From Big Medical Encyclopedia

ANTILEPROTIC MEANS — the chemotherapeutic means applied to specific therapy and prevention of a leprosy.

As P. villages use some synthetic chemotherapeutic drugs and antibiotics having activity concerning mycobacteria of a leprosy.

In modern medical practice as the main P. pages use drugs from group of sulphones: diafenilsulfon (see), Solusulfonum (see), atsedapson (diacetyl diaminodiphenylsulphone) and others (see. Sulphones aromatic ). In the USSR drugs dimotsifon and Diuciphonum which are also sulphones are received and offered for use.

At treatment of a leprosy in addition to the main P. of page (sulphones) appoint rifampicin (see. Rifamycinums ), lampren, and also the antitubercular drugs having antileprotic activity — Etioniamidum (see) and Prothionamidum. Besides, in initial stages of tuberculoid type of a leprosy, high-quality on a current, some streptocides, napr, Sulfapyridazinum and sulfalene having considerably smaller antileprotic activity can be applied.

Mechanisms of action of P. of page on a mycobacterium of a leprosy are studied insufficiently. Assume that sulphones have antileprotic effect at the expense of competitive antagonism with n-aminobenzoic to - that, and also by activation of lysosomes of macrophages. Etioniamidum and Prothionamidum are inhibitors of synthesis of Miko Liyevykh to - t and thereof break processes of formation of a cell wall of mycobacteria of a leprosy. Antimicrobic (and including antileprotic) effect of rifampicin, obviously, is caused by inhibition of a DNA-dependent RNA polymerase of microorganisms.

Items of page in the course of chemotherapy of a leprosy use is long, appointing separate drugs courses of various duration. Against the background of P.'s use by the village development of medicinal stability of mycobacteria of a leprosy, and also emergence of palindromias is possible. Development of a recurrence is connected most often with a persistirovaniye of page of the activator, sensitive to P., in marrow, nervous and muscular fabrics. For the prevention of development of medicinal stability of mycobacteria of a leprosy and emergence of palindromias it is reasonable to use the combined treatment by two-three drugs of a different chemical structure. Besides, it is reasonable to carry out chemotherapy of a leprosy in combination with an immunotherapy and nonspecific treatment (vitamins, etc.).

Efficiency of treatment judge on regress a wedge, displays of a disease, dynamics of indicators a kliniko-lab. researches, to results of the bakterioskopichesky analysis of the centers of defeat and substitution of granulomas connecting fabric.

Side effect of P. of page of a different chemical structure variously. E.g., drugs of a sulfonic row can cause dispeptic frustration, a headache, pains in heart, toxic hepatitis and anemia. At use of a lampren the hyperpegmentation of skin develops, emergence of nausea, vomiting, symptoms of impassability of intestines is possible. Side effect of Etioniamidum and Prothionamidum is shown by hl. obr. dispeptic frustration and skin rashes. Rifampicin can cause disturbances of functions of a liver and a pancreas, dispeptic frustration, a leukopenia and allergic reactions.

See also Leprosy, treatment .

Bibliography: Scientific notes of Institute on studying of a leprosy, No. 8(13), 1974, JsT: 9(14), Astrakhan, 1976; Experimental chemotherapy at a leprosy, Bulletin WHO, t. 53, L» 4, page 368,1977, bibliogr.; A guide to leprosy control, Geneva, WHO, 1980, bibliogr.; Colston M. J., Ella rd G. A. a. G a m m about n P. T. Drugs for combined therapy, experimental studies on the antileprosy activity of ethio-namide and prothionamide, and a général review, Leprosy Rev., v. 49, p. 115, 1978; E 1 1 a r d G. A. Growing points in leprosy research, 4 — Recent advances in the chemotherapy of leprosy, ibid., v. 45, p. 31, 1974, bibliogr.; Huikeshoven H. Patient compliance with dapsone administration in leprosy, Int. J. Leprosy, v. 49, p. 228, 1981.

A. A. Yushchenko.