Manjeet S. Jangra and Manik Chhabra* Pages 211 - 213 ( 3 )
Introduction: Cycloserine and Kanamycin are approved for treatment of multidrug-resistant tuberculosis with good tolerability in Tuberculosis patients and have various labeled adverse reactions but the neuropsychiatric adverse drug reactions with cycloserine are rarely explained.
Case Report: We present a case report on Cycloserine induced Suicidal tendencies and Kanamycin induced decrease in hearing sensation in Indian MDR-TB patient. A 55-year-old male patient who was diagnosed with MDR-TB was prescribed with category IV anti-tubercular therapy. Within one month of initiation of therapy, he developed repeated suicidal thoughts, joint pain, restlessness, depression, constipation, insomnia, tinnitus and a decrease in hearing sensation.
Results and Discussion: Cycloserine and kanamycin were closely associated with suicidal tendency and tinnitus followed by a decrease in hearing sensations respectively. On causality assessment using WHO-UMC Causality assessment scale, Adverse Drug Reaction with Cycloserine was found to be certain and for kanamycin, ADR was found to be possible.
Conclusion: Early management of such fatal ADR can improve the compliance, thus preventing the relapse of infection as well as improving therapeutic outcome in Tuberculosis patients.
Cycloserine, kanamycin, adverse drug reactions, multi drug resistance tuberculosis, suicidal tendencies, tinnitus.
Patient Safety Pharmacovigilance Associate, National Co-ordination Centre, PvPI, Indian Pharmacopoeia Commission, Ghaziabad, UP, PharmD Intern, Department of Pharmacy Practice, ISF College of Pharmacy, Moga, Punjab