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Neurological Manifestations and Toxicities of the Antituberculosis Drugs

A Review

  • Adverse Drug Experience Review
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Summary

The neurological manifestations and toxicities of 12 antituberculosis drugs [isoniazid, rifampicin (rifampin), ethambutol, p-aminosalicylic acid, pyrazinamide, streptomycin, kanamycin, ethionamide, cycloserine, capreomycin, viomycin and thiacetazone] are reviewed. Their effects upon the central nervous system, cranial nerves, peripheral nerves and the neuromuscular junction are examined, and drug interactions of neurological concern are briefly discussed. Isoniazid is well known to increase the concentrations of γ-aminobutyric acid in neural tissues. Although conflicting data have been published, isoniazid may play a limited future role in reducing the degree of adventitious movements noted in certain neurological diseases such as multiple sclerosis, spasmodic torticollis, and other segmental dystonic syndromes. With rifampicin neurological complications have been observed infrequently. Rifampicin penetrates into the CSF and has been shown to have useful activity against various micro-organisms in the CSF, including certain viruses; however, contrary to earlier suggestions, it appears to have no role in the treatment of subacute sclerosing panencephalitis.

A number of studies have indicated that isoniazid is associated with a large number of accidental and intentional poisonings. The highest incidence has been observed with Southwestern American Indians in which this agent was involved in 7% of all suicide attempts and 19% of the suicide deaths. Degeneration of the optic chiasma and nerve is a well-known adverse effect of ethambutol; toxicity is manifested by impairment of visual acuity, marked loss of colour discrimination, constricted visual fields, and central and peripheral scotoma. Ototoxicity is a well known problem caused by streptomycin, kanamycin, capreomycin and viomycin. The use of streptomycin in pregnant mothers is associated with congenital deafness in newborns in certain cases. The aminoglycoside antibiotics are also associated with flaccid paralysis following neuromuscular blockade. Adverse reactions to cycloserine are mainly dose-related with neurological and psychiatric syndromes noted in up to 50% of patients.

Recent data indicate that isoniazid, rifampicin, ethambutol, pyrazinamide, streptomycin, kanamycin, ethionamide, and cycloserine appear in measurable quantities in the cerebrospinal fluid. Five of these compounds (isoniazid, rifampicin, ethambutol, kanamycin, cycloserine) pass to some degree through non-inflamed meninges.

Other than discontinuation of the therapeutic regimen and general supportive measures, very few methods are described in the literature for treatment of acute intoxications with antituberculosis drugs.

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References

  • Abbott RJ, Currie S, Howe JG, Summer DW. Cerebrospinal fluid GABA in spasmodic torticollis. Annals of Neurology 13: 342, 1983

    PubMed  CAS  Google Scholar 

  • Acocella G, Bonollo L, Mainardi M, Margaroli P. Kinetic studies on rifampicin. III. Effect of phenobarbital on the half-life of the antibiotic. Tijdschrift voor Gastro-enterologie 17: 151–158, 1974

    CAS  Google Scholar 

  • Adams HR. Neuromuscular blocking effect of aminoglycoside antibiotics in non-human primates. Journal of the American Veterinarian Association 163: 613–616, 1973

    CAS  Google Scholar 

  • Ahmad I, Clark LA. Isoniazid hypersensitivity reaction involving the eyes: report of a case. Diseases of the Chest 52: 112–113, 1967

    PubMed  CAS  Google Scholar 

  • Allen BW, Ellard GA, Gammon PT, King RC, McDougall AC, et al. The penetration of dapsone, rifampicin, isoniazid and pyrazinamide into peripheral nerves. British Journal of Pharmacology 55: 151–155, 1975

    PubMed  CAS  Google Scholar 

  • Baciewicz AW, Self TH. Rifampicin drug interactions. Archives of Internal Medicine 144: 1667–1671, 1984

    PubMed  CAS  Google Scholar 

  • Baciewicz AW, Self TH. Isoniazid interactions. Southern Medical Journal 78: 714–718, 1985

    PubMed  CAS  Google Scholar 

  • Bear ES, Hoffman PF, Siegel SR, Randall RE. Suicidal ingestion of isoniazid: an uncommon cause of metabolic acidosis and seizures. Southern Medical Journal 69: 31–32, 1976

    PubMed  CAS  Google Scholar 

  • Benson WM, Stefko PL, Roe MD. Pharmacologic and toxicologic observations on hydrazine derivatives of isonicotinic acid. American Review of Tuberculosis 65: 376–391, 1952

    PubMed  CAS  Google Scholar 

  • Biehl JP, Vilter RW. Effect of isoniazid on vitamin B-6 metabolism; its possible significance in producing isoniazid neuritis. Proceedings of the Society of Experimental Biology and Medicine 85: 349–392, 1954

    Google Scholar 

  • Block SH. Carbamazepine-isoniazid interaction. Pediatrics 69: 494–495, 1982

    PubMed  CAS  Google Scholar 

  • Bolletti M, Croatto L. Deafness in a five year old girl resulting from streptomycin therapy during pregnancy. Acta Pediatrica Latina 11: 1–15, 1958

