Antituberculous therapy

A case report describes a 54-year-old woman with type 1 diabetes whose insulin requirements increased from 36 units to 48 units daily when she took rifampicin. Immediately on discontinuing her antituberculous therapy, she developed frequent hypoglycaemic attacks, which persisted until her insulin dose was reduced back to 36 units daily. ... 

Wenning GK, O Connell MT, Patsalos PN, Quinn NP A clinical andphannacokinetic case study of an interaction of levodcpa and antituberculous therapy in Parianson s disease. Mov Disord( 995) 10,664-7... 

Jurewicz WA, Gunsc BK, I ail T, Ang isani L, McMaster P. Cyclosporin and antituberculous therapy LatKet(19Z5) i, 1343. 

Coward RA, Raftery AT, Brown CB. Cyclosporin and antituberculous therapy. Lancia/(1985) i, 1342-3. 

Singanayagam A, Sridhar S, Dhariwal J, Abdel-Aziz D, Munro K, Connell DW, et al. A comparison between two strategies for monitoring hepatic function during antituberculous therapy. Am J Respir Crit Care Med 2012 185(6) 653-9. 

Hepatomegaly with mild disturbance of liver function was reported in a 49-year-old man taking paracetamol, an analgesic powder containing phenacetin and anti-pyrine and multiple antituberculous therapy including isoniazid. Liver biopsies showed marked accumulation of lipofuscin (190 ). Although attributed to phenacetin, hepatomegaly and abnormal liver function were more likely to be due to paracetamol and isoniazid. 

Rifampin, usually 600 mg/d (10 mg/kg/d) orally, must be administered with isoniazid or other antituberculous drugs to patients with active tuberculosis to prevent emergence of drug-resistant mycobacteria. In some short-course therapies, 600 mg of rifampin are given twice weekly. Rifampin 600 mg daily or twice weekly for 6 months also is effective in combination with other agents in some atypical mycobacterial infections and in leprosy. Rifampin, 600 mg daily for 4 months as a single drug, is an alternative to isoniazid prophylaxis for patients with latent tuberculosis only, who are unable to take isoniazid or who have had exposure to a case of active tuberculosis caused by an isoniazid-resistant, rifampin-susceptible strain. 

Iproniazid 24, an alkyl analog of the antituberculous drug isoniazid 25 (Figure 2.8), surprisingly showed mood-improving activity in several depressed tuberculosis patients, which turned out to result from a monoamine oxidase (MAO) inhibitory activity. Since the compound was already registered as an antituberculosis drug and since it constituted the very first effective treatment of depression, more than 400 000 patients received it within only one year after the first announcement of its antidepressant activity [2, 33], Later it was withdrawn from therapy, due to hepatotoxic side effects. 

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