Taking isoniazid while in nursing school.

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Specializes in ER/Emergency Behavioral Health....

I wasn't sure where to post this; I just want to know if anyone else went through this and how they dealt.

The last 6 years at my job, my PPD started coming out positive after I was exposed to a patient who potentially had TB. I'm guessing the patient did, because my PPD was always negative before that. My employer just had me do a chest x-Ray every year and then just had me fill out a form to have documentation that I was symptom free.

2 months ago I had to get a physical at my PCP for nursing school. I informed him my PPD was always positive, so he decided we should do a quantiferon gold test. It came out positive. I got yet another chest x-Ray which was negative. Then I'm told that I should take isoniazid (a tb med) for a year since that's what the city health bureau requires. Meanwhile, work and school are happy with the negative chest X-ray.

I'm ok with not being allowed to drink on this med, but I can't take Tylenol if I have a fever, and I have to go for monthly liver function tests. It makes me feel weak and tired all the time. I wasn't like this before. I used to have energy.

Has anyone taken this and if so, how did you get through it? I start my first year of nursing school in a week. I can't overload on caffeine because of the fact that I'm on beta blockers and my resting HR is 90 with them (130 without).

I was hoping someone out there could give me advice. I'm already taking a multivitamin plus vitamin d and b6 as recommended by my doctor.

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Specializes in Critical Care, Education.

BTDT - I ended up with full blown "chemical hepatitis" -- absolutely miserable & sick as a hound dog so I had to stop the meds. It took a while to bounce back sufficiently to work full time. My doc told me that I should have been told to stop taking the meds when abnormal LFT first appeared. Since that time, I have just done CXR & had no problems. Keep a close eye on your labs.

Best of luck on school!

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Specializes in ER/Emergency Behavioral Health....

Thanks. I'm going to keep up with the LFT and if it is off a bit I'm telling my doctor I'm not taking the meds.

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Specializes in Emergency.

I had to take Isoniazid several weeks before my nursing school endeavor started. I finished it the year after that. No problems, whatsoever; however, there was (and maybe still is) a national shortage of it. I think the routine LFT once a month is overkill, though -- but, if your insurance covers it, who cares? Just remember to take your B6.

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I did the year of INH my first year of nursing school. Had no problems with it.

I'm surprised your employer was "okay" with your PPD converting, and just gave you annual x-rays. I though TB was a reportable condition. When my PPD turned I was told I was required to report to the local public health department, and it was the public health physician who insisted I take the INH and be seen monthly in the TB clinic (I never had active TB, just the exposure). I had no choice in the matter.

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Specializes in ER/Emergency Behavioral Health....

I was surprised too. They never addressed the positive PPD. It wasn't addressed until I got the physical for nursing school.

I assumed that it was always a false positive or something. I figured I could trust them.

Oh well...

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Specializes in Neuro, Telemetry.

It sounds like your employer was trying to get out of paying for your INH treatment since this happened while you were at work. Without the proper testing soon after the work exposure there is no proof that this occurred on the job. I can only imagine that monthly labs daily medication for a year is not cheap.

Did they send you to their occ health, or did you see a PCP right after the incident? Or did they just start sending you for yearly CXR to cover their behinds? I believe this is a reportable illness due to the severity of active TB and strict enforcement of treatment so your employer should have reported it and then treated you.

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Specializes in ER/Emergency Behavioral Health....

Nothing happened after the incident. No one contacted me. I was 20 and uneducated about it so I thought it was fine. Then the positive PPD happened and they just did the chest x ray. After a few years they didn't even do that, just had me fill out a questionnaire to show I was symptom free.

The blood test and the current INH is my own doing because of the physical I needed for school. So my insurance (through this employer) will hopefully cover my labs and the INH is only $4 with my prescription plan, thankfully.

After 6 years there is nothing I can do to claim it as workmans comp, so I'll just pay for my meds.

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Specializes in Neuro, Telemetry.
Nothing happened after the incident. No one contacted me. I was 20 and uneducated about it so I thought it was fine. Then the positive PPD happened and they just did the chest x ray. After a few years they didn't even do that, just had me fill out a questionnaire to show I was symptom free.

The blood test and the current INH is my own doing because of the physical I needed for school. So my insurance (through this employer) will hopefully cover my labs and the INH is only $4 with my prescription plan, thankfully.

After 6 years there is nothing I can do to claim it as workmans comp, so I'll just pay for my meds.

Oh, I'm not saying you should or could do anything about it now, just mentioning the likely reason why nothing was done about it initially.

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Specializes in LDRP.

Last summer I took a 3 month round of priftin and isoniazid. Other than feeling really crappy if I forgot to take food with one or have an empty stomach with the other and having sunshine yellow pee every week for about 3 days it wasn't so bad. I'm sorry you're feeling so weak and tired on the meds. Have you been on them long? Maybe it will stop affecting you like that in a little time? Best of luck!

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Specializes in occupational health.

I took INH in nursing school. (My PPD converted to + in my second year of clinicals). I had some complication and they switched me to Rifampin. I was fatigued and my grades dropped from an A to a B.

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How long have you been taking the INH?

If you could help it, I would take it to completion. We've had small clusters of TB in our area (that is potentially drug-resistant, due to non-compliance/incomplete therapy of a few carriers), and it is not something to take lightly.

TB meds are tough... You have my sympathy.

Having said that, in my limited experience as a TB research assistant (which is to say that it's VERY limited, so this is not medical advice), I've only seen INH therapy for latent TB last for 6 to 9 months.

Be sure to keep a record of your symptoms, and follow up with your prescribing doctor as soon as you feel them. There may be other options out there.

Good luck!

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