    Google Scholar 

  • Borman G, Calissendorf B. A case of irreversible bilateral optic damage after ethambutol therapy. Scandinavian Journal of Respiratory Disease 55: 176–180, 1974

    Google Scholar 

  • Boston Collaborative Drug Surveillance Program. Psychiatric side effects of nonpsychiatric drugs. Seminars in Psychiatry 3: 406–419, 1974

    Google Scholar 

  • Braham J. Isoniazid therapy for Huntington’s disease. Neurology 31: 1580–1581, 1981

    PubMed  CAS  Google Scholar 

  • Brazil OV, Corrando AP. The curariform action upon transmitter release and action. Journal of Pharmacology and Experimental Therapeutics 200: 576–587, 1957a

    Google Scholar 

  • Brazil OV, Corrando AP. The curariform action of streptomycin. Journal of Pharmacology and Experimental Therapeutics 120: 452–459, 1957b

    PubMed  CAS  Google Scholar 

  • Brazil OV, Prado-Franseschi J. The nature of neuromuscular block produced by neomycin and gentamycin. Archives of International Pharmacodynamics and Therapeutics 179: 78–85, 1969

    CAS  Google Scholar 

  • Brown CV. Acute isoniazid poisoning. American Review of Respiratory Disease 105: 206–216, 1972

    PubMed  CAS  Google Scholar 

  • Brown CB, Ogg CS, Cameron JS, Bewick M. High dose furosemide in acute reversible intrinsic renal failure: a preliminary communication. Scottish Medical Journal 19 (Suppl): 35–39, 1974

    PubMed  Google Scholar 

  • Bunn DA, Westlake RE. Toxicity of streptomycin in the human. In Waksman (Ed.) Streptomycin: nature and practical applications, pp.524–545, Bailliere, Tindall and Fox, London, 1949

  • Bush GH. Prolonged neuromuscular block due to intraperitoneal streptomycin. British Medical Journal 1: 557–558, 1961

    PubMed  CAS  Google Scholar 

  • Centers for Disease Control. Tuberculosis — United States 1984. Morbidity and Mortality Weekly Report 34: 86–87, 1985

    Google Scholar 

  • Chang MJ, Escabedo M, Anderson DC, Hillman L, Feigin RD. Kanamycin and gentamycin treatment of neonatal sepsis and meningitis. Pediatrics 56: 695–699, 1975

    PubMed  CAS  Google Scholar 

  • Chinyanga HM, Stoyka WW. The effect of colymycin M, gentamycin and kanamycin on depression of neuromuscular transmission induced by pancuronium bromide. Canadian Anaesthetists Society Journal 21: 569–579, 1974

    PubMed  CAS  Google Scholar 

  • Citron KM. Ethambutol: a review with special reference to ocular toxicity. Tubercle 5 (Suppl.): 32–36, 1969

    Google Scholar 

  • Clark M, McCarthy CF. Electrolyte changes due to viomycin. Tubercle 54: 1317–1327, 1970

    Google Scholar 

  • Conway N, Birt BD. Streptomycin in pregnancy: effect on the foetal ear. British Medical Journal 2: 260–263, 1965

    PubMed  CAS  Google Scholar 

  • Coyer JR, Nicholson DP. Isoniazid induced convulsions: Part I — clinical and Part II — experimental. Southern Medical Journal 69: 294–297, 1976

    PubMed  CAS  Google Scholar 

  • Davidson S, Brish M, Rein N, Rubinstein M, Rubinstein E. Ototoxicity in premature infants treated with kanamycin. Pediatrics 66: 479–480, 1980

    PubMed  CAS  Google Scholar 

  • Dayal D, Shanto H. Some observations on the ototoxicity of thiacetazone. Indian Journal of Tuberculosis 17: 155–159, 1970

    Google Scholar 

  • Deka RC, Ghosh P, Kacker SK. Streptomycin ototoxicity: an audiologic and vestibular study. Ear, Nose and Throat Journal 56: 218–224, 1977

    CAS  Google Scholar 

  • Devadatta S. Isoniazid-induced encephalopathy. Lancet 2: 440, 1965

    PubMed  CAS  Google Scholar 

  • Donald PR, Seilars SL. Streptomycin ototoxicity in the unborn child. South African Medical Journal 60: 316–318, 1981

    PubMed  CAS  Google Scholar 

  • Donomae I, Yamanato K. Clinical evaluation of ethambutol in pulmonary tuberculosis. Annals of the New York Academy of Science 135: 849–881, 1966

    CAS  Google Scholar 

  • Dretchen KL, Gergis SD, Sokoll MD. Effect of various antibiotics on neuromuscular transmission. European Journal of Pharmacology 18: 201–203, 1972

    PubMed  CAS  Google Scholar 

  • Dretchen KL, Sokoll MD, Gergis SD. Relative effects of streptomycin on motor nerve terminal and end-plate. European Journal of Pharmacology 22: 10–16, 1973

    PubMed  CAS  Google Scholar 

  • Ducobu J, Dupont P, Laurent M, Bruat J. Acute isoniazid, ethambutol, rifampicin overdosage. Lancet 1: 632, 1982

