Reversal of prolonged isoniazid-induced coma by pyridoxine
Article Abstract:
An overdose of the antituberculosis drug isoniazid can result in seizures, metabolic acidosis, and coma. Pyridoxine, commonly known as vitamin B6, has been used successfully to treat overdoses of isoniazid that result in seizures. The drug is effective because it alleviates the isoniazid-induced state of pyridoxine or vitamin B6 deficiency, which plays a role in the development of seizures, rather than specifically treating the seizures. Three cases are reported of patients who had seizures and were at various levels of unconsciousness from overdoses of isoniazid. Intravenously administration of pyridoxine promptly reversed all three patients' seizures and the patients also quickly awakened. It is believed that the coma associated with isoniazid overdose is also related to the pyridoxine deficiency, since such a quick response occurs after administration of the antidote, vitamin B6. The effect upon consciousness associated with isoniazid overdose may range from slight lethargy to deep coma. Patients with continued unconsciousness would benefit from additional doses of pyridoxine, since large doses are often needed to match the amount of isoniazid ingested. Nevertheless, there are complications related to the use of high doses of pyridoxine, such as peripheral nervous disorders. Until the dose of pyridoxine that can cause these complications is clarified, caution should be taken to not administer too much antidote. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Archives of Internal Medicine
Subject: Health
ISSN: 0003-9926
Year: 1990
User Contributions:
Comment about this article or add new information about this topic:
Hypoglycemic coma in anorexia nervosa
Article Abstract:
Anorexia nervosa is the severe loss of appetite occurring most commonly in women between the ages of 12 and 21 years. The patient with anorexia nervosa has an intense fear of becoming obese; the fear does not decrease as weight loss progresses. This eating or appetite disorder is rarely complicated by hypoglycemia, an abnormal decrease in blood glucose levels. However, a case is described of a 44-year old woman with a five-year history of anorexia nervosa, who developed hypoglycemia, which led to coma and death. During hypoglycemia, the patient was shown to have decreased levels of the hormone insulin, C peptide, which is a product of insulin production, and proinsulin, the substance from which insulin is produced. She also had increased levels of growth hormone and cortisol, a hormone released from the adrenal gland. These findings suggested that hypoglycemia was associated with severe malnutrition. Nine other cases of severe hypoglycemia associated with anorexia nervosa are discussed, including six patients who subsequently died. The occurrence of severe hypoglycemia in anorexia nervosa is associated with a poor outcome and requires aggressive medical care and nutritional therapy for survival of the anorectic patient. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Archives of Internal Medicine
Subject: Health
ISSN: 0003-9926
Year: 1990
User Contributions:
Comment about this article or add new information about this topic:
A physiologic approach to diagnosis of the Cushing syndrome
Article Abstract:
Cushing syndrome may be a reversible cause of the metabolic syndrome, which is characterized by obesity, insulin resistance, hypertension, and high cholesterol levels. Cushing syndrome is caused by increased blood levels of the hormone cortisol, which is produced by the adrenal glands. Since it produces many of the same symptoms as metabolic syndrome, it may be more common than many doctors believe.
Publication Name: Annals of Internal Medicine
Subject: Health
ISSN: 0003-4819
Year: 2003
User Contributions:
Comment about this article or add new information about this topic: