症例 challenge · Emergency / Toxicology / Infectious disease · teaching

Isoniazid (INH) Poisoning — Management Pathway · case challenge

Given a case, work through the care pathway step by step; the tool checks each choice and scores you. Decisions and basis are taken from this site's reviewed care pathways.

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Case #1Emergency / Toxicology / Infectious disease

📋 Case data

Suspect INH poisoning?Ingestion history, no seizures yet

Data is taken from this pathway's reviewed node text. Work through the pathway step by step.

Step 1 / 1 · Suspect INH poisoning?

Refractory seizures + metabolic acidosis — suspect INH poisoning?

💡 A TB drug; depletes pyridoxine (B6) → reduced GABA → seizures. Toxic from ≥1.5 g, seizures >30 mg/kg. Onset 30 min–2 h. Classic triad: refractory seizures unresponsive to usual anticonvulsants + high-anion-gap metabolic acidosis + coma; refractory seizures + acidosis should prompt suspicion of INH (especially TB patients / those with drug access).

For teaching. Decisions and their basis are taken from this site's reviewed care pathways; for licensed clinicians/trainees, this does not replace clinical judgment or local protocols.