Interventions for Tuberculosis Control and Elimination 2002

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�� Figure 8. Pharmacokinetics of isoniazid following fasting and a high-fat meal. 55 Original data kindly provided by Charles A Peloquin. �� half as long for rapid acetylators. 59,60 The AUC is similarly affected by acetylator type which is approximately 14.2 mg/h/L in slow eliminators as compared to 2.3 mg/h/L in rapid eliminators. 60 The acetylator type is important for widely spaced intermittent therapy. It explains to a large extent why once-weekly therapy with isoniazid is particularly ineffective in rapid acetylators. For thrice-weekly treatment, the acetylator type is not impor- 21 �� Figure 9. Clearance of isoniazid from serum, by acetylator type and age among tuberculosis patients. 57 ��
tant. Isoniazid also has excellent penetration into cerebrospinal fluid, although the peak concentrations achieved are much lower in rapid than in slow acetylators. 61 Dosage. The recommended dosage of isoniazid is 5 mg/kg body weight (usually up to a maximum of 300 mg) in daily, and 10 mg/kg body weight in thrice-weekly treatment. 8,13 Adverse drug events (table 2). Toxic reactions include peripheral neuropathy, 62 seizures, 62-68 and other central nervous system toxic reactions, such as hallucinosis, 69 psychosis, 70 memory loss, 71 optic neuropathy, 72 and pellagra. 73,74 Other toxic reactions from isoniazid include pyridoxine responsive anemia, 15,75,76 metabolic acidosis. 77 Pyridoxine is effective in both treatment and prevention of these reactions, 78-80 but pyridoxine non-responsive psychosis has also been reported. 81 In case of accidental or intentional overdose both charcoal treatment, if given early, 82,83 and hemodialysis 84 have proved useful. Table 2. Summary of adverse reactions from isoniazid with estimated frequencies of occurrence. Note that these are estimates of frequencies which may vary across population groups. Frequent Common Infrequent Rare (� 5 per 100) (� 1 per 100 and (� 1 per 1,000 (< 1 per 1,000) < 5 per 100) and < 1 per 100) Liver enzyme Hepatitis Seizures elevations Peripheral Hallucinosis neuropathy Psychosis Drug fever Memory loss Optic neuropathy Pellagra Pyridoxine responsive anemia Metabolic acidosis Pyridoxine non-responsive psychosis Lupus erythematosus Hemolytic anemia Agranulocytosis Pure red cell aplasia Alopecia Asthma Dermatitis 22
Page 1 and 2: Tuberculosis Interventions Interven
Page 3 and 4: Editor International Union Against
Page 5 and 6: Isoniazid plus rifampicin plus pyra
Page 7 and 8: 4. Preventive chemotherapy . . . .
Page 10: Acknowledgments It would not have b
Page 13 and 14: This monograph deals with the fourt
Page 15 and 16: ��
Page 17 and 18: ��
Page 19 and 20: contraceptives and anti-retroviral
Page 21 and 22: is scant. However, the limited evid
Page 24 and 25: 1. Chemotherapy The primary interve
Page 26 and 27: ability of the drug in the serum of
Page 28 and 29: emain elusive, 47 the general mecha
Page 32 and 33: Idiosyncratic reactions from isonia
Page 34 and 35: tis risk per 1,000 subjects was zer
Page 36 and 37: ��
Page 38 and 39: ��
Page 40 and 41: ��
Page 42 and 43: Rifampicin may rarely cause pseudom
Page 44 and 45: • opioids; 292-294 • vitamin K
Page 46 and 47: Table 4. Summary of adverse reactio
Page 48 and 49: ��
Page 50 and 51: Effect of drug potentiated by etham
Page 52 and 53: orne out by experiments which have
Page 54 and 55: longed respiratory depression follo
Page 56 and 57: quent adverse drug events are gastr
Page 58 and 59: ��
Page 60 and 61: Table 9. Grading of activities of a
Page 62 and 63: ��
Page 64 and 65: Effective or functional monotherapy
Page 66 and 67: ��
Page 68 and 69: drugs with a high therapeutic margi
Page 70 and 71: Council 122 or the individual trial
Page 72 and 73: article. The experiences in Edinbur
Page 74 and 75: Per cent positive 100 80 60 40 20 0
Page 76 and 77: Based on evidence that the addition
Page 78 and 79: esented a major advance in research
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cipal consideration is the prevaili
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of six months’ duration with ison
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Treatment efficacy As enteropathy i
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Influence of isoniazid resistance o
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• Patients with sputum smear-posi
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medications were taken daily throug
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of the disease, as alternative drug
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Number of cases per 100,000 populat
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number of cases, the health care pr
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necessary). If the event occurs in
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The patient with acute renal toxici
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and no association with diarrhea. 5
Page 105 and 106:
Schools Contacts of new cases Conta
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too small to allow a meaningful int
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Cases per 1,000 140 120 100 80 60 4
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Pasteur, 1921 Moreau, 1924 Tokyo, 1
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mendation by WHO states that no pri
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the number of person-years of obser
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• protection afforded by vaccinat
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Saskatchewan Saskatchewan Chicago C
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Three retrospective studies among c
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Harm / protection (%) 20 0 -20 -40
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• Differences in virulence of M.
