Isoniazid induced early-onset of motor dominant neuropathy and treatment with high dose of pyridoxine. Isoniazid though a very effective treatment for tuberculosis can cause severe motor-dominant neuropathy which can be reversible with pyridoxine supplementation. Neurological and Psychiatric Adverse Effects of Antimicrobials.  |  INH induced status epilepticus: response to pyridoxine. [2–3] The first description of psychotic symptoms due to isoniazid was by Mandel et al., who reported three such cases in 1956. Isoniazid, Neuropathy, Pyridoxine, Anti tuberculous therapy.. NLM  |  The isoniazid-induced peripheral neuropathy occurring in adult tuberculous patients results from a deficiency of biologically active pyridoxine. Mechanism of action — The antimicrobial activity of isoniazid (INH) is selective for mycobacteria, likely due to its ability to inhibit mycolic acid synthesis, which interferes with cell wall synthesis, thereby producing a bactericidal effect . Isoniazid though a very effective treatment for tuberculosis can cause severe motor-dominant neuropathy which can be reversible with pyridoxine supplementation. Isoniazid may cause hepatic toxicity and an also be an asue of peripheral neuropathy. Epub 2017 May 3. Unfortunately, peripheral neuropathy occurredin 18%of74patients receiving isoniazidin the moderate dosage (7.8-9.6 mg/kg) whenthis was given once daily. 2018 Apr;65(2):175-176. doi: 10.1016/j.ijtb.2017.04.004. lsoniazid resistant Mycobacterium tuberculosis bacilli develop rapidly when lsoniazid monotherapy is administered. Timely therapeutic intervention with high-dose vitamin B6 can reduce the long-term morbidity associated with this easily reversible condition. NIH A 45-year-old female diagnosed with psoas abscess, culture positive for mycobacterium tuberculosis, was started on anti- tuberculous treatment with four drugs, including isoniazid at a dose of 5 mg/kg/day. USA.gov. Peripheral neuropathy can be caused by medication, and various descriptions have been applied for this condition. In this MiniReview, the term ‘drug‐induced peripheral neuropathy’ (DIPN) is used with the suggested definition: Damage to nerves of the peripheral nervous system caused by a chemical substance used in the treatment, cure, prevention or diagnosis of a disease. CNS Drugs. 2006 Apr;23(2 Pt 1):157-60. doi: 10.1016/s0761-8425(06)71480-2. regimen. Her motor weakness gradually improved in a few months, but mild sensory impairment persisted even after two years. Get the latest public health information from CDC: https://www.coronavirus.gov. Clipboard, Search History, and several other advanced features are temporarily unavailable. Indian J Chest Dis Allied Sci. [Isoniazid induced neuropathy: consider prevention]. 2006 Jul-Sep;48(3):205-6. 1980 Dec;61(4):191-6. doi: 10.1016/0041-3879(80)90038-0. Mechanism : Isoniazid inhibits the synthesis of mycologic acids, an essential component of the bacterial cell wall. Isoniazid Mechanism of action. Astill larger dosage ofisoniazid wouldtherefore beunsuitable unless somemeansof preventing toxicity could befound. Synonym : INH. 2019 Aug;33(8):727-753. doi: 10.1007/s40263-019-00649-9. A low threshold should be used for pyridoxine administration in the setting of isoniazid toxicity. A 45-year-old female diagnosed with psoas abscess, culture positive for mycobacterium tuberculosis, was started on anti- tuberculous treatment with four drugs, including isoniazid at a dose of 5 mg/kg/day. Thus, side effects to isoniazid may be somewhat more frequent in people of European or African descent than in people originating from the Western Pacific region. It can be prevented by administration of pyridoxine whenever isoniazid is given. Isoniazid inhibits synthesis of mycolic acids, essential components of mycobacterial cell walls.  |  ... most notably peripheral neuropathy. At therapeutic levels isoniazid is bactericidal against actively growing intracellular and extracellular Mycobacterium tuberculosis organisms. Steichen O, Martinez-Almoyna L, De Broucker T. Rev Mal Respir. Loss of memory and death following ingestion of isoniazid has also been reported. Isoniazid-related psychiatric disorders reported in the literature include psychosis, obsessive-compulsive neurosis, and mania. This site needs JavaScript to work properly. There is need for vigilance regarding neurological effects of isoniazid in seemingly low-risk individuals in whom development of symptoms should raise the suspicion about slow acetylator status.