Isoniazid


Questions | Reviews ***~

Isoniazid


My Dad was in the Phillipines in the 1950s, he was infected with tb while in the service. He was treated with isoniazid in Colorado and was told at that time the drug was experimental. Since that time my Dad has a severe hearing loss. His family docto...
by Judy F in ga/usa, 12/03/2005

use of Isoniazid


I will soon be starting a 9 month period of Isoniazid for curing a Latent TB infection (contracted while working in a health care facility.) Otherwise, very healthy. I understand that I can't drink any alcohol while on the medication. However, wou...
by Janet in Dallas, TX, 05/09/2007

Isoniazid side effect


i feel like i cant swallow the pain move from my upper right side to the left side of my chest ,when i swallowthen to my upper back it is a very sharp pain is this a normal side effect i also experence like i cant breath it my first time taking this m...
by kare in usa, 03/15/2007

Clinical Chemistry


How often should blood be monitored for the liver function in a patient who is starting prophylactic TB treatment with Isoniazid 300mg/day for nine months?
by Dina in Fairborn, OH, 09/07/2006

Isoniazid side effects(I am still havin hard time breathing )


Hi, my name is Elif . Iam Turkish and i had to take tb test formy school and I came false positive . Back in turkey we had live bacteria so thats why Icome positive . About 2 monts ago I stared to use isoniazid 300mg . After i started to use it I star...
by Elif Thompson in USA, VA, 08/13/2006

Isoniazid
(INH, Isonicotinic acid hydrazide)

Isoniazid
INH
Isonicotinic acid hydrazide
Isoniazid
(eye-so- NYE-ah-zid)
Pregnancy Category: C Dom-Isoniazide Isotamine Laniazid Laniazid C.T. Nydrazid Injection PMS-Isoniazid (Rx)

Classification: Primary antitubercular agent

Action/Kinetics: The most effective tuberculostatic agent. Probably interferes with lipid and nucleic acid metabolism of growing bacteria, resulting in alteration of the bacterial wall. Is tuberculostatic. Readily absorbed after PO and parenteral (IM) administration and widely distributed in body tissues, including cerebrospinal, pleural, and ascitic fluids. Peak plasma concentration: PO, 1-2 hr. t 1/2, fast acetylators: 0.5-6 hr; t 1/2, slow acetylators: 2-5 hr. Liver and kidney impairment increase these values. Metabolized in liver and excreted primarily in urine.
The metabolism of isoniazid is genetically determined. Clients fall into two groups, depending on the rapidity with which they metabolize isoniazid. As a rule, 50% of whites and blacks inactivate the drug slowly, whereas the majority of American Indians, Eskimos, Japanese, and Chinese are rapid acetylators (inactivators).

    1. Slow acetylators: These clients show earlier, favorable response but have more toxic reactions (e.g., neuropathies because of higher blood levels of drug).

    2. Rapid acetylators: These clients have possible poor clinical response due to rapid inactivation, which is 5-6 times faster than slow acetylators. This group requires an increased daily dose of the drug. They are more likely to develop hepatitis.

Uses: Tuberculosis caused by human, bovine, and BCG strains of Mycobacterium tuberculosis. Not to be used as the sole tuberculostatic agent. Prophylaxis of tuberculosis. Investigational: To improve severe tremor in clients with multiple sclerosis.

Contraindications: Severe hypersensitivity to isoniazid or in clients with previous isoniazid-associated hepatic injury or side effects.

Special Concerns: Severe and sometimes fatal hepatitis may occur even after several months of therapy; incidence is age-related and current alcohol use increases the risk. Increased risk of fatal hepatitis in minority women, especially Blacks and Hispanics; also increased risk postpartum. Extreme caution should be exercised in clients with convulsive disorders, in whom the drug should be administered only when the client is adequately controlled by anticonvulsant medication. Also, use with caution for the treatment of renal tuberculosis and, in the lowest dose possible, in clients with impaired renal function and in alcoholics.

