A 32-year-old man on isoniazid for latent tuberculosis presents after intentionally ingesting an unknown quantity of his medications. He is febrile (38.5°C), tachycardic (118 bpm), tachypneic (22 bpm), with BP 132/88 mmHg. He has refractory generalized seizures unresponsive to benzodiazepines and lorazepam. Laboratory studies reveal a high anion gap metabolic acidosis (pH 7.18, AG 16). Serum glucose is normal. Which medication is the most appropriate antidotal therapy?
- A)Methylene blue
- B)N-acetylcysteine
- C)Folate
- D)Thiamine
- E)PyridoxineGABARITO
Explicação
Isoniazid toxicity causes seizures and metabolic acidosis by depleting pyridoxine, which is required for GABA synthesis. Pyridoxine is the specific antidote and is high yield board material. Ver explicação completa e trilha adaptativa →