Isoniazid Metabolisms and its Clinical Implications in Koreans Part 1. Isoniazid Metabolic Pattern in Koreans, Part 2. the Clinical Implications of the Isoniazid Metabolisms in Koreans

Abstract

Preliminary clinical observations indicate that that, in general, a persons to a rapid inactivator my demonstrates suboptimal response to isonse to isoniazid therapy. In contrast, the patients who belong to a slow inactivator is much more likely to achieve optimal response to isoniazid therapy. Furthermore, a significant relationship has been demonstrated between isoniazid metabolism and catalase cetivity, drug susceptibility of tubercle bacilli, and toxicity of isoniazid. Patients with high serum isoniazid values(i.e., slow inactivators) are more likely to excrete catalase-negative, isoniazid-resistants, whereas those patients are rapid inactivators and who have low serum isoniazid concentrations more often excrete catalase-positive, isoniazid sucilli. Peripheral neuritis is the most commonly observed toxic effect. Although patients who ar slow inactivators are more likely to experience maximal antimierobil results, they are also more likely develop peripheral neuritis. The purpose of this study is to determine the clinical implic-actions of the isoniazid metabolism ms in Korea. RESULTS1. Fourpundered and nity-seven pulmonary tuberculosis patients were treated with INH(4-16mg./kg.)-PAS(10-12gm.) and the clinical efficacies sere analyzed by the isoniazid metabolic patterns and its doses. 2. In minimal cases there were no significant differences between therapeutic efficacies and metabolic patterns of isoniazid. 3. In moderately advanced cases, particularly in rapid inactivators, high doses ef INH(8-16mg./kg.)-PAS were superior than conventional daily dose of INH(4mg./kg.)-PAS.4. Peripheral neuritis occurred more frequently in the high doses of INH(8-16mg./kg.) groups, predominantly in show inactivators. 5. Patents who are rapid inactivators excreted isoniazid-sensitive bacilli predominantly, whereas patients who are slow inactivators exerted isoniazid resistant bacilli predominantly. 6. Considering the clinical efficacy and toxicity, the optimal daily doses of isoniazid in moderately advanced and far doses of isoniazid in moderately advanced cased were 8-16mg./kg. in rapid inactivators, 4-8mg./Kg. in rapid inactivators, 4-8mg./Kg. in intermediate an slow inactivators.