A client with latent tuberculosis has been taking oral isoniazid (INH) 300 mg daily for 2 months. The client tells the nurse that for the past week she has had numbness, a burning sensation, and tingling in her hands and feet. Additional intake of which of the following would most likely have prevented this?
1. Folic acid 2. Vitamin B 3. 4.
INH interferes with the action of vitamin B6 (pyridoxine), resulting in peripheral neuropathy; it manifests as ataxia and paresthesia. Individuals who are most predisposed to becoming neurotoxic from taking INH include older adults, those who are malnourished, diabetic clients, pregnant or breastfeeding clients, alcoholics, children, those with liver or renal disease, and HIV-positive individuals. To prevent these complications, a vitamin B, supplement at a dose of 25-50 mg/day is recommended for those at high risk.
(Option 1) Folic acid deficiency does not cause peripheral neuropathy. It is associated with macrocytic anemia and neural tube defects in children.
(Option 3) Vitamin B12 deficiency can cause peripheral neuropathy; however, it is not seen with INH therapy.
(Option 4) Vitamin D deficiency causes osteomalacia but not peripheral neuropathy.
Educational objective: High-risk clients on isoniazid therapy for treatment of tuberculosis may experience neurological side effects due to a decrease in the body's ability to utilize vitamin B6 (pyridoxine). A vitamin B supplement will prevent these effects.
INH interferes with the action of vitamin B6 (pyridoxine), resulting in peripheral neuropathy; it manifests as ataxia and paresthesia. Individuals who are most predisposed to becoming neurotoxic from taking INH include older adults, those who are malnourished, diabetic clients, pregnant or breastfeeding clients, alcoholics, children, those with liver or renal disease, and HIV-positive individuals. To prevent these complications, a vitamin B, supplement at a dose of 25-50 mg/day is recommended for those at high risk.
(Option 1) Folic acid deficiency does not cause peripheral neuropathy. It is associated with macrocytic anemia and neural tube defects in children.
(Option 3) Vitamin B12 deficiency can cause peripheral neuropathy; however, it is not seen with INH therapy.
(Option 4) Vitamin D deficiency causes osteomalacia but not peripheral neuropathy.
Educational objective: High-risk clients on isoniazid therapy for treatment of tuberculosis may experience neurological side effects due to a decrease in the body's ability to utilize vitamin B6 (pyridoxine). A vitamin B supplement will prevent these effects.
