Keep in mind that Isonaizd(INH) is the established treatment for preventive therapy , and the usual regimen is up to 300mg daily for adults. You can keep pts on for 6 months or 12 months with a positive CXR. Always give vitB6 when treating pts with INH. If there is a suspected resistance then use Rifampin (RIF) alone or in combo with the said INH. How do we treat current CLASSES III & IV diseases.
The first line medications are used in combinations since these tend to delay the development of resistance and to enhance activity.
INH(p.o. or IM) 300mg. inhibits synthesis of mycolic acid in the bacterial cell wall thus making it easy to kill the organism in the dividing stage. The drug is however, bacteriostatic for the bacilli in the stationary phase. The drug is metabolized by N-acetyl transferase. Some of side effects include paresthesia, fever, convulsions, hepatotoxic, optic neuritis and Hemolysis in G6PD deficient pts. High level resistance involves deletion in the katG gene that codes for catalase, and low-level resistance involves deletions in the inhA gene that codes for the target acyl carrier protein. Keep in mind that genotypic variability exists with FAST ACETYLATORS needing high doses of INH. Remember for the boards that Vit …show more content…
Also against M. leprae. Can be used prophylactically in meningitis. The drug suppress the initial step of RNA synthesis by inhibiting DNA dependent RNA polymerase, and resistance occurs via change in polymerase sensitivity to inhibition. The drug undergoes hepatic metabolism to red-orange colored metabolites. So let the patient know that the urine and feces will be red-orange in color. Nausea ,vomiting, rashes, fever, jaundice and flu like symptoms with high doses. This drug will reduce the efficacy of anticonvulsants,contraceptive steroids and warfarin so take note for your boards and clinical