==================================HSR12================================== 12. I would like any information, review articles, you have available on Rifampin. Specifically, I would like information on this drug as it is used in humans, and any information as it pertains to overdosage, and bleeding problems that may stem from the use of this drug. 1 UI - 87043684 AU - Parthasarathy R ; Sarma GR ; Janardhanam B ; Ramachandran P ; Santha T ; Sivasubramanian S ; Somasundaram PR ; Tripathy SP TI - Hepatic toxicity in South Indian patients during treatment of tuberculosis with short-course regimens containing isoniazid, rifampicin and pyrazinamide. AB - Results are presented of the incidence of hepatitis, nearly always with jaundice, among 1686 patients in clinical trials of the treatment of spinal tuberculosis, of tuberculosis meningitis and of pulmonary tuberculosis with short-course regimens containing rifampicin, isoniazid, streptomycin and pyrazinamide. The incidence was high in patients treated with daily regimens of isoniazid and rifampicin: 16-39% in children with tuberculous meningitis, 10% in patients with spinal tuberculosis (non-surgical cases), and 2-8% in those with pulmonary tuberculosis. Hepatitis, in those receiving rifampicin occurred more often in slow than in rapid acetylators of isoniazid, the proportions amongst those whose acetylator phenotype had been determined being 11% of 317 slow acetylators and 1% of 244 rapid acetylators. In children with tuberculous meningitis, the risk of hepatitis with isoniazid 20 mg/kg (39%) was higher than that with 12 mg/kg (16%), and appreciably lower in patients given rifampicin twice-weekly (5%) rather than daily (21%). There was no indication that pyrazinamide contributed to the hepatic toxicity. MH - Adolescence ; Adult ; Antitubercular Agents/*ADVERSE EFFECTS ; Child ; Child, Preschool ; Hepatitis, Toxic/*ETIOLOGY ; Human ; Infant ; Isoniazid/ADVERSE EFFECTS/THERAPEUTIC USE ; Jaundice/CHEMICALLY INDUCED ; Liver/DRUG EFFECTS ; Pyrazinamide/ADVERSE EFFECTS/THERAPEUTIC USE ; Rifampin/ADVERSE EFFECTS/THERAPEUTIC USE ; Tuberculosis/*DRUG THERAPY ; Tuberculosis, Meningeal/DRUG THERAPY ; Tuberculosis, Pulmonary/DRUG THERAPY ; Tuberculosis, Spinal/DRUG THERAPY SO - Tubercle 1986 Jun;67(2):99-108 2 UI - 87029899 AU - Katz MD ; Lor E TI - Acute interstitial nephritis associated with intermittent rifampin use. AB - Rifampin is a widely used antimicrobial agent, most commonly administered in the treatment of tuberculosis. Since its introduction in the late 1960s, rifampin has become a standard agent in the treatment of tuberculosis, especially with the acceptance of short-course chemotherapy in the U.S. Rifampin also is being used with increasing frequency in the treatment of nontuberculous infections, especially serious staphylococcal infections. While rifampin usually is well tolerated in most patients, adverse effects, including serious forms of toxicity, have been reported. Some of these adverse effects include liver toxicity and various immunologic reactions such as skin rashes, eosinophilia, and interstitial nephritis. This report documents a case of acute interstitial nephritis, most likely secondary to intermittent rifampin administration. MH - Acute Disease ; Case Report ; Female ; Human ; Middle Age ; Nephritis, Interstitial/*CHEMICALLY INDUCED ; Rifampin/ADMINISTRATION & DOSAGE/ *ADVERSE EFFECTS ; Self Administration SO - Drug Intell Clin Pharm 1986 Oct;20(10):789-92 3 UI - 86314543 AU - Onwubalili JK ; Scott GM ; Smith H TI - Acute respiratory distress related to chemotherapy of advanced pulmonary tuberculosis: a study of two cases and review of the literature. AB - Two patients with non-miliary pulmonary tuberculosis developed a syndrome resembling adult respiratory distress following initiation of drug treatment. They were studied clinically and with a representative range of in vitro and in vivo tests of immune function. Both were alcoholic, malnourished and presented with radiologically widespread, smear-positive disease and lymphocytopenia. One had cutaneous