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infected persons may thus mask any
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If environmental mycobacteria do in
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Relative risk (log scale) 10 3 1 0.
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Because BCG vaccination is given ea
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the largest purchaser in the world)
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made here to provide a comprehensiv
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year following commencement of trea
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might be expected, therefore, that
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tionally considered to belong to gr
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Prevention of disease following ces
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��
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��
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� ��
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Table 11. Preventive therapy - effe
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Logistical problems may, however, i
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In an uncontrolled study in Zambia,
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In none of the nine prospective tri
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is not usually an option, this is t
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Like other aminoglycosides, amikaci
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twice rather than once per day, red
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Quinolones Quinolones have a potent
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Rifapentine Rifapentine (cyclopenty
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published a scientific blueprint fo
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to that of isoniazid. 1162 It appea
Page 176 and 177:
Appendix 3 Current vaccine developm
Page 178:
this type of vaccine may not only p
Page 181 and 182:
15. Goldman AL, Braman SS. Chest 19
Page 183 and 184:
44. Heym B, Alzari PM, Honoré N, C
Page 185 and 186:
76. McCurdy PR, Donohoe RF. Pyridox
Page 187 and 188:
112. Van den Brande P, van Steenber
Page 189 and 190:
147. Murray FJ. Outbreak of unexpec
Page 191 and 192:
183. Acocella G, Conti R, Luisetti
Page 193 and 194:
215. Prazuck T, Fisch A, Simonnet F
Page 195 and 196:
248. Powell-Jackson PR, Jamieson AP
Page 197 and 198:
281. LeBel M, Masson E, Guilbert E,
Page 199 and 200:
310. Yeager RL, Munroe WGC, Dessau
Page 201 and 202:
341. Crowle AJ, Sbarbaro JA, Judson
Page 203 and 204:
376. Graham SM, Daley HM, Salanipon
Page 205 and 206:
410. Paradelis AG, Triantaphyllidis
Page 207 and 208:
443. Nunn P, Kibuga D, Gathua S, Br
Page 209 and 210:
471. Mitchison DA. Basic mechanisms
Page 211 and 212:
501. East African / British Medical
Page 213 and 214:
526. East African / British Medical
Page 215 and 216:
554. Medical Research Council. Five
Page 217 and 218:
580. Nolan CM. Failure of therapy f
Page 219 and 220:
606. Crofton J, Chaulet P, Maher D,
Page 221 and 222:
631. Weis SE, Slocum PC, Blais FX,
Page 223 and 224:
662. Griffith AS. A study of the BC
Page 225 and 226:
695. Horwitz O, Meyer J. The safety
Page 227 and 228:
723. World Health Organization. Rec
Page 229 and 230:
756. Al-Kassimi FA, Al-Hajjaj MS, A
Page 231 and 232:
785. Comstock GW, Webster RG. Tuber
Page 233 and 234:
814. Vynnycky E, Fine PEM. The annu
Page 235 and 236:
843. Talic RF, Hargreve TB, Bishop
Page 237 and 238:
871. Pamra SP, Mathur GP. Effects o
Page 239 and 240:
897. American Thoracic Society, Cen
Page 241 and 242:
924. Elliott AM, Halwiindi B, Bagsh
Page 243 and 244:
957. Escobar JA, Belsey MA, Dueñas
Page 245 and 246:
989. Hoffner SE, Källenius G. Susc
Page 247 and 248:
1021. Helmy B. 220-5. Side effects
Page 249 and 250:
1053. Thomas L, Naumann P, Crea A.
Page 251 and 252:
1083. Perumal VK, Gangadharam PRJ,
Page 253 and 254:
1109. Lucchesi M. L’éthionamide
Page 255 and 256:
1141. Ashtekar DR, Costa-Perira R,
Page 257 and 258:
1165. Oleksijew A, Meulbroek J, Ewi
Page 259 and 260:
1193. Hondalus MK, Bardarov S, Russ
Page 262:
IMPRESSION, BROCHAGE IMPRIMERIE CHI
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