    PubMed  CAS  Google Scholar 

  • Duquette P, Pleines J, duSouich P. Isoniazid for tremor in multiple sclerosis: a controlled trial. Neurology 35: 1772–1775, 1985

    PubMed  CAS  Google Scholar 

  • Echenwald HF. Some observations on dosage and toxicity of kanamycin in premature and full term infants. Annals of the New York Academy of Science 132: 984–990, 1966

    Google Scholar 

  • Elland GA. The potential clinical significance of the isoniazid acetylator phenotype in the treatment of pulmonary tuberculosis. Tubercle 65: 211–227, 1984

    Google Scholar 

  • Emery ERJ. Neuromuscular blocking properties of antibiotics as a cause of post-operative apnoea. Anaesthesia 18: 57–65, 1983

    Google Scholar 

  • Engle J, Cruz ME, Shapiro B. Phenytoin encephalopathy. Lancet 2: 824–825, 1971

    Google Scholar 

  • Everett ED. Strausbaugh LJ. Antimicrobial agents and the CNS. Neurosurgery 6: 691–714, 1980

    CAS  Google Scholar 

  • Eviatar L, Eviatar A. Development of head control and vestibular response in infants treated with aminoglycosides. Developmental Medicine and Child Neurology 24: 372–379, 1982

    PubMed  CAS  Google Scholar 

  • Fausti SA, Rappaport BZ, Schechter MA, Frey RH, Ward TT, et al. Detection of aminoglycoside ototoxicity by high frequency auditory evaluation. American Journal of Otolaryngology 5: 177–182, 1984

    PubMed  CAS  Google Scholar 

  • Finitzo-Hieber T, McCracken GH, Roeser RJ. Ototoxicity in neonates treated with gentamycin and kanamycin: results of a four year controlled follow up study. Pediatrics 63: 443–447, 1979

    PubMed  CAS  Google Scholar 

  • Fisk GC. Respiratory paralysis after a large dose of streptomycin: report of a case. British Medical Journal 1: 556–557, 1961

    PubMed  CAS  Google Scholar 

  • Francis DA, Grundy D, Heron JR. The response to isoniazid of action tremor in multiple sclerosis and its assessment using polarised light goniometry. Journal of Neurology, Neurosurgery and Psychiatry 49: 87–89, 1986

    CAS  Google Scholar 

  • Friedman SA. Death following massive ingestion of isoniazid. American Review of Respiratory Disease 100: 859–862, 1969

    PubMed  CAS  Google Scholar 

  • Ganguin G, Rempt E. Streptomycin behandlung in der Schwangerschaft und ihre Auswirkung auf das Gehor des kinder. Zeitschrift fur Laryngologie, Rhinologie, Otologie und Ihre Grenzgebiete 49: 496–503, 1970

    PubMed  CAS  Google Scholar 

  • Garfield JW, Jones JM, Cohen NL, Daly JF, McClement JH. The auditory, vestibular and renal effects of capreomycin in humans. Annals of the New York Academy of Science 135: 1039–1046, 1966

    CAS  Google Scholar 

  • Geiseler PJ, Manis RO, Maddux MS. Dosage of antituberculosis drugs in obese patients. American Review of Respiratory Disease 131: 944–946, 1985

    PubMed  CAS  Google Scholar 

  • Girgis NI, Yassin MW, Sippell JE, Sorenson K, Hassan A, et al. The value of ethambutol in the treatment of tuberculosis meningitis. American Review of Respiratory Disease 99: 14–17, 1976

    Google Scholar 

  • Girling DJ. Adverse effects of antituberculosis drugs. Drugs 23: 56–74, 1982

    PubMed  CAS  Google Scholar 

  • Goldman AL, Braman SS. Isoniazid: a review with emphasis on adverse effects. Chest 62: 71–77, 1972

    PubMed  CAS  Google Scholar 

  • Graham MD, Sataloff RT, Kemink JL. Titration of streptomycin therapy for bilateral Ménière’s disease: a preliminary report. Otolaryngology, Head and Neck Surgery 92: 440–447, 1984

    CAS  Google Scholar 

  • Gupta SK, Hollingworth A, Alan J, William HO, Craig JW, et al. Toxic hazard from ‘1314’. British Medical Journal 1: 58, 1960

    Google Scholar 

  • Haas HL, Wieser HG. Effect of 1-cycloserine in cortical neurons in the rat. European Journal of Pharmacology 61: 79–83, 1980

    PubMed  CAS  Google Scholar 

  • Hallett M, Lindsey JW, Adelstein BD, Riley PO. Controlled trial of isoniazid therapy for severe postural cerebellar tremor in multiple sclerosis. Neurology 35: 1374–1377, 1985

    PubMed  CAS  Google Scholar 

  • Harada T, Satake S, Ichibawa H. Ocular toxicity with ethambutol. Japanese Journal of Clinical Opthalmology 23: 1345–1347, 1979

    Google Scholar 

  • Hokkanen E. The aggravating effect of some antibiotics on the neuromuscular blockade in myasthenia gravis. Acta Neurologica Scandinavica 40: 346–352, 1964

    PubMed  CAS  Google Scholar 

  • Holdiness MR. Chromatographic analysis of neurotransmitters and antitubercular drugs. PhD Dissertation, Emory University, Atlanta, 1981

