Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0023380 (lethargy)
 5,697 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Isoniazid overdose is known to result in the rapid onset of seizures, metabolic acidosis, and prolonged obtundation. Pyridoxine has been reported to be effective in treating isoniazid-induced seizures. We report three cases of obtundation secondary to isoniazid overdose that was immediately reversed by intravenous pyridoxine. In two of these cases, status seizures were stopped by intravenous pyridoxine administration, but the patients remained comatose for prolonged periods. The comas were immediately reversed by the administration of additional pyridoxine. In the third case, the patient's lethargy was treated by intravenous pyridoxine on presentation and was followed by immediate awakening. Pyridoxine is effective in treating not only isoniazid-induced seizures, but also the mental status changes associated with this overdose. The dose required to induce awakening may be higher than that required to control seizures.
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PMID:Reversal of prolonged isoniazid-induced coma by pyridoxine. 129 May 58

The National Animal Poison Control Center received 28 calls of isoniazid (INH) exposures in dogs and cats between 1987 and 1993. The ingestion of a single 300 mg INH tablet was the most common complaint. Isoniazid has a low therapeutic margin and produces life threatening signs in dogs ingesting single 300 mg human tablets. The LD50 of INH in dogs is estimated at 50 mg/kg bw, which is probably similar to that for humans. However, rodents are among the species most resistant to INH and thus are not good animal models for toxic dose extrapolation. The more consistent clinical signs reported were recurrent clonic-tonic seizures followed by a stuporous state with poor response to stimulus. Ideal treatment combines vitamin B6 given as a single i.v. bolus at an equivalent dose to the amount of INH ingested and anticonvulsants such as 1 mg diazepam/kg bw. This combination acts synergistically to improve GABAergic transmission in the CNS and has proved effective in protecting animals from further convulsions and death, even after several seizure episodes, as often encountered in clinical situations.
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PMID:Treatment of acute isoniazid overdose in dogs. 859 42