Isoniazid in Pulmonary Tuberculosis* *From the Chest Service, Gorgas Hospital, Ancon, Canal Zone
| Autor: | Amadeo Vicente-Mastellari, Rodolfo V. Young |
|---|---|
| Rok vydání: | 1954 |
| Předmět: |
Drug
medicine.medical_specialty Globulin biology Dose business.industry media_common.quotation_subject Isoniazid General Medicine Gastroenterology Surgery chemistry.chemical_compound chemistry Pulmonary tuberculosis Internal medicine medicine biology.protein Voracious appetite medicine.symptom business Weight gain Dihydrostreptomycin media_common medicine.drug |
| Zdroj: | Diseases of the Chest. 25:559-572 |
| ISSN: | 0096-0217 |
| DOI: | 10.1378/chest.25.5.559 |
| Popis: | Sixty two cases of active pulmonary tuberculosis treated with isonicotinic acid hydrazide over a period of from 90 to 297 days have been reported. The drug was administered in dosages of 4 mgm. and 8 mgm. per kilo of body weight. Twenty six received combined treatment of dihydrostreptomycin and isoniazid. In spite of the small number of cases it is considered that some of the results are significant. General manifestations of pulmonary tuberculosis disappeared in two to three weeks, temperature becoming normal, with considerable weight gain and development of voracious appetite. Cough and expectoration were completely eliminated. Of 32 positive cases that received isoniazid, 16 reverted to negative. Of 21 positive cases that received combined dihydrostreptomycin and isoniazid 10 reverted. The reversions were higher in the early exudative and mixed cases. All laryngeal and endobronchial lesions responded favorably. Roentgenological changes were not as impressive as the clinical benefits, but 36 out of 55 patients showed some improvement, mostly in the early exudative and mixed cases. The action of isoniazid seems to be mostly limited to the exudative element of the tuberculous process. No demonstrable clinical, radiological, or bacteriological improvement was found when the dosage of isoniazid was increased from 4 to 8 mgm. per kilo of body weight. However, an accentuation in toxic manifestations was evident. From a therapeutic standpoint, 4 mgm. of isoniazid per kilo of body weight provides an adequate concentration and satisfactory dosage. Combined treatment with dihydrostreptomycin and isoniazid requires further studies before the advantages and limitations of such therapy can be properly evaluated. It has been confirmed that an initial, natural or spontaneous as well as an acquired resistance to isoniazid exists and has to be considered in the treatment of patients. Toxic symptoms are practically non-existant on a 4 mgm. per kilo of body weight dosage. These respond quickly to treatment and disappear when the drug is discontinued. Although no increase in the total proteins of the blood was found, an elevation of the globulin fraction and inversion of the albumen-globulin ratio was observed in 14 patients, for which we have no satisfactory explanation. Isonicotinic acid hydrazide is an effective drug in the treatment of pulmonary tuberculosis. Further studies toward solving the many therapeutic problems arising from its use should be continued. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|