  • Holdiness MR. Chromatographic analysis of glutamic acid decarboxylase in biological samples. Journal of Chromatography Biomedical Applications 277: 1–24, 1983a

    PubMed  CAS  Google Scholar 

  • Holdiness MR. Mycobacterial diseases. Archives of Internal Medicine 143: 2333, 1983b

    PubMed  CAS  Google Scholar 

  • Holdiness MR. Clinical pharmacokinetics of the antituberculosis drugs. Clinical Pharmacokinetics 9: 511–544, 1984a

    PubMed  CAS  Google Scholar 

  • Holdiness MR. Mycobacterium colonization. Archives of Internal Medicine 144: 653–654, 1984b

    PubMed  CAS  Google Scholar 

  • Holdiness MR. Mycobacterium avium-intracellulare infection. Southern Medical Journal 77: 1614, 1984c

    PubMed  CAS  Google Scholar 

  • Holdiness MR. Cerebrospinal fluid pharmacokinetics of the antituberculosis drugs. Clinical Pharmacokinetics 10: 532–534, 1985a

    PubMed  CAS  Google Scholar 

  • Holdiness MR. Adverse cutaneous reactions to antituberculosis drugs. International Journal of Dermatology 24: 280–285, 1985b

    PubMed  CAS  Google Scholar 

  • Holdiness MR. Mycobacterium bovis infection. Archives of Internal Medicine 145: 1930, 1985d

    PubMed  CAS  Google Scholar 

  • Holdiness MR. Contact dermatitis to the antituberculosis drugs: a review. Contact Dermatitis 15, in press, 1987a

  • Holdiness MR. Ethionamide. In Dollery (Ed.) Therapeutic drugs: a clinical pharmacopoeia, Churchill Livingstone, Edinburgh, in press, 1987b

  • Holdiness MR. Thiacetazone. In Dollery (Ed.) Therapeutic drugs: a clinical pharmacopoeia, Churchill Livingstone, Edinburgh, in press, 1987c

  • Howard JB, McCracken GH. Reappraisal of kanamycin usage in neonates. Journal of Pediatrics 86: 949–956, 1975

    PubMed  CAS  Google Scholar 

  • Howard JB, McCracken GH, Trijillo H, Mohs E. Amikacin in newborn infants: comparative pharmacology with kanamycin and clinical efficacy in 45 neonates with bacterial disease. Antimicrobial Agents and Chemotherapy 10: 205–210, 1976

    PubMed  CAS  Google Scholar 

  • Johnson AH, Hamilton CH. Kanamycin ototoxicity — possible potentiation by other drugs. Southern Medical Journal 63: 511–513, 1970

    PubMed  CAS  Google Scholar 

  • Johnson DAW. Drug-induced psychiatric disorders. Drugs 22: 57–69, 1981

    PubMed  CAS  Google Scholar 

  • Johnson J. Epanutin and isoniazid interactions. British Medical Journal 1: 152, 1975

    PubMed  CAS  Google Scholar 

  • Johnson J, Freeman L. Death due to isoniazid and phenytoin. British Medical Journal 129: 511, 1976

    CAS  Google Scholar 

  • Johnson RN, Smith DH, Ritchie RT, Lockhart W. Prolonged streptomycin and isoniazid for pulmonary tuberculosis. British Medical Journal 1: 1679, 1964

    Google Scholar 

  • Joint IUAT/WHO Study Group. Tuberculosis control. Tubercle 63: 157, 1982

    Google Scholar 

  • Joshi VG. Isoniazid in the treatment of depressive syndrome: a pilot trial. Diseases of the Nervous System 38: 106–110, 1977

    Google Scholar 

  • Kanda T, Igarashi M. Ultrastructural changes in vestibular sensory end organs after viomycin sulfate intoxication. Acta Otolaryngology 68: 474–488, 1969

    CAS  Google Scholar 

  • Karmon G, Savir H, Zevin D, Levi J. Bilateral optic neuropathy due to combined ethambutol and isoniazid treatment. Annals of Ophthalmology 11: 1013–1017, 1979

    PubMed  CAS  Google Scholar 

  • Karnik AM, Al-Shamali MA, French FF. A case of ocular toxicity to ethambutol: an idiosyncratic reaction. Postgraduate Medical Journal 61: 811–813, 1985

    PubMed  CAS  Google Scholar 

  • Kass I, Mandel W, Cohen H, Dressler SH. Isoniazid as a cause of optic neuritis and atrophy. Journal of the American Medical Association 164: 1740–1743, 1957

    PubMed  CAS  Google Scholar 

  • Kass I. Chemotherapy regimens used in the treatment of pulmonary tuberculosis. Observations on the efficacy of combination of ethambutol, capreomycin and companion drugs, including 4,4-diisoamyloxythiosemicarbanilide. Tubercle 46: 166, 1965

    CAS  Google Scholar 

  • Kay L, Kampmann JP, Svendsen TL, Vergman B, Molholm JE, et al. Influence of rifampicin and isoniazid on the kinetics of phenytoin. British Journal of Clinical Pharmacology 20: 323–326, 1985