anergy in vivo and profound reduction on mononuclear cell proliferative and interferon responses to tuberculoprotein (PPD) in vitro; the other patient, who died two weeks after starting treatment, had relatively normal values for these measures of cell-mediated immunity. In both cases there was a progressive increase during treatment, in peripheral blood lymphocyte counts, skin reactions and in vitro cellular responses to PPD, and a sudden rise in ESR at the time of their deterioration. We propose that the reactions may represent local manifestations of heightened delayed hypersensitivity, mounted by increasing numbers of 'resuscitated' lymphocytes against immunogenic cell wall substances released from dying tubercle bacilli in patients whose level of cellular immunity is being enhanced as a result of chemotherapy. The likelihood of an acute respiratory reaction during treatment may therefore depend on the bacillary load, the extent of lung disease present, and its severity may be related to the pre-treatment immune status of the patient. MH - Adult ; Antitubercular Agents/*ADVERSE EFFECTS ; Blood Sedimentation ; Case Report ; Ethambutol/ADVERSE EFFECTS ; Human ; Isoniazid/ADVERSE EFFECTS ; Male ; Middle Age ; Respiratory Distress Syndrome, Adult/ *CHEMICALLY INDUCED ; Rifampin/ADVERSE EFFECTS ; Tuberculosis, Pulmonary/ *DRUG THERAPY SO - Q J Med 1986 Jun;59(230):599-610 4 UI - 86306229 AU - Dedhia NM ; Almeida AF ; Khanna UB ; Mittal BV ; Acharya VM TI - Acute renal failure--a complication of new multidrug regimen for treatment of leprosy. AB - A leprosy patient who developed acute renal failure on multidrug therapy is reported. The patient had initially received a once-weekly dose of rifampin and after he had stopped taking the drug for a time, was given rifampin on a once-monthly dose schedule. He recovered completely from his acute renal failure. Kidney biopsy showed interstitial nephritis with mononuclear and eosinophilic cellular infiltrates. MH - Adult ; Case Report ; Dapsone/THERAPEUTIC USE ; Drug Hypersensitivity/ *ETIOLOGY ; Drug Therapy, Combination ; Human ; Kidney Failure, Acute/ *CHEMICALLY INDUCED ; Leprosy/*DRUG THERAPY ; Male ; Nephritis, Interstitial/*CHEMICALLY INDUCED ; Rifampin/ADMINISTRATION & DOSAGE/ *ADVERSE EFFECTS/THERAPEUTIC USE SO - Int J Lepr Other Mycobact Dis 1986 Sep;54(3):380-2 5 UI - 86252768 AU - Groenen G ; Janssens L ; Kayembe T ; Nollet E ; Coussens L ; Pattyn SR TI - Prospective study on the relationship between intensive bactericidal therapy and leprosy reactions. AB - A systematic study was performed on the reactions occurring during several short-course therapy regimens for the treatment of paucibacillary and multibacillary patients. Most type 1 upgrading reactions in paucibacillary (PB) leprosy were mild to moderate and of short duration, while the time of onset was extremely variable. Their incidence was higher in the regimen rifampin (RMP) 900 mg once weekly for ten weeks than when a single dose of RMP 40 mg/kg body weight was given or 1500 mg in one dose followed by one year of dapsone (DDS) 100 mg daily. In multibacillary (MB) leprosy, three regimens were compared: MB-WHO regimen; regimen C, consisting of daily RMP 600 mg, ethionamide (ETH) 500 mg, and DDS or clofazimine (CLO) 100 mg for six months, followed by six months of daily DDS or CLO; and regimen D, identical to regimen C but comprising daily DDS or CLO plus ETH 500 mg during the second semester. Type 1 upgrading reactions occurred more frequently in MB patients and were more severe than in PB patients. They occurred more frequently and were more severe in regimens C and D than in the MB-WHO regimen. CLO 100 mg daily prevented type 1 reactions in MB patients and rendered them less severe. ENL was also more frequent in regimens C and D and was not prevented by CLO in the dosage used. Although there is some correlation between type 1 reactions and the total amount of RMP administered, other aspects of RMP administration.