Patients on isoniazid which vitamin deficiency is more likely to be seen.
**Core Concept**
Isoniazid, a first-line antitubercular medication, is known to interfere with vitamin metabolism, particularly affecting the utilization and storage of a specific water-soluble vitamin. This interaction is critical in patients undergoing isoniazid therapy, as it can lead to a deficiency state with potential consequences for the patient's health.
**Why the Correct Answer is Right**
Isoniazid promotes the formation of pyridone metabolites from vitamin B6 (pyridoxine), which are excreted in the urine, thereby reducing the availability of this essential vitamin for various enzymatic reactions. Vitamin B6 plays a crucial role in amino acid metabolism, neurotransmitter synthesis, and the regulation of various enzymes involved in energy production. A deficiency in vitamin B6 can lead to neurological symptoms, such as peripheral neuropathy, and hematological abnormalities, including macrocytic anemia. The increased excretion of vitamin B6 due to isoniazid therapy can lead to a deficiency state, particularly in patients with a marginal intake of this vitamin.
**Why Each Wrong Option is Incorrect**
**Option A:** Vitamin B9, or folate, is not directly affected by isoniazid therapy. Folate deficiency is more commonly associated with a lack of dietary intake, pregnancy, or certain gastrointestinal disorders.
**Option B:** Vitamin B12, or cobalamin, is not directly affected by isoniazid. Vitamin B12 deficiency is more commonly associated with a lack of dietary intake, gastric atrophy, or certain gastrointestinal disorders.
**Option D:** Vitamin B3, or niacin, is not directly affected by isoniazid therapy. Niacin deficiency, or pellagra, is more commonly associated with a lack of dietary intake or increased urinary excretion due to certain diseases.
**Clinical Pearl / High-Yield Fact**
To prevent vitamin B6 deficiency in patients on isoniazid therapy, it is essential to provide supplemental pyridoxine, especially in patients with a marginal dietary intake or those with a history of vitamin B6 deficiency. A maintenance dose of 10-20 mg of pyridoxine per day is often recommended to prevent deficiency.
**✓ Correct Answer: C. Vitamin B6**