    PubMed  CAS  Google Scholar 

  • Keeping JA, Searle CWA. Optic neuritis following isoniazid therapy. Lancet 2: 278, 1955

    Google Scholar 

  • Korein J. Treatment questioned in familial spasmodic torticollis. Neurology 27: 899, 1977

    PubMed  CAS  Google Scholar 

  • Korein J, Kupersmith M. Reply. Annals of Neurology 13: 342, 1983

    Google Scholar 

  • Korein J, Lieberman A, Kupersmith M, Levidow L. Effect of L-glutamine and isoniazid on torticollis and segmental dystonia. Annals of Neurology 10: 247–250, 1981

    PubMed  CAS  Google Scholar 

  • Krauthammer C, Klerman GL. Secondary mania: manic syndromes associated with antecedent physical illness or drugs. Archives of General Psychiatry 35: 1333–1339, 1978

    PubMed  CAS  Google Scholar 

  • Kutt H, Brennan R, Dehejia H. Diphenylhydantoin intoxication. American Review of Respiratory Diseases 101: 377–384, 1970

    CAS  Google Scholar 

  • Kutt H, Penny JK. Usefulness of blood levels of antiepileptic drugs. Archives of Neurology 31: 283–288, 1974

    PubMed  CAS  Google Scholar 

  • Kutt H, Verebley K, McDowell F. Inhibition of diphenylhydantoin metabolism in rats and in rat liver microsomes by anti-tuberculosis drugs. Neurology 18: 706–710, 1968

    PubMed  CAS  Google Scholar 

  • Kutt H, Winters W, McDowell FH. Depression of parahydroxylation of diphenylhydantoin by antituberculosis chemotherapy. Neurology 16: 594–602, 1966

    PubMed  CAS  Google Scholar 

  • Lansdown FS, Beran M, Litwak T. Psychotoxic reaction during ethionamide therapy. American Review of Respiratory Disease 95: 1053–1055, 1967

    PubMed  CAS  Google Scholar 

  • Lederle Laboratories. Myambutol: guide to recognition and treatment of acute overdosage with Lederle products, 1976

  • Lees AW. Ethionamide and isoniazid in previously untreated cases of pulmonary tuberculosis. Diseases of the Chest 45: 247–250, 1964

    PubMed  CAS  Google Scholar 

  • Leggat PO. Ethionamide neuropathy. Tubercle 43: 95–96, 1962

    PubMed  CAS  Google Scholar 

  • Leibold JE. The ocular toxicity of ethambutol and its relation to dose. Annals of the New York Academy of Science 135: 304–309, 1966

    Google Scholar 

  • Leroux ML. Existe-t-il une surdite congenital acquise due a la streptomycin? Annals of Otolaryngology 67: 194–196, 1950

    CAS  Google Scholar 

  • Levanen J, Nordman R. Complete respiratory paralysis caused by a large dose of streptomycin and its treatment with calcium chloride. Annals of Clinical Research 75: 47–49, 1975

    Google Scholar 

  • Lewis WC, Calden G, Thurslan JR, Gibson WE. Psychiatric and neurological reaction to cycloserine in the treatment of tuberculosis. Diseases of the Chest 32: 172–177, 1957

    PubMed  CAS  Google Scholar 

  • L’Hommedieu C, Strough R, Brown L, Kettrick R, Polm R. Potentiation of neuromuscular weakness infant botulism by aminoglycosides. Journal of Pediatrics 95: 1065–1070, 1979

    PubMed  Google Scholar 

  • Lichstein HC. Mechanism of competitive action of isonicotinic acid hydrazide and vitamin pyridoxine. Proceedings of the Society for Experimental Biology and Medicine 88: 519–522, 1955

    PubMed  CAS  Google Scholar 

  • Liggett SB, Berger JR, Hush J. Cerebrospinal fluid xanthochromia with rifampicin. Archives of Neurology 12: 282–283, 1982

    Google Scholar 

  • Line DH, Poole GW, Watersworth PM. Serum streptomycin levels and dizziness. Tubercle 51: 76–81, 1970

    PubMed  CAS  Google Scholar 

  • Lubinska L. Les troubles d’origine peripherique au cours de la narcose magnesienns. Archives of International Physiology 41: 456–473, 1935

    Google Scholar 

  • Mandell GL, Sande MA. Antimicrobial agents: drugs used in the chemotherapy of tuberculosis and leprosy. In Goodman AS, et al. (Eds.) The pharmacological basis of therapeutics, 6th ed., pp. 1200–1221, Macmillan, New York, 1980

    Google Scholar 

  • Manyan BV, Katz L, Hare TA, Kaniefski K, Tremblay RD. Isoniazid-induced elevation of CSF GABA levels and effects on chorea in Huntington’s disease. Annals of Neurology 10: 35–37, 1981

    Google Scholar 

  • Manyan BV, Tremblay RD. Free and conjugated GABA in human cerebrospinal fluid: effect of degenerative neurological disease and isoniazid. Brain Research 307: 217–223, 1984

    Google Scholar 

  • Mattson RH, Lott IT, Fink AJ. Treatment of SSPE with inosiplex: a preliminary report. Archives of Neurology 32: 503, 1975