(ABSTRACT TRUNCATED AT 250 WORDS) MH - Adult ; Child ; Clofazimine/ADMINISTRATION & DOSAGE/ADVERSE EFFECTS/ THERAPEUTIC USE ; Dapsone/ADMINISTRATION & DOSAGE/ADVERSE EFFECTS/ THERAPEUTIC USE ; Drug Therapy, Combination ; Edema/*ETIOLOGY ; Erythema Nodosum/ETIOLOGY ; Ethionamide/ADMINISTRATION & DOSAGE/ADVERSE EFFECTS/ THERAPEUTIC USE ; Female ; Human ; Leprostatic Agents/ADMINISTRATION & DOSAGE/*ADVERSE EFFECTS/THERAPEUTIC USE ; Leprosy/COMPLICATIONS/*DRUG THERAPY ; Male ; Neuritis/*ETIOLOGY ; Prospective Studies ; Rifampin/ ADMINISTRATION & DOSAGE/*ADVERSE EFFECTS/THERAPEUTIC USE SO - Int J Lepr Other Mycobact Dis 1986 Jun;54(2):236-44 6 UI - 86246550 AU - Dutt AK ; Moers D ; Stead WW TI - Short-course chemotherapy for pleural tuberculosis. Nine years' experience in routine treatment service. AB - Short-course chemotherapy (SCC) for pulmonary tuberculosis for nine months with isoniazid (INH) and rifampin (RIF) is well established. However, there is still no report on results of such therapy in pleural disease. From January 1976 through December 1984, we treated 201 patients (average age 61.6 years) for pleural tuberculosis, 143 with SCC for nine months of mainly INH and RIF and 58 with conventional therapy (CT) for 18 to 24 months. Findings indicated that SCC with INH and RIF was as effective as in pulmonary tuberculosis. The results were equivalent or even better than CT given for prolonged periods. MH - Adolescence ; Adult ; Aged ; Drug Evaluation ; Drug Therapy, Combination ; Female ; Follow-Up Studies ; Human ; Isoniazid/ADMINISTRATION & DOSAGE/ ADVERSE EFFECTS ; Male ; Middle Age ; Rifampin/ADMINISTRATION & DOSAGE/ ADVERSE EFFECTS ; Time Factors ; Tuberculosis, Pleural/*DRUG THERAPY SO - Chest 1986 Jul;90(1):112-6 7 UI - 86243146 AU - Miyagawa S ; Yamashina Y ; Okuchi T ; Konoike Y ; Kano T ; Sakamoto K TI - Exacerbation of pemphigus by rifampicin. AB - Rifampicin therapy caused exacerbation of skin lesions, rising serum pemphigus antibody titres, and decreased serum betamethasone levels in a 59-year-old man with pemphigus vulgaris. Exacerbation of pemphigus was confined to the period of rifampicin therapy and seems to be best explained by the effect of rifampicin on the metabolism of betamethasone. Physicians prescribing rifampicin for the treatment of tuberculosis should be aware of its potential to produce such an important adverse reaction. MH - Betamethasone/*ANTAGONISTS & INHIBITORS/BLOOD/THERAPEUTIC USE ; Case Report ; Human ; Male ; Middle Age ; Pemphigus/BLOOD/*CHEMICALLY INDUCED/ DRUG THERAPY ; Rifampin/*ADVERSE EFFECTS ; Tuberculosis, Pulmonary/DRUG THERAPY SO - Br J Dermatol 1986 Jun;114(6):729-32 8 UI - 86240424 AU - Sarma GR ; Immanuel C ; Kailasam S ; Narayana AS ; Venkatesan P TI - Rifampin-induced release of hydrazine from isoniazid. A possible cause of hepatitis during treatment of tuberculosis with regimens containing isoniazid and rifampin. AB - The effect of daily administration of rifampin on the direct conversion of isoniazid to isonicotinic acid and hydrazine by isoniazid hydrolase was investigated in 6 slow and 8 rapid acetylators of isoniazid. The proportion of isoniazid metabolized through this direct pathway during the first 6 h was estimated from the ratio of total isonicotinic acid formed to acetylisoniazid in urine after administration of isoniazid or acetylisoniazid. In slow acetylators, this proportion was approximately 3% when isoniazid alone was administered and approximately 6% during the maximal phase of induction caused by the daily administration of rifampin in addition to isoniazid (p less than 0.001); in rapid acetylators, the proportions were considerably less (less than 1 and 2.5%, respectively), suggesting that isoniazid hydrolase was induced by rifampin. The increased formation of hydrazine, a known hepatotoxic agent in animals, could explain the substantially higher frequency of the occurrence of hepatitis in slow than in rapid acetylators among tuberculous patients treated with daily rifampin and isoniazid. MH - Acetylation ; Drug Combinations ; Hepatitis, Toxic/*COMPLICATIONS ; Human ; Hydrazines/*BIOSYNTHESIS ; Isoniazid/ADVERSE EFFECTS/*METABOLISM ; Rifampin/ADVERSE EFFECTS/*PHARMACODYNAMICS ; Tuberculosis/COMPLICATIONS/ *DRUG THERAPY SO - Am Rev Respir Dis 1986 Jun;133(6):1072-5 9 UI - 86232379 AU - Martinez-Ro:ig A ; Cam:i J ; Llorens-Terol J ; de la Torre R ; Perich F TI - Acetylation phenotype and hepatotoxicity in the treatment of tuberculosis in children. AB - We studied the relationship between acetylation phenotype and the appearance of biochemical and clinical signs of liver damage in 73 tuberculous children treated with isoniazid and rifampin. No significant differences were found with respect to the distribution of acetylation phenotype between tuberculous patients and a control group consisting of 256 children. Hepatotoxicity manifested in 27 cases (37%), of which only five (7%) had clinical signs. Application of the Fisher exact probability test did not show a relationship between acetylation phenotype and hepatotoxicity. MH - Acetylation ; Adolescence ; Child ; Child, Preschool ; Comparative Study ; Drug Therapy, Combination ; Female ; Hepatitis, Toxic/*ETIOLOGY ; Human ; Infant ; Infant, Newborn ; Isoniazid/*ADVERSE EFFECTS/METABOLISM ; Liver Function Tests ; Male ; *Phenotype ; Rifampin/*ADVERSE EFFECTS/ METABOLISM ; Time Factors ; Tuberculosis in Childhood/*DRUG THERAPY ; Tuberculosis, Pulmonary/DRUG THERAPY SO - Pediatrics 1986 Jun;77(6):912-5 10 UI - 86205126 AU - Bolan G ; Laurie RE ; Broome CV TI - Red man syndrome: inadvertent administration of an excessive dose of rifampin to children in a day-care center. AB - A cluster of toxic reactions among children inadvertently given excessive doses of rifampin for chemoprophylaxis of invasive Haemophilus influenzae disease in a day-care center was investigated. In all 19 children, who received five times the therapeutic dose of rifampin, dramatic adverse reactions developed. A striking, "glowing: red discoloration of the skin and facial or periorbital edema were found to be the hallmarks of rifampin toxicity. These clinical signs of acute toxicity contrast sharply with the adverse side effects of rifampin reported with therapeutic doses. MH - Acute Disease ; Child Day Care Centers ; Child, Preschool ; Edema/ CHEMICALLY INDUCED ; Female ; Haemophilus Infections/*PREVENTION & CONTROL ; Haemophilus Influenzae ; Human ; Infant ; Male ; Medication Errors ; Pigmentation Disorders/*CHEMICALLY INDUCED ; Rifampin/ ADMINISTRATION & DOSAGE/*ADVERSE EFFECTS ; Scalp Dermatoses/CHEMICALLY INDUCED ; Skin Diseases/*CHEMICALLY INDUCED ; Vomiting/CHEMICALLY INDUCED SO - Pediatrics 1986 May;77(5):633-5 11 UI - 86075445 AU - Dutt AK ; Moers D ; Stead WW TI - Short-course chemotherapy for extrapulmonary tuberculosis. Nine years' experience. AB - Short-course chemotherapy with isoniazid and rifampin is well established for pulmonary tuberculosis but not yet for extrapulmonary disease. We report our 9-year experience with short-course chemotherapy in treating 350 patients; 402 extrapulmonary sites were involved. Therapy was largely self-administered with careful monitoring by local public health nurses. Administration of drugs was directly supervised in less than 2% of patients. Short-course chemotherapy with isoniazid and rifampin for 9 months was successful in 95% of patients, equivalent to conventional therapy with two to three drugs for 18 to 24 months. It was found that early drainage and complete debridement of necrotic material in bone lesions enhances healing. Short-course chemotherapy has excellent patient acceptance, short duration, fewer doses, and modest toxicity. Our largely twice-weekly regimen has the additional advantages of reduced cost, fewer doses, and ease of supervision when needed. MH - Adolescence ; Adult ; Aged ; Antitubercular Agents/*ADMINISTRATION & DOSAGE ; Drug Administration Schedule ; Female ; Human ; Isoniazid/ ADMINISTRATION & DOSAGE/ADVERSE EFFECTS ; Male ; Middle Age ; Prospective Studies ; Pyrazinamide/ADMINISTRATION & DOSAGE ; Rifampin/ADMINISTRATION & DOSAGE/ADVERSE EFFECTS ; Streptomycin/ADMINISTRATION & DOSAGE ; Tuberculosis/*DRUG THERAPY SO - Ann Intern Med 1986 Jan;104(1):7-12