Certified Neuroscience Registered Nurse (CNRN) Practice Exam

Patients receiving HIV therapies such as INH, RIF, EMB, and PZA should be supplemented with which vitamin?

1. Vitamin A

2. Vitamin C

3. Vitamin B6 (pyridoxine)

4. Vitamin D

The correct answer is: Vitamin B6 (pyridoxine)

Patients undergoing treatment with certain antitubercular medications, specifically isoniazid (INH), often require supplementation with Vitamin B6, also known as pyridoxine. Isoniazid can interfere with vitamin B6 metabolism, potentially leading to a deficiency. This deficiency may result in neurological side effects such as peripheral neuropathy, which is particularly concerning in patients who are already immunocompromised due to HIV. Vitamin B6 plays a crucial role in the synthesis of neurotransmitters and the metabolism of amino acids. When isoniazid inhibits the action of pyridoxine, it can cause symptoms like numbness, tingling, and pain in the hands and feet, which are indicative of peripheral neuropathy. Therefore, routine supplementation of Vitamin B6 is recommended for patients on this medication to prevent these adverse effects. While other vitamins such as A, C, and D have their own health benefits, they do not directly address the specific interactions and deficiencies caused by isoniazid and do not play the same critical preventative role against the side effects associated with its use in the context of HIV therapy.