    Google Scholar 

  • McKenzie SA, Macnab AJ, Katz G. Neonatal pyridoxine responsive convulsions due to isoniazid therapy. Archives of Diseases of Children 51: 567–568, 1976

    CAS  Google Scholar 

  • McLean DR. Failure of isoniazid therapy in Huntington’s disease. Neurology 32: 1189–1191, 1982

    PubMed  CAS  Google Scholar 

  • Meswesther WD, Mange RJ, Serpeck AA. Deafness following standard intravenous doses of ethacrynic acid. Journal of the American Medical Association 216: 795–798, 1971

    Google Scholar 

  • Miller AB, Fox W, Tall R. An international co-operative investigation into thiacetazone side effects. Tubercle 47: 33–40, 1966

    PubMed  CAS  Google Scholar 

  • Miller J, Robinson A, Percy AK. Acute isoniazid poisoning in childhood. American Journal of Diseases of Children 134: 290–292, 1980

    PubMed  CAS  Google Scholar 

  • Miller RR, Porter J, Greenblatt DJ. Clinical importance of the interaction of phenytoin and isoniazid. Chest 75: 356–358, 1979

    PubMed  CAS  Google Scholar 

  • Molgo J, Lemeignan M, Uchiyama T. Inhibitory effect of kanamycin on evoked transmitter release. European Journal of Pharmacology 2: 93–97, 1979

    Google Scholar 

  • Morales SM, Lincoln EM. The effect of isoniazid therapy on pyridoxine metabolism in children. American Review of Tuberculosis 75: 594–600, 1957

    PubMed  CAS  Google Scholar 

  • Morrow J, McDowell H, Ritchie C, Patterson V. Isoniazid and action tremor in multiple sclerosis. Journal of Neurology, Neurosurgery and Psychiatry 48: 282–283, 1985

    CAS  Google Scholar 

  • Murray FJ. Outbreak of unreported reactions among epileptics taking isoniazid. American Review of Respiratory Disease 86: 729–732, 1962

    PubMed  CAS  Google Scholar 

  • Nagami P, Yoshikawa TT. Aging and tuberculosis. Gerontology 30: 308–315, 1984

    PubMed  CAS  Google Scholar 

  • Narang RK. Acute psychotic reaction probably caused by ethionamide therapy. Tubercle 53: 137–138, 1972

    PubMed  CAS  Google Scholar 

  • Nelson LG. Grand mal seizures following observations of isoniazid. American Review of Respiratory Disease 91: 600–604, 1965

    PubMed  CAS  Google Scholar 

  • Newton RW. Side effects of drugs used to treat tuberculosis. Scottish Medical Journal 20: 47–49, 1975

    PubMed  CAS  Google Scholar 

  • Organick AB, Wilson EM. Multiple drugs in retreatment of chronic pulmonary tuberculosis. Diseases of the Chest 53: 183–193, 1968

    Google Scholar 

  • Paradilis AG, Triantaphyllidis C, Markomichelakis JM. The neuromuscular blocking activity of aminodeoxykanamycin as compared with most of other aminoglycoside antibiotics. Drug Research 27: 141–143, 1977

    Google Scholar 

  • Pearson CA. Thiacetazone toxicity in the treatment of tuberculosis patients in Nigeria. Journal of Tropical Medicine and Hygiene 81: 238–242, 1978

    PubMed  CAS  Google Scholar 

  • Perry TL, Hansen S. Sustained drug induced elevation of brain GABA in the rat. Journal of Neurochemistry 21: 1167–1175, 1973

    PubMed  CAS  Google Scholar 

  • Perry TL, MacLeod PM, Hansen S. Treatment of Huntington’s chorea with isoniazid. New England Journal of Medicine 297: 840, 1977

    PubMed  CAS  Google Scholar 

  • Perry TL, Urquhart N, Hansen S, Kennedy J. GABA drug-induced elevation in monkey brain. Journal of Neurochemistry 23: 443–445, 1974

    PubMed  CAS  Google Scholar 

  • Perry TL, Wall RA, Hansen S. Brain amino compounds in Huntington’s disease patients on isoniazid therapy. Neurology 35: 755–758, 1985

    PubMed  CAS  Google Scholar 

  • Perry TL, Wright JM, Hansen S, MacLeod PM. Isoniazid therapy of Huntington’s disease. Neurology 29: 370–375, 1985

    Google Scholar 

  • Pitts FW. Tuberculosis: prevention and therapy. In Hook et al. (Eds) Current concepts in infectious diseases, pp. 181–194, John Wiley & Sons, New York, 1977

    Google Scholar 

  • Poole GW, Schneeweiss J. Peripheral neuropathy due to ethionamide. American Review of Respiratory Disease 84: 890–892, 1961

    PubMed  CAS  Google Scholar 

  • Prazic M, Salaj B. Ototoxicity with children caused by streptomycin. Audiology 14: 173–176, 1975

    PubMed  CAS  Google Scholar 

  • Prado WA, Corrado AP, Marseillan RP. Competitive antagonism between calcium and antibiotics at the neuromuscular junction. Archives of International Pharmacodynamics and Therapeutics 231: 297–307, 1978

