Pediatric Isoniazid Toxicity Workup

  • Author: David Tran, MD; Chief Editor: Timothy E Corden, MD   more...
 
Updated: Mar 21, 2012
 

Laboratory Studies

  • Serum isoniazid (INH) level does not correlate with the degree of acute intoxication. Serum level is not readily available in most hospitals and does not help in the initial management of isoniazid toxicity.
  • Additional laboratory studies may be performed to assess for the following:
    • Aspirin and acetaminophen levels in patients with intentional exposure
    • Urine toxicological screen, if suicide is suspected
    • Pregnancy, if indicated
    • CBC count for leukocytosis
    • Lactic acidosis secondary to seizure
    • Hyperglycemia
    • Ketonuria
    • Glycosuria
    • Ketonemia
    • Hypokalemia
    • Transient elevation of liver enzymes
    • Myoglobinuria
    • Cerebrospinal fluid (CSF) pleocytosis
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Imaging Studies

  • CT scans of the head, with and without intravenous contrast, are recommended in patients with questionable etiology of seizure.
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Other Tests

  • ECG is recommended in patients with a suspected history of tricyclic antidepressant toxicity, which can reveal QRS prolongation.
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Contributor Information and Disclosures
Author

David Tran, MD  Attending Physician, Department of Emergency Medicine, North Shore-LIJ Plainview Hospital

David Tran, MD is a member of the following medical societies: American Academy of Emergency Medicine and American College of Emergency Physicians

Disclosure: Nothing to disclose.

Coauthor(s)

Binita R Shah, MD, FAAP  Professor of Clinical Pediatrics and Emergency Medicine, SUNY Health Sciences Center at Brooklyn; Director of Pediatric Emergency Medicine, Departments of Emergency Medicine and Pediatrics, Kings County Hospital Center

Binita R Shah, MD, FAAP is a member of the following medical societies: American Academy of Pediatrics

Disclosure: Nothing to disclose.

Specialty Editor Board

William T Zempsky, MD  Associate Director, Assistant Professor, Department of Pediatrics, Division of Pediatric Emergency Medicine, University of Connecticut and Connecticut Children's Medical Center

William T Zempsky, MD is a member of the following medical societies: American Academy of Pediatrics

Disclosure: Nothing to disclose.

Mary L Windle, PharmD  Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

Jeffrey R Tucker, MD  Assistant Professor, Department of Pediatrics, Division of Emergency Medicine, University of Connecticut School of Medicine, Connecticut Children's Medical Center

Disclosure: Merck Salary Employment

Daniel Rauch, MD, FAAP  Director, Pediatric Hospitalist Program, Associate Professor, Department of Pediatrics, New York University School of Medicine

Daniel Rauch, MD, FAAP is a member of the following medical societies: Ambulatory Pediatric Association, American Academy of Pediatrics, and Society of Hospital Medicine

Disclosure: Baxter Honoraria Consulting

Chief Editor

Timothy E Corden, MD  Associate Professor of Pediatrics, Co-Director, Policy Core, Injury Research Center, Medical College of Wisconsin; Associate Director, PICU, Children's Hospital of Wisconsin

Timothy E Corden, MD is a member of the following medical societies: American Academy of Pediatrics, Phi Beta Kappa, Society of Critical Care Medicine, and Wisconsin Medical Society

Disclosure: Nothing to disclose.

Additional Contributors

The authors and editors of eMedicine gratefully acknowledge the contributions of previous author Binita R Shah, MD, FAAP, to the original writing and development of this topic.

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Isoniazid metabolism.
Gamma-aminobutyric acid (GABA) synthesis.
 
 
 
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