virgola82
Forum Guru
Topics: 85
Posts: 348
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A 55 yo woman recent immigrant from East Asia presnts complaining of cough, night sweats and weight loss. CXR shows cavitary lesions and sputum smear confirms the diagnosis of pulmonary TB. Her past medical history is significant for type 2 diabetes mellitus for which she takes glyburide. She is started on INH, rifampin, pyrainamide and ethambutol. After 1 month of therapy she comes back to your ofice because her glucose levels are significantly higher than they had been 3 months ago. She has been taking all of her TB medications and glyburide for diabetes. A few weeks after starting TB therapy the patient reposrts decreased cough and improved energy levels. Which is the most likely explanation for thsi patient 's hyperglycemia?
A. INH
B. Rifampin
C. Pyrazinamid
D. Ethambutol
E. Pancreatic tuberculosis
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| sprint123
Forum Guru
Topics: 129
Posts: 870
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I think Rifampin decreases the plasma concentration of glyburide since it increases the liver clearance and hence there is hyperglycemia
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| arlete
Intern in 2009!!!!!
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Posts: 2,892
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Makes sense to me...
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| dr in trouble
Forum Guru
Topics: 62
Posts: 601
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Rifampin induce p450 system and leads to increase metabolism of glyburide.
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| ashfaque
Forum Newbie
Topics: 0
Posts: 142
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rifampicin enzyme induer= may also cause pregnancy in female taking oral contraceptive due to same reason
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