Drug Metabolism · Pharmacology

What is the clinical consequence of 'Slow Acetylator' status in a patient taking Isoniazid for tuberculosis?

  1. Increased risk of peripheral neuropathy and toxicity
  2. Rapid clearance of the drug leading to treatment failure
  3. Inability of the drug to be absorbed from the gut
  4. Permanent discoloration of the skin and nails
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Correct answer: Increased risk of peripheral neuropathy and toxicity

Acetylation (a Phase II reaction) is the primary pathway for Isoniazid. Slow acetylators have a genetic deficiency in the enzyme NAT2, leading to higher plasma concentrations of the drug and a greater risk of adverse effects.

Difficulty: Medium Question 15 of 20

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