A 33-year-old man with newly diagnosed pulmonary tuberculosis (CXR: upper lobe infiltrates) started on rifampin, isoniazid, pyrazinamide, and ethambutol presents with numbness and tingling in his feet. Vital signs: BP 118/76, HR 88, RR 16, Temp 37.2°C, SpO2 98%. He denies visual changes or joint pain. Serum glucose is normal. Which of the following is the best next step to prevent progression of this adverse effect?
- A)Start inhaled fluticasone
- B)Stop rifampin and start azithromycin
- C)Add pyridoxine supplementationGABARITO
- D)Switch ethambutol to linezolid
- E)Add leucovorin supplementation
Explicação
Isoniazid can cause peripheral neuropathy by inducing vitamin B6 deficiency. Pyridoxine supplementation prevents and treats this complication, especially in patients with malnutrition, diabetes, HIV, pregnancy, or alcohol use disorder. The neuropathy clue in a... Ver explicação completa e trilha adaptativa →