    CAS  Google Scholar 

  • Pyle MM. Ethambutol and viomycin. Medical Clinics of North America 54: 1317–1327, 1970

    PubMed  CAS  Google Scholar 

  • Pyle MM, Pfeutze KH, Pearlson MD, de la Huerga J, Hubble RH. A 4 year clinical investigation of ethambutol in initial and retreatment cases of tuberculosis: efficiency, toxicity and bacterial resistance. American Review of Respiratory Disease 93: 428–441, 1966

    CAS  Google Scholar 

  • Radner DB. Toxicologic and pharmacologic aspects of rifampicin. Chest 64: 212–216, 1973

    Google Scholar 

  • Rapport RL, Shaw CM. Phenytoin related cerebellar degeneration without seizures. Annals of Neurology 2: 437–439, 1977

    PubMed  Google Scholar 

  • Reilly RH, Killman KF, Jenny EH, Marshal WH, Tausey T, et al. Convulsant effects of isoniazid. Journal of the American Medical Association 152: 1317–1321, 1953

    PubMed  CAS  Google Scholar 

  • Robertson WC, Clarke DB, Markesbery A. Review of 38 cases of subacute sclerosing panencephalitis: effect of amantadine on the natural course of the disease. Annals of Neurology 8: 422–425, 1980

    PubMed  Google Scholar 

  • Robinson GC, Camborn KG. Hearing loss in infants of tuberculosis mothers treated with streptomycin during pregnancy. New England Journal of Medicine 271: 949–951, 1964

    PubMed  CAS  Google Scholar 

  • Rubin B, Burke JC. Further observations on the pharmacology of isoniazid. American Review of Tuberculosis 67: 644–651, 1953

    PubMed  CAS  Google Scholar 

  • Ruiz RC. D-Cycloserine in the treatment of pulmonary tuberculosis resistant to standard drugs. Diseases of the Chest 45: 181–184, 1964

    PubMed  CAS  Google Scholar 

  • Russo T, Tsalkos A. The toxicity of ethambutol on the human eye. Annals of Ophthalmology 2: 577–580, 1970

    Google Scholar 

  • Sakula A. Streptomycin and the foetus. British Journal of Tuberculosis 48: 69–72, 1954

    CAS  Google Scholar 

  • Sandyk R. Phenytoin toxicity induced by antituberculosis drugs. South African Medical Journal 61: 382, 1982

    PubMed  CAS  Google Scholar 

  • Schaffeld HG, Garthwaite B, Amberson JR. Viomycin therapy in human tuberculosis. American Review of Tuberculosis 69: 520–525, 1954

    PubMed  CAS  Google Scholar 

  • Scharden JL. Drugs as teratogens, pp. 231, CRC Press, Inc., Cleveland, 1976

    Google Scholar 

  • Schmidt IG. CNS effects of ethambutol in monkeys. Annals of the New York Academy of Sciences 135: 759–774, 1966

    PubMed  CAS  Google Scholar 

  • Schmidt IG, Schmidt LH. Studies on the neurotoxicity of ethambutol and its racemate for the rhesus monkey. Journal of Neuropathology and Experimental Neurology 25: 40–67, 1966

    Google Scholar 

  • Senanyake N, Vyravanathan S, Kanacjasuriyam S. Cerebrovascular accident after a skipjack reaction in a patient taking isoniazid. British Medical Journal 2: 1127–1128, 1978

    Google Scholar 

  • Shepard TH. Catalog of teratogenic agents, pp. 111, 2nd ed., The Johns Hopkins University Press, Baltimore, 1976

    Google Scholar 

  • Sievers ML, Herrier RN. Treatment of acute isoniazid toxicity. American Journal of Hospital Pharmacy 32: 202–206, 1975

    PubMed  CAS  Google Scholar 

  • Silverstine H, Hyman SM, Feldbaum J, Silverstein D. Use of streptomycin sulfate in the treatment of Meniere’s disease. Otolarynology, Head and Neck Surgery 92: 229–232, 1984

    Google Scholar 

  • Singh YN, Harvey AL, Marshall IG. Antibiotic induced paralysis of the mouse phrenic nerve hemidiaphragm preparation and reversibility by calcium and neostigmine. Anaesthesiology 48: 418–424, 1978b

    CAS  Google Scholar 

  • Singh YN, Marshall IG, Harvey AL. Some effects of the aminoglycoside antibiotic amikacin on neuromuscular and autonomic transmission. British Journal of Anaesthesiology 50: 109–117, 1978a

    CAS  Google Scholar 

  • Smith CK, Durack DT. Isoniazid and reaction to cheese. Annals of Internal Medicine 88: 520–521, 1978

    PubMed  CAS  Google Scholar 

  • Snavely SR, Hodges GR. The neurotoxicity of antibacterial agents. Annals of Internal Medicine 101: 92–104, 1984

    PubMed  CAS  Google Scholar 

  • Sokoll MD, Diecke FPJ. Some effects of streptomycin on frog nerve in vitro. Archives Internationales de Pharmacodynamie et de Therapie 177: 332–339, 1978

