Isoniazid Nursing Considerations [Interventions & Implications]

Isoniazid is an important medication for tuberculosis but can also cause serious side effects. Without proper monitoring and nursing interventions, the risks of taking this drug could be life-threatening. Unfortunately, many healthcare providers are unaware of the precautions to take when administering Isoniazid.

That’s why we created our comprehensive guide on Isoniazid Nursing Interventions And Care. Our guide provides detailed information on safely administering this medication and monitoring patients for potential adverse reactions or complications. With our help, you can ensure your patients receive the best possible care while taking Isoniazid.

What is Isoniazid?

Isoniazid, or isonicotinic acid hydrazide (INH), is a commonly used antibiotic for treating Tuberculosis. It is often prescribed with rifampicin, pyrazinamide, streptomycin, or ethambutol to treat active TB infections. For latent tuberculosis cases, it can be taken alone. This drug is also prescribed for atypical mycobacterial infections, such as

  • M. avium,
  • M. kansasii and
  • M. xenopi.

It can be taken orally or injected into the muscle for treatment.

Side Effects and Mechanism of Action

Isoniazid is a powerful drug and can cause serious side effects. Common side effects of Isoniazid include headaches, dizziness, nausea, and vomiting. Rarely, it can lead to liver damage or even death if not appropriately monitored. Additionally, this drug can interact with other medications and should be used cautiously when taking anticoagulants or acetaminophen.

The mechanism of action for Isoniazid is that it inhibits the synthesis of mycolic acids in mycobacteria by preventing the formation of NADH-dependent enoyl-ACP reductase enzyme complex. This causes the bacteria to die before they can replicate themselves.

History, Society, and Culture

Isoniazid was first created in 1952 and is listed by the World Health Organization (WHO) as an essential medicine. WHO further classifies this medication as critically important for human health. Isoniazid is also available as a generic drug.

Routes, Dosage & Frequency

  • Oral, Intramuscular
  • DOSAGE: Adults and Elderly: 300 mg per day; Children: 10-15mg/kg/day
  • FREQUENCY: Once daily or divided into two doses

Medical uses

Isoniazid is employed with other medicines to combat active tuberculosis (TB) infections. It can also be used independently to prevent TB from developing in individuals who may have been exposed to the bacteria (people with positive TB skin test). This antibiotic works by preventing bacteria from multiplying further. It only treats bacterial infections and will not work against viral illnesses like the common cold or flu. Taking antibiotics when unnecessary can weaken their effectiveness against future infections.

How to Use Isoniazid?

Take this medication orally, on an empty stomach, either 1 hour before or 2 hours after meals. Carefully measure the dosage using a special measuring device/spoon; do not use a household spoon to avoid getting an incorrect dose.

For optimal effect, take this drug at evenly spaced intervals. If you take it daily, take it simultaneously each day.

If you take it every week, stick to the same day(s) of the week and time of day. Mark the days off in your calendar so that you can keep track. Remember to also take this one hour before antacids containing aluminum. The dosage may depend on age, weight, medical condition, and response to treatment.

Continue taking this and other TB medications until you complete the prescribed dosage, even if your symptoms disappear. If you stop too soon or skip doses, the bacteria may continue to grow, making it more challenging to treat and causing a relapse of the infection.

Your doctor may recommend taking vitamin B6 (pyridoxine) to help prevent specific side effects, such as nerve problems caused by isoniazid. Make sure to follow their instructions carefully.

Isoniazid can interact with foods containing tyramine/histamine (for example, red wine, cheese, and certain types of fish). These interactions can cause increased blood pressure, skin flushing, headaches, dizziness, or a rapid or pounding heartbeat. If you experience any of these symptoms, inform your doctor right away. They may advise that you follow a special diet while taking this medication, so ask them for details.

