| Concentration of Biologically Active Isoniazid in Koreans |
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Ho Seun Song1, Seung Suh Park2, Young Chan An2, Keun Youl Kim2 |
1Department of Internal Medicine, Medical College of Seoul National University, Seoul, Korea
2Inchon Red Cross Tbuerculosis Sanatorium, Inchon, Korea |
| 한국인의 Isonicotinic Acid Hydrazide 혈중농도의 생물학적 측정 성적 |
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송호성1, 박승서2, 안영찬2, 김건열2 |
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| Abstract |
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Studies of the metabolism of Isoniazid by metabolic fate of this drug in different subjects. Another author has given evidence which suggests that the result of treatment with Isoniazid in patients with pulmonary tuberculosis may depend upon the concentration of biologically active drug in the blood. In addition, the demonstration of a high incidence of rapid inactivators among persons of Japanese descent has provided another means of investigating the significance of biologically active Isoniazid serum concentrations in the treatment of tuberculosis. The present study was undertaken to estimate the metabolic pattern of Isoniazid in the people of Korea, as compared to the concentration of biologically active Isoniazid in the blood from other non oriental groups. 121 persons were studied; 96 were patients with pulmonary tuberculosis, ranging in age from six to seventeen. 25 were a group of healthy adults made up of doctors, nurses and employees. The method is a slight modification of that used by Bell and his associates, and is as follows.
1) Youmans modification of Proskaur & Beckliquid medium was used.
2) Individual tubercle bacilli solution of H37 Rv. strain was made as follows; Colonies were crushed in an tube with liquid media and were centrifuged for 10 minutes at 1,000 r.p.m. and then were centrifuged again, and the supernate fluid was used as the solution of bacteria.
3) Then 0.1 ml of bacilli solution were inoculated in the media in each tube with graded concentrations of Isoniazid and were incubated for three days.
4) From the above cultures, stained smears were made.
5) Inhibition of growth is determined micro scopically on the stained smear by the change in the size of the tubercle bacillis. Inhibited bacilli were remained in their initial size in good contrast with growing bacilli which were markedly increase in their size.
6) The determination of serum Isoniazid concentration is performed by comparing the highest dilution of serum inhibiting growth with the minimam inhibiting concentration of Isoziazid in the control tube. The result are shown in Fig.1 The great majority of people of Korean descent are rapid inactivators, as high as 72.7%. Therefore most tuberculous patients of Korean descent are expected to have serum concentrations of free Isonizid below the "optimal"range A clinical and bacteriological response significantly less than tiat described in American patients would be anticipated in Korea patients with pulmonary tuberculosis treated on drug regimens utilizing conventional doses of 4-5 MGM per kilograms. Based on the estimation of Isoniazid blood levels, it is felt that a dosage of Isoniazid higher than conventional recommended amounts is required in the treatment of pulmonary tuberculosis in this specific racial group, the Korean people. |
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