Abstract
Isoniazid is a major component in tuberculosis (TB) treatment, which is often used in combination or alone as prophylaxis for its high efficiency on bacilli of Mycobacterium tuberculosis. It is responsible for an increased risk of developing serious liver side effects involving the prognosis of the patient. Its coinfection with HIV is currently a real public health problem. The purpose of this study was to establish the pharmacokinetic profile of isoniazid in Ivorian patients infected with TB taking a combination containing isoniazid at Abidjan. A cross-sectional analytical and descriptive study on the pharmacokinetics of isoniazid in 30 adults Ivorian patients on TB treatment was conducted. Blood samples at intervals of time were performed by high performance liquid chromatography-ultra violet (HPLC-UV). 30 adult patients were enrolled, with sex ratio M/F = 2. Mean age was 38.67 (18 to 67 years). 56 (7%) were slow acetylators. 14 (46.7%) were treated for pulmonary TB smear negative and 36.67% had a co-infection TB/HIV. A positive correlation was also observed between body mass index (BMI) and Vd (0.444 and p = 0.14) and a negative correlation between BMI and Tmax (-0.399, P = 0.29). The main biological variable influencing pharmacokinetic parameters according to the analysis is the acetylation profile of the patient. Key words: Pharmacokinetics, Isoniazid (INH), tuberculosis, Abidjan.
Highlights
Isoniazid (INH) is the most bactericidal molecule active ingredients commonly used against tuberculosis (TB) (World Health Organization (WHO), 2010)
INH is responsible for the onset of serious liver side effects life-threatening to the patient, which is based on its metabolism and bioactivation made by NAT2 (N- Acetyltransferase 2) and CYP 2E1 (Chamorro et al, 2013)
This study provides the originator of data that clinical feasibility of determination of INH is very relevant
Summary
Isoniazid (INH) is the most bactericidal molecule active ingredients commonly used against tuberculosis (TB) (World Health Organization (WHO), 2010). Major TB drugs, INH, is often used in combination with other molecules or alone in prophylaxis for its high efficiency bacilli Mycobacterium tuberculosis (WHO, 2010). If the effectiveness of this molecule is undeniable, its toxicity is often a ransom for its therapeutic success. In fixed combinations of antiTB including INH, the doses are not exactly in the normal range and can rise plasma levels concentrations above or below therapeutic. The increase or decrease in plasma concentration cause sides effects or harmful bacterial resistance. Isoniazid is associated with hepatotoxicity and peripheral neuropathy, and slow acetylators may be as a result of increased risk of toxicity (Cho et al, 2007). Treatment with isoniazid is further complicated by the expression of the polymorphism in the enzyme system involved in the metabolism, including genetic defect on chromosome involved in the metabolism of INH (acetylators slow and rapid acetylators) (Parkins, 1997)
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