    Google Scholar 

  • Sokoll MD, Gergis SD. Antibiotics and neuromuscular function. Anesthesiology 55: 148–159, 1981

    PubMed  CAS  Google Scholar 

  • Spittle BJ. Drug-induced psychotic syndromes. New Zealand Medical Journal 95: 349–352, 1982

    PubMed  CAS  Google Scholar 

  • Standaert FG, Riker WF. The consequences of cholinergic drug action on motor nerve terminals. Annals of the New York Academy of Sciences 144: 517–533, 1967

    CAS  Google Scholar 

  • Starke H, Williams S. Acute poisoning from overdose of isoniazid: a case report. Lancet 83: 406–408, 1963

    CAS  Google Scholar 

  • Sutton PH, Beattie A. Optic atrophy after administration of isoniazid with para-aminosalicylic acid. Lancet 1: 650–651, 1955

    Google Scholar 

  • Swash M, Roberst AH, Murnaghan A. Reversible pellagra-like encaphalopathy with ethionamide and cycloserine. Tubercle 53: 132–136, 1972

    PubMed  CAS  Google Scholar 

  • Swick HM. Rifampin ineffective in treating SSPE. New England Journal of Medicine 293: 405, 1975

    PubMed  CAS  Google Scholar 

  • Thulasimnay MT, Kela AK. Improvement of psychomotor epilepsy due to interaction of phenytoin-isoniazid. Tubercle 65: 229–230, 1984

    PubMed  CAS  Google Scholar 

  • Timmerman JE, Long JP, Pittinger GB. Neuromuscular blocking properties of various antibiotic agents. Toxicology and Applied Pharmacology 1: 299–304, 1959

    CAS  Google Scholar 

  • Valsalan VC, Cooper GL. Carbamazepine intoxication caused by interactions with isoniazid. British Medical Journal 285: 261–262, 1982

    PubMed  CAS  Google Scholar 

  • Vanasin B, Colmer M, Davis PJ. Hypocalcemia, hypomagnesemia, and hypokalemia during chemotherapy of pulmonary tuberculosis. Chest 61: 496–498, 1972

    PubMed  CAS  Google Scholar 

  • van Wieringen A, Vrijlandt CM. Ethosuximide intoxication caused by interaction with isoniazid. Neurology 33: 1227–1228, 1983

    PubMed  Google Scholar 

  • Vysniauskas CV, Hueckner HH. Severe reaction of the CNS following isoniazid therapy. American Review of Tuberculosis 69: 759–765, 1954

    PubMed  CAS  Google Scholar 

  • Wagner JC, Slama TG. Rifampicin-phenytoin drug interaction. (Abstract.) Drug Intelligence and Clinical Pharmacy 18: 497, 1984

    Google Scholar 

  • Walby AP, Kerr AG. Streptomycin sulphate and deafness: a review of the literature. Clinical Otolaryngology 7: 63–68, 1982

    PubMed  CAS  Google Scholar 

  • Walker WC, Murdock JM. Cycloserine in the treatment of pulmonary tuberculosis. Tubercle 38: 297–300, 1957

    PubMed  CAS  Google Scholar 

  • Warkany J. Antituberculosis drugs. Teratology 20: 133–138, 1979

    PubMed  CAS  Google Scholar 

  • Watson EH, Stow RM. Streptomycin therapy — effects on fetus. Journal of the American Medical Association 137: 1599–1600, 1948

    PubMed  CAS  Google Scholar 

  • Weinstein L, Goldfield M, Adamis D. A study of intrathecal chemotherapy in bacterial meningitis. Medical Clinics of North American 37: 1363–1378, 1953

    Google Scholar 

  • Werner CA, Tompsett R, Muschenheim E. The toxicity of viomycin in humans. American Review of Tuberculosis 63: 49–59, 1951

    PubMed  CAS  Google Scholar 

  • Wood ER. Isoniazid toxicity: pyridoxine controlled seizures in a dialysis patient. Journal of the Kansas Medical Society 12: 551–552, 1981

    Google Scholar 

  • Woods JD, Peesker SJ. Gorecki DKJ, Tsui D. Effect of L-cycloserine on brain GABA metabolism. Canadian Journal of Physiology and Pharmacology 56: 62–68, 1978

    Google Scholar 

  • Wright J, Stokes EF, Sweeny VP. Isoniazid induced carbamazepine toxicity and vice versa: a double blind drug interaction. New England Journal of Medicine 307: 1325–1327, 1982

    PubMed  CAS  Google Scholar 

  • Yamamoto M, Otsuki S, Kuroda H, Ogawa N. Isoniazid effects on choreiform movement and on GABA, HVA and 5-HIAA in CSF. Acta Neurologica Scandinavica 67: 124–127, 1983

    PubMed  CAS  Google Scholar 

  • Yiannikas C, Walsh J, McLeod JG. Visual evoked potentials in the detection of subclinical optic toxic effects secondary to ethambutol. Archives of Neurology 40: 645–648, 1983

    PubMed  CAS  Google Scholar 

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Holdiness, M.R. Neurological Manifestations and Toxicities of the Antituberculosis Drugs. Drugs 2, 33–51 (1987). https://doi.org/10.1007/BF03259859

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