocytopenia Differentiation. Major bleeding -Intracranial and Retroperitoneal Minor bleeding -Excessive menstrual bleeding Trivial bleeding -Purpurae all over body, Epistaxis.

10. 10 Thrombocytopenia - Ethambutanol, Pyrazinamide. Keep eye on platelet count during treatment. Use new drugs while restarting the therapy. Offending drug should not be used again. Discussion Cont….

11. 11 Ethical Issues Rifampicin was given to the patient with informed consent. Ethical concerns would have arisen if- - New drug - Without Patients permission.

12. 12 Current Research In T.B. Project - 2001 with EU And WHO. Gatifloxacin-Reduces treatment period. Phase II trials- South Africa. public and private partners. Expected to come- End of 2009.

13. 13 An Apple a day keep Dr. away. Thank You

14. Tuesday, August 24, 2010 14 References James N George et al. Drug induced thrombocytopenia a systematic review of published case reports. Ann Intern Med 1998; 129: 886-890. Rifampicin – Sister Mary Gabriel, Ruttonjee Snatorium, Hong Kong. Pg no. 47-54(the bulletin of hong Kong Medcal Association Vol.25, 1973).