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INTRODUCTION

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This chapter will be most useful after having a basic understanding of the material in Chapter 56, Chemotherapy of Tuberculosis, Mycobacterium Avium Complex Disease, and Leprosy in Goodman & Gilman’s The Pharmacological Basis of Therapeutics, 12th Edition. In addition to the material presented here, the 12th Edition contains:

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  • Table 56-1 Pathogenic Mycobacterial Rapid and Slow Growers (Runyon Classification)

  • Table 56-2 Population Pharmacokinetic Parameter Estimates for Antimycobacteial Drugs in Adult Patients

  • Table 56-3 Pharmacokinetic Parameters of Rifampin, Rifabutin, and Rifapentine

  • Table 56-5 Drugs Used in the Treatment of Mycobacteria Other Than for Tuberculosis, Leprosy, or MAC (Mycobacterium Avium Complex)

  • Figure 56-4 Multimodal distribution of isoniazide (INH) clearance due to NAT2 polymorphisms

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LEARNING OBJECTIVES

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  • Understand the rationale for combination drug therapy in the treatment of tuberculosis (TB).

  • Know the mechanisms of action and resistance for drugs used to treat TB and leprosy.

  • Describe the adverse effects and drug interactions commonly associated with anti-TB drugs.

  • Know the principles of anti-TB chemotherapy.

  • Understand the principles of therapy of Mycobacterium Avium Complex (MAC) disease.

  • Understand the principles of antileprosy therapy.

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DRUGS INCLUDED IN THIS CHAPTER

  • Aminoglycosides (streptomycin, amikacin, kanamycin) (See Chapter 40)

  • Capreomycin (CAPASTAT)

  • Clofazimine (LAMPRENE)

  • Cycloserine (SEROMYCIN)

  • Dapsone

  • Ethambutol (MYAMBUTOL)

  • Ethionamide (TRECATOR)

  • Fluoroquinolones (ofloxacin, ciprofloxacin, moxifloxacin) (See Chapter 38)

  • Isoniazid (NYDRAZID)

  • PA-824

  • Pyrazinamide

  • Rifamycins: Rifampin (RIFADIN, RIMACTANE, others), Rifapentine (PRIFTIN), Rifabutin (MYCOBUTIN)

  • TMC-207

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Table Graphic Jump Location
MECHANISMS OF ACTION AND RESISTANCE OF DRUGS USED TO TREAT TUBERCULOSIS AND LEPROSY

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