INH treatment is associated with the development of peripheral neuropathies. Which of the following interventions would the nurse teach the client to help prevent this complication?
A. Adhere to a low cholesterol diet.
B. Supplement the diet with pyridoxine (vitamin B6).
C. Get extra rest.
D. Avoid excessive sun exposure.
Correct Answer: B. Supplement the diet with pyridoxine (vitamin B6).
INH competes with the available vitamin B6 in the body and leaves the client at risk for development of neuropathies related to vitamin deficiency. Supplemental vitamin B6 is routinely prescribed. Peripheral neuropathy is avoided and treated with daily pyridoxine administration along with INH. Though there are no specific therapies for INH-induced liver damage, some studies have shown a mortality benefit in using corticosteroids and N-acetylcysteine early in the course of liver injury.
Option A: The treatment is generally supportive with hydration and monitoring. If there is evidence of liver damage, small case studies suggest the use of N-acetyl cysteine and corticosteroids. In rare cases, a liver transplant may be required. Today, peripheral neuropathy is rarely seen because most patients are prescribed pyridoxine at the initiation of isoniazid therapy.
Option C: The patient should be instructed properly on consumption of an adequate dose of the drug at the appropriate time. If the patient is not able to remember properly, the task can be assigned to a family member to dispense the medicine.
Option D: Acute toxicity is approached by strict airway management, activated charcoal if the patient presents early, seizure management with the use of benzodiazepines, and pyridoxine administration. This helps with the rapid restoration of GABA stores.
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