Isoniazid Nursing Considerations

Nursing Assessment

  • Monitor patients for signs of liver toxicity or other drug-related side effects.
  • Take a thorough medical history from the patient, including any potential allergies and recent illnesses.
  • Perform regular laboratory tests to monitor Isoniazid levels in the blood.
  • Educate the patient about the importance of taking their medication as prescribed.
  • Assess the patient for signs of an allergic reaction, such as rash, difficulty breathing, or hives.
  • Monitor treatment adherence and provide additional support if needed.
  • Provide advice on any dietary restrictions that may be necessary due to drug interactions.
  • Assess for signs of overdose, including dizziness, nausea, vomiting, abdominal discomfort or pain, and difficulty breathing.
  • Provide information on potential drug interactions with other medications the patient is taking.
  • Monitor for any signs of an infection or immunosuppression due to Isoniazid use.
  • Recommend a vitamin B6 supplement to prevent nerve damage caused by Isoniazid.

Isoniazid Nursing Intervention

  • Administer Isoniazid as prescribed.
  • Monitor the patient for signs of liver toxicity, and report any changes to the doctor immediately.
  • Provide education on potential side effects and how to manage them.
  • Encourage the patient to adhere to their medication regimen and maintain a healthy lifestyle.
  • Assist in arranging for laboratory tests to monitor Isoniazid levels in the blood.
  • Report any signs of an allergic reaction or overdose to the doctor immediately.
  • Provide advice on dietary restrictions and potential drug interactions with other medications the patient is taking.
  • Monitor for signs of infection or immunosuppression due to Isoniazid use.
  • Recommend a vitamin B6 supplement to prevent nerve damage caused by Isoniazid.
  • Educate the patient and family members about Isoniazid, its side effects, and the importance of treatment adherence.
  • Monitor for signs of any adverse reactions or interactions.

Isoniazid Nursing Implications

Nurses should closely monitor patients taking Isoniazid to ensure optimal outcomes and reduce the risk of side effects. Nurses must be aware of the potential drug interactions and possible signs of an allergic reaction or overdose. They must also educate patients on proper usage, the importance of adherence to treatment, dietary restrictions, and potential side effects.

Additionally, it is important to recommend a vitamin B6 supplement if needed to prevent nerve damage caused by the medication. Nurses should also provide emotional support and encouragement throughout treatment to promote patient compliance with their prescribed regimen.

Isoniazid Patient Teaching

Patients taking Isoniazid should be informed about the potential side effects and how to manage them. They should also be educated on proper usage, including the importance of adherence to treatment and dietary restrictions. Patients should understand that they may need to take a vitamin B6 supplement to prevent nerve damage caused by Isoniazid. Patients need to report any signs of an allergic reaction or overdose immediately. Lastly, nurses should encourage patients to maintain a healthy lifestyle to promote optimal outcomes from their treatment regimen.

Isoniazid Safety Considerations

If a client diagnosed with tuberculosis is taking isoniazid, it is essential to consider the following safety considerations:

  • Isoniazid can interact with certain medications, including antacids and some anti-inflammatory drugs. It should not be combined with alcohol or monoamine oxidase inhibitors (MAOIs).
  • People who have liver disease, diabetes, or a history of seizures should consult with their doctor before taking isoniazid.
  • Isoniazid can cause a severe allergic reaction in some people and should be discontinued immediately if any signs of an allergy are present.
  • Isoniazid may decrease vitamin B6 levels, so supplementing with this vitamin might be necessary during treatment.
  • Regular liver tests should be performed while the patient is on isoniazid therapy.
  • Women who are pregnant or breastfeeding should talk to their doctor before starting isoniazid treatment as there may be additional risks involved for these patients.
  • Patients should not stop taking their medication without consulting their doctor, even if they feel better.
  • Lastly, patients must report any other medications, as there may be potential drug interactions with Isoniazid.


What should be monitored while taking isoniazid?

Patients undergoing the INH-RPT regimen should undergo a monthly physical examination to evaluate for jaundice, liver tenderness, and rash.

What are the nursing implications?

Nursing implications refer to the nursing-related consequences of a disease, medication, or procedure. These implications are distinct from the medical side effects and encompass the responsibilities of nurses in resolving them. A comprehensive understanding of the disease, medication, or procedure is crucial to identify these implications.



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