PPT-Isoniazid induced Acute Metabolic Acidosis and Neurotoxicity–A Case Report and

Review of Literature Sumeet Prakash Mirgh Jehangir Soli Sorabjee Isoniazid INH is a crucial drug in the prevention and treatment of tuberculosis INH is commonly known to cause derangements in liver function tests and peripheral neuropathy due to pyridoxine deficiency in slow acetylators However in toxic doses it is known to cause severe neurologic manifestations and acute metabolic acidosis INH toxicity is characterized by the clinical triad of repetitive seizures unresponsive to the usual anticonvulsants metabolic acidosis with a high anion gap and coma Hence the diagnosis of INH overdose should be considered in any patient who presents to Emergency medical services EMS with the triad Though accidental overdose of antituberculosis drugs have been reported in children and adults acute toxicity is rare When recognized intravenous pyridoxine and correction of acidosis with sodium bicarbonate and supportive treatment is effective The condition is easily treated with intravenous pyridoxine but if not treated in time could prove fatal Unlike other poisonings serum INH levels do not corelate with either symptomatology or liver injury. Lee Jr Induced is a term implying that a particular condition is indirectly caused by another condition In the case of traffic volumes the term arose from the phenomenon that improvements to a highway especially capacity improvements seemed to res ICU SRMO. Sodium Bicarbonate . - use in critical care. Metabolic Acidosis. Hyperkalaemia. Toxicology. Cardiac arrest. RTA. CRRT. Others?. Potential Sodium Bicarbonate Uses:. NaHCO3. Available in 8.4% solution, 10/50/100 ml. 1. Mohammed A. Almeziny. . BPharm.RPh. . . Msc. . PhD. Clinical . Pharmacist. The Body and pH. Homeostasis of pH is tightly controlled. Extracellular fluid = 7.4. Blood = 7.35 – 7.45. < 6.8 or > 8.0 death occurs. By Sheila Mulhern. Understanding Drug Metabolism. Pharmacokinetics Process (ADME). Conversion process of breaking down drug into metabolites. Absorption. Distribution. Metabolism (biotransformation in the liver). Combined EM/IM Residency Program. Virginia Commonwealth University Health System. Overview. Physiologic Effects of Acid-Base Disturbances. Traditional (Schwartz-Bartter) Approach. Stewart Method. Fluid Resuscitation. In vitro. Testing be used for Toxicity Assessment instead of . in vivo. Approaches?. Timothy J. Shafer. 2012 SOT In vitro Lunch. Disclaimer: The views expressed . in this presentation . are solely those of the Author. They do not represent Agency . Acidosis ACIDOSIS REDUCED ACIDOSIS Breath holding after an exhalation causes a decrease to the concentration of oxygen to trigger increased lactic acid, therefore increased H+. At the same time, carbon dioxide also increases leading to an increased concentration of hydrogen ions to further acidify the blood. Alok Agrawal, MD, FASN, FNKF. Clinical Associate Professor. WSU, Dayton, Ohio. Arterial Blood Gas. ABG’s - necessary to correctly diagnose AB disorders. Interpret ABG s in conjunction with history, PE and labs. Abdullah Alsakka . EM.Consutant. . . . Objectives . To provide a simple, systematic approach to interpreting arterial blood gas (ABG) samples. . Multiple formulas and rules exist to help guide us through the forest of diagnoses and complex problems. Critical Care Clinical Fellow. Royal Papworth Hospital. Metabolic Acidosis: Anion Gap. [Na. +. ] - [Cl. -. ] - [HCO. 3. -. ]. Reference range 8 – 12 (+/- 4) mmol/L. Sometimes [K. +. ] is included:. . . . Asst. Prof. Dr. Dalya Basil. Disorders of Acid-Base Balance. There are two types of acid-base disorders: . Cnidoscolus. . aconitifolius. ,. . Gongronema. . latifolium. and . Moringa. . oleifera. . Leaves. Nene O. Uchendu. 1*. , . Emeka. G. Anaduaka. 1. , . Chiemekam. S. Ezechukwu. 2. , . Chinelo. C. Nkwocha. Brian A. Juber, MD. Neonatologist, Assistant Professor of Pediatrics. Children’s Hospital & Medical Center. University of Nebraska Medical Center. Omaha, NE. Objectives. The participant should be able to:. MOHAMMED YOUNUS AL ATBEE. Consultant nephrologist and physician . Assistant professor of medicine and nephrology. Interactive session . Definitions. The acidity or alkalinity of a solution is determined by its Hydrogen ion concentration.