Question

a nurse is caring for a 52-year-old client who has been diagnosed with a latent tuberculosis infection. the health care provider is considering ordering isoniazid (inh). the preexistence of what condition would require cautious use of inh in this client?

Answer 1

Patients with liver disease should be treated cautiously with isoniazid (INH) due to the risk of hepatotoxicity, especially if they have preexisting conditions such as chronic hepatitis or cirrhosis.

Step-by-step explanation:

The preexistence of liver disease would require cautious use of isoniazid (INH) in a patient. INH is administered as a prodrug and has efficacy against mycobacteria, the causative agents of tuberculosis, by ultimately inhibiting the synthesis of mycolic acid, essential for the mycobacterial cell wall. However, hepatotoxicity is a possible side effect of INH, thus making liver disease a concerning condition when considering INH treatment for latent tuberculosis infection (LTBI). Patients with existing liver disease are at a higher risk for developing drug-induced liver injury, which could potentially exacerbate their condition.

Furthermore, conditions such as chronic hepatitis, acute liver failure, or cirrhosis could greatly increase the risk of serious liver damage when treated with INH. Therefore, the healthcare provider must closely monitor the liver function of patients with these preexisting conditions and consider alternative treatment options or adjustment of INH dosage.