Drug of choice to treat leprosy is \ \ \ \ \ \ - OSSSC Nursing Officer-2023

OSSSC Nursing Officer-2023

Pharmacology

Easy

Appeared in: OSSSC Nursing Officer-2023

Explanation

Dapsone is a sulfone antibiotic that acts as a competitive antagonist of para-aminobenzoic acid (PABA), inhibiting folic acid synthesis in Mycobacterium leprae.
Historically, Dapsone was the primary drug used as monotherapy for leprosy.
Due to the emergence of resistance, it is now a cornerstone of the World Health Organization's (WHO) recommended Multidrug Therapy (MDT) for all forms of leprosy.
While Rifampicin is more potent, Dapsone is the foundational daily medication in both Paucibacillary and Multibacillary treatment regimens.

Option A: Rifampicin is never used as a single agent ('drug of choice') for treating leprosy because resistance develops rapidly. It is a powerful component of combination therapy (MDT) but not a standalone treatment.
Option B: Acyclovir is an antiviral medication. Leprosy is a bacterial infection caused by Mycobacterium leprae, so an antiviral drug would be ineffective.
Option C: Zidovudine (AZT) is an antiretroviral drug used to treat HIV infection. It has no therapeutic effect on leprosy.

Clinical Relevance

Nursing practice connection: Knowing Pharmacotherapy for Leprosy (Hansen's Disease) helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
Nurses play a vital role in educating patients about the absolute necessity of completing the full course of MDT to cure the disease, prevent relapse, and stop the spread of drug-resistant strains.
Patient counseling must include information on common side effects. Key points include: Rifampicin causes a harmless orange-red discoloration of urine, sweat, and tears; Clofazimine can cause dark pigmentation of the skin; and Dapsone can cause anemia.
A critical nursing assessment involves monitoring for adverse effects, particularly Dapsone-induced hemolytic anemia. This risk is significantly higher in patients with a G6PD (glucose-6-phosphate dehydrogenase) deficiency.

How to Approach the Question

First, identify the core subject of the question: the pharmacological treatment for leprosy (Hansen's disease).
Second, recall that leprosy is a chronic bacterial infection requiring long-term antibiotic therapy.
Third, evaluate the options to eliminate those used for other types of infections. Acyclovir (antiviral) and Zidovudine (antiretroviral) are incorrect and can be immediately discarded.
Fourth, differentiate between the remaining two antibiotics, Rifampicin and Dapsone. Both are known treatments for leprosy.
Finally, recall that modern treatment is always combination therapy (MDT) to prevent resistance. Dapsone was the historical monotherapy and remains the foundational daily drug in all MDT regimens, making it the best fit for a 'drug of choice' question.

Concept Tested & Keywords

QDlmzp82doiAxlvCnIjXhl

E6 Pharmacology Katzung 16e p. 1322-1324

E6 Pharmacology KD Tripathi Essentials 9e Part 3 p. 111-113

E6 Nelson Textbook of Pediatrics(2024) — Volume 1 p. 1837-1839