PGIMER Sangrur NO - 2023
Pharmacology
Easy
Patients with tuberculosis who are on isoniazid therapy should also be administered?
Appeared in: PGIMER Sangrur NO - 2023
Explanation
- Isoniazid (INH), a primary anti-tuberculosis drug, can induce a deficiency of Pyridoxine (Vitamin B6).
- This deficiency occurs because INH interferes with the metabolism of Vitamin B6 and increases its excretion from the body, as stated in pharmacology textbooks.
- A lack of Vitamin B6 leads to peripheral neuropathy, which presents as tingling, numbness, or burning pain in the hands and feet.
- Administering Pyridoxine prophylactically (usually 10-50 mg/day) is the standard of care to prevent this neurotoxicity.
Why Other Options Were Wrong
- Option A: Thiamine (Vitamin B1) deficiency is not a known side effect of isoniazid therapy. Its deficiency leads to beriberi or Wernicke-Korsakoff syndrome, which have different causes and clinical presentations.
- Option B: Rifampicin is another first-line anti-tuberculosis drug, not a supplement. It is part of the multi-drug regimen to treat TB but does not prevent the specific side effects of isoniazid.
- Option C: Nicotinic Acid (Vitamin B3) deficiency is not caused by isoniazid. Its deficiency results in pellagra, characterized by dermatitis, diarrhea, and dementia.
Related Visual
Clinical Relevance
- Nursing practice connection: Knowing Pharmacological management of tuberculosis and prevention of drug-induced side effects helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
- A key nursing responsibility is patient education. Nurses must teach patients on INH about the importance of taking pyridoxine to prevent nerve damage and to report any symptoms of neuropathy (tingling, numbness) immediately.
- Nurses must also monitor for hepatotoxicity (jaundice, elevated LFTs), as this is another serious side effect of isoniazid.
- Adherence to the multi-drug TB regimen is crucial for cure and preventing drug resistance. Explaining the role of each medication, including supplements like pyridoxine, can improve patient compliance.
How to Approach the Question
- First, identify the core of the question: It asks for a medication given to prevent a known side effect of a specific drug (isoniazid).
- Recall the pharmacology of isoniazid, a very common anti-TB drug. Access your knowledge about its primary side effects.
- The most frequently tested side effect of isoniazid is peripheral neuropathy. The second most common is hepatotoxicity.
- Connect the side effect (neuropathy) to its underlying cause and preventive measure. Isoniazid causes a functional deficiency of Vitamin B6.
- Scan the options to find the chemical name for Vitamin B6. Pyridoxine is the correct name.
- Finally, evaluate the other options to confirm they are incorrect. Thiamine (B1), Rifampicin (another TB drug), and Nicotinic Acid (B3) have different roles and are not used to prevent isoniazid-induced neuropathy.
Concept Tested & Keywords
- Concept Tested: Pharmacological management of tuberculosis and prevention of drug-induced side effects.
- Stem keywords: tuberculosis, isoniazid therapy
- Lead-in keywords: should also be administered
- Negative lead-in flag: false
Question ID
QuMR_emIumv9mEVu88PgcC
Reference Book
E6 Pharmacology Katzung 16e p. 1313-1315
E6 Nelson Textbook of Pediatrics(2024) — Volume 1 p. 1834-1836
E6 Pharmacology KD Tripathi Essentials 9e Part 3 p. 274-276
Practise the full PGIMER Sangrur NO - 2023
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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