Isoniazid Blood Levels in Patients with Pulmonary Tuberculosis at a Tuberculosis Referral Center

Abstract

Background: Serum concentrations of isoniazid (INH) were evaluated in Iranian patients admitted to the Tuberculosis Ward of Masih Daneshvari Hospital, Tehran, Iran. Factors correlated to plasma INH levels were determined. Methods: Blood samples were obtained 2 h after ingestion of 5 mg/kg INH in 82 patients (1 sample/patient) on days 3–15 of treatment. The following variables were investigated: INH plasma level, duration of therapy, age, sex, weight, dose of INH administered and smoking status. Results: The average (±SD) age and weight of patients were 60.68 ± 18.53 years and 74.96 ± 7.15 kg, respectively. INH concentrations were low in 14.63% and high in 23.17% of the patients (INH reference range: 3–5 µg/ml). Plasma INH was statistically correlated with duration of INH administration (Kendall’s rank correlation, r = 0.66, p < 0.001) but not with other variables. Conclusion: Based on the result of this study, plasma INH concentrations were not within the therapeutic range for 37.80% of the patients on conventional therapy. Therefore therapeutic drug monitoring may be needed to optimize INH dosage, especially in patients with inadequate clinical response or toxicity to INH.

Isoniazid, rifampicin and pyrazinamide plasma concentrations 2 and 6 h post dose in patients with pulmonary tuberculosis

“…20 In a previous clinical study on INH blood concentrations, we observed low concentrations of the drug in 14.6% of patients and reported a significant correlation between INH plasma concentrations and duration of INH administration (P < 0.001), i.e., INH concentration increased with each day of treatment. 21 In the present study, low INH concentrations were found in almost half of our patients. Furthermore, the median INH serum concentration was higher in female patients than in males at 2 and 6 h post dose.…”

<b><i>embB</i></b>306 Mutations as Molecular Indicators to Predict Ethambutol Susceptibility in <b><i>Mycobacterium tuberculosis</i></b>

“…Instead, it is more likely that following the development of drug resistance to the powerful antituberculosis compounds (INH and rifampicin), subpopulations resistant to the less powerful EMB emerge due to increased selective pressure. Subtherapeutic plasma concentrations of INH in patients with a rapid acetylator status could create selective pressure that may lead to treatment failure and the emergence of drug resistance [25]. SNPs at embB 306 displayed diverse MICs of which a significant proportion (73%) was scattered along the critical concentration resulting in borderline resistance.…”

He-Wei granules inhibit chemotherapy-induced vomiting (CINV) in rats by reducing oxidative stress and regulating 5-HT, substance P, ghrelin and obestatin

“…6,20,41 6-Gingerol in ZB is found to be effective in controlling CINV. [55][56][57] GR is a well-known TCM that is believed to be the king of herbs in the Orient, especially in China, Korea, and Japan. Ginsenosides and polysaccharides are considered to be active constituents with anticancer, antioxidant, and immunomodulation effects, which contribute to enhance immunomodulation effect against CINV.…”