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[Isoniazid intoxication]
J Graf1, N Scheffold, W Radunz
1Medizinische Klinik I, SLK-Kliniken Heilbronn GmbH, Klinikum am Gesundbrunnen, 74078 Heilbronn.
Deutsche Medizinische Wochenschrift (1946)
|December 26, 2006
Summary
This case highlights isoniazid (a tuberculosis medication) overdose causing severe seizures and metabolic acidosis. Prompt administration of pyridoxine (an antidote) and seizure control are crucial for patient recovery.
Area of Science:
- Pharmacology
- Toxicology
- Internal Medicine
Background:
- Isoniazid is a first-line antituberculosis drug.
- Co-ingestion of alcohol can exacerbate isoniazid toxicity.
- Drug-induced seizures and metabolic acidosis are serious adverse effects.
Observation:
- A patient presented with status epilepticus after ingesting isoniazid, rifampin, ethambutol, and alcohol.
- Initial assessment revealed severe metabolic acidosis and signs of isoniazid-induced hepatotoxicity.
- Diazepam was ineffective in controlling the seizures.
Findings:
- Intubation and aggressive seizure management led to cessation of convulsions.
- Metabolic acidosis rapidly improved with therapeutic interventions.
- Intravenous pyridoxine was administered as a specific antidote for isoniazid toxicity.
Implications:
- This case underscores the critical need for immediate pyridoxine administration in suspected isoniazid overdose.
- Aggressive management of seizures and metabolic acidosis is vital for improving outcomes.
- Clinicians should be vigilant for rare but severe adverse effects of antituberculosis medications.
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