LIVER FUNCTION TESTS IN PATIENTS OF PULMONARY TUBERCULOSIS USING FOUR DIFFERENT DRUG REGIMENS
Abstract
Background: Chemotherapy is the basic approach to clinical tuberculosis control. Antituberculous therapy causesderangement of hepatic functions revealed by disturbed liver function tests. The incidence of side effects may varydepending upon a number of factors. The primary purpose of this study was to determine the relative and absolutehepatotoxicity of different antituberculous drug regimens in Pakistani population where majority of the tuberculouspatients belong to poor socioeconomic status. Methods: One hundred patients between 30 to 70 years of age withnewly diagnosed pulmonary tuberculosis were selected and divided into four groups on the basis of different drugregimens. Blood and urine tests of these patients were made. Liver function tests were performed before therapy andthen after one. two. three, six and nine months of treatment. Results <& Conclusions: Antituberculous therapy causesderangement of hepatic function to a variable extent in patients of four different antituberculous drug regimens understudy. Drug combination of Streptomycin. Isoniazid and Myambutol seem to be best tolerated of all the four regimens.Monitoring of the liver function in patients on antituberculous therapy indicated that liver dysfunction most frequentlyoccurs during first three months of therapy. There is a tendency for enzyme values to return to normal inspite ofcontinuous treatment. The mechanism underlying this adaptation to injury to the liver is unknown. Biochemical testsin the patients presenting with jaundice yielded the pattern of acute hepatocellular necrosis with high transaminasesand moderately elevated Alkaline Phosphatase. None of the patients had hepatitis associated antigen in their serum.References
Hinshaw, C H and Murrey J F The abstract from
paper presented in Fifth Asia Pacific Congress on
diseases of the Chest. (1977)
khan I Adverse reaction of mil anti-tuberculosis
drugs with special reference to Rifampicin and
Pyrazinamide. The Challenge. 1984 Vol 25 No. 2
Peter J.R. Miller k S and Brown P Studies on the
metabolic basis of the genetically determined
capacities for Isoniazid activation in man
Pharmacol. Exp. Ther 1965150 298-304
Mitchell JR. Thorgeirsson. UP and Black M
Increased incidence of Isoniazid hepatitis in rapid
acetylastors and possible relation to hydrazine
metabolites. Clin Pharmacol Ther. 1975 – 18-70-
Nelson. SD. Snodgrass. W.R. Mitchell. JR>
Metabolic activation of hydrazine to reactive
intermediates mechanistic implications for
Isoniazid and Improniazid Jaundice (1975)
Survey report of Tuberculous Advisory
Committee. (1974)
Renault, H., Compasgon. P. Rapin. J/R and
Jacquot. C Syntheses de L. Ethambutol -14 C et
Pharma cocinetique Chez la Souris Eur. J Med.
Chem. Chemica Therapeutica 1978 13(6) 569.
Lis RH Tuberculosidal activity if Ethambutol in
Human alveolar macrophages A synopsis of the
Scientific Session. B Buenos Aires Argentina. Dec.
(1982)
Bobrowitz. I.D. and Gokulana. K.S. Ethambutol in
the retreatment of Pulmonary Tuberculosis Dis
Chest 1965 48L 238.
Mandel. G.I. Interaction of interleukocytic bacteria
and antibiotics. J. Clin Invest. (1973)
Gonzaler. D.U. Adverse effects of anti-tuberculous
drugs causing changes in the treatment Tubercle.
Robson & Sullivan, F.M. Anti-tuberculous drugs
Pharmacol Rev. 1963 15 169
Hinshaw. C.H and Murray, JJ Diseases of the
Chest. 4th Eds. 1980
Pitts. F.W Tuberculosis. Prevention and therapy. In
Current Concepts of infectious diseases p 1974
-194.
William. C Bailey, Sally, I, Taylor, Harry, E
Dascomb. Morton and Zeskind. M Disturbed
hepatic function during Isoniazid Chemoprphlaxin
Am. Rev. of Respiratory Disease Vol. 107 (1973.
Scherer. P.K Sumer Field J a I. al. S And Sherlock.
S Rifampicin Hepatitis Lancet I 1974 421.
Harolod, I. Isreal. M.D Isoniazid associated
hepatitis Gastroenterology. 1975 69 539-542
Ronaq, Z.R. Mamranm. M.A Shaukat A. Liver
function tests in patients taking Rifampicin
Specialists 1986 50 – 56.
Richard. J Lederman. M D. Faith B and Paul. J
Exchange transfusion as treatment of acute hepatic
failure due to anti-tuberculous drugs Ann Inter
Med 68 (4), (1968)
Black, M Mitchell. Jr. Zimmerma. H.J Isoniazid
associated hepatitis in 114 patients
Gastroenterology. 1975 69 289 – 302.
Mitchell. J R. Isoniazid liver inquiry. Clinical
spectrum Pathology and probable pathologists.
Ann Inter, Med 1976 84-181 – 192.
Mcdermott. W Ormond. I., Muschenchem, C
Daschle. K and Thompsett. R. Pyrazinamide
Isoniazid in tuberculous. A. Rev. Tuber. 1954. 69
Pembran, R.A Handog. I.B Rai Secedes. T and
Widow. A controlled Clinical trial on the treatment
of pulmonary tuberculosis with a regimen
containing Rifampicin Isoniazid and Pyrazinamide
Meducation Foundation (1968)
Grilling. DJ Hepatic toxicity of antituberculous
regimens containing Isoniazid. Rifampicin and
Pyrazinamide. Tubercle. 1978: 59;73
Girdwood. R.H Clinical Pharmacology. 25th Eds.
: p; 37.
Robson, J. M and Sullivan F.M. Anti-tuberculous
drugs Pharmacol. Rev. 1963.15/ 169-223
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