Side Effects: Neurologic: Peripheral neuropathy characterized by symmetrical numbness and tingling of extremities (dose-related). Rarely, toxic encephalopathy, optic neuritis, optic atrophy, seizures impaired memory, toxic psychosis. GI: N&V, epigastric distress, xerostomia. Hypersensitivity: Fever, skin rashes and eruptions, vasculitis, lymphadenopathy. Hepatic: Liver dysfunction, jaundice, bilirubinemia, bilirubinuria, serious and sometimes fatal hepatitis (especially in clients over 50 years of age). Increases in serum AST and ALT. Hematologic: Agranulocytosis eosinophilia, thrombocytopenia, hemolytic, sideroblastic, or aplastic anemia. Metabolic/Endocrine: Metabolic acidosis, pyridoxine deficiency, pellagra, hyperglycemia, gynecomastia. Miscellaneous: Tinnitus, urinary retention, rheumatic syndrome, lupus-like syndrome, arthralgia.
NOTE: Pyridoxine, 10-50 mg/day, may be given concomitantly with isoniazid to decrease CNS side effects. Ophthalmologic and liver function tests are recommended periodically.

Laboratory Test Alterations: Altered liver function tests. False + or potassium, AST, ALT, urine glucose (Benedict's test, Clinitest).

Overdose Management: Symptoms: N&V, dizziness, blurred vision, slurred speech, visual hallucinations within 30-180 min. Severe overdosage may cause respiratory distress, CNS depression (coma can occur), severe seizures, metabolic acidosis, acetonuria, hyperglycemia. Treatment: Maintain respiration and undertake gastric lavage (within first 2-3 hr providing seizures are not present). To control seizures, give diazepam or a short-acting IV barbiturate followed by pyridoxine (1 mg IV/1 mg isoniazid ingested). Sodium bicarbonate, IV, to correct metabolic acidosis. Forced osmotic diuresis; monitor fluid I&O. For severe cases, consider hemodialysis or peritoneal dialysis.

Drug Interactions: Aluminum salts / Effect of isoniazid R/T GI tract absorption Anticoagulants, oral / Anticoagulant effect Atropine / Side effects of isoniazid Benzodiazepines / Effect of benzodiazepines that undergo oxidative metabolism (e.g., diazepam, triazolam) Carbamazepine / Risk of both carbamazepine and isoniazid toxicity Chlorzoxazone / Chlorzoxazone peak levels and plasma elimination t 1/2 R/T liver metabolism Cycloserine / Risk of cycloserine CNS side effects Disulfiram / Risk of acute behavioral and coordination changes Enflurane / May high levels of hydrazine defluorination of enflurane Ethanol / Chance of isoniazid-induced hepatitis Halothane / Risk of hepatotoxicity and hepatic encephalopathy Hydantoins (phenytoin) / Hydantoins effect R/T liver breakdown Ketoconazole / Serum ketoconazole levels effect Meperidine / Risk of hypotension or CNS depression PAS / Effect of isoniazid by blood levels Rifampin / Additive liver toxicity

How Supplied: Syrup: 50 mg/5 mL; Tablet: 100 mg, 300 mg

Dosage
?Syrup, Tablets Active tuberculosis.
Adults: 5 mg/kg/day (up to 300 mg/day) as a single dose; children and infants: 10-20 mg/kg/day (up to 300 mg total) in a single dose.
Prophylaxis.
Adults: 300 mg/day in a single dose; children and infants: 10 mg/kg/day (up to 300 mg total) in a single dose.
?IM Active tuberculosis.
Adults: 5 mg/kg (up to 300 mg) once daily. Pediatric: 10-20 mg/kg (up to 300 mg) once daily.
Prophylaxis.
Adults/adolescents: 300 mg/day. Pediatric: 10 mg/kg/day.
NOTE: Pyridoxine, 6-50 mg/day, is recommended in the malnourished and those prone to neuropathy (e.g., alcoholics, diabetics).

Isoniazid Ratings

Overall Rating:

3.5***~

 

(based on 2 reviews)

Effectiveness:

**

Ease of Use:

****~

Overall Satisfaction:

****

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