Treatment of a potentially lethal dose isoniazid ingestion.
A seven-year-old boy ingested 3,000 mg (125 mg/kg) of isoniazid. Initial blood levels of isoniazid were 250 micrograms/mL approximately six hours after ingestion. Despite IV treatment in the emergency department with 3,000 mg pyridoxine and a repeat of the same antidote one hour later in the intensive care unit, the high isoniazid blood levels and persistent metabolic acidosis and coma prompted a decision to increase drug clearance by hemodialysis. Clearance data confirmed the effectiveness of hemodialysis in removing the poison, and the clinical response was dramatic.
Orlowski
J P
JP
Pediatric Unit, Cleveland Clinic Foundation, Ohio 44106.
Paganini
E P
EP
Pippenger
C E
CE
D000138:Acidosis / Q000209:etiology / Q000628:therapy; D001784:Blood Gas Analysis; D002648:Child; D003128:Coma / Q000209:etiology / Q000628:therapy; D004630:Emergencies; D006801:Humans; D007538:Isoniazid / Q000097:blood / Q000378:metabolism / Q000506:poisoning*; D008297:Male; D009846:Oliguria / Q000209:etiology / Q000628:therapy; D006435:Renal Dialysis; D012640:Seizures / Q000150:complications / Q000628:therapy
D007538:Isoniazid