rifampin and Nasal-Obstruction

Topics: Antitubercular Agents; Biopsy; Diagnosis, Differential; Drug Therapy, Combination; Humans; Isoniazid; Male; Middle Aged; Nasal Obstruction; Nasopharyngeal Diseases; Nasopharyngeal Neoplasms; Pyrazinamide; Rifampin; Smoking; Tuberculosis; Tuberculosis, Lymph Node; Young Adult

Although cytochrome P450 (CYP) 2D6 is often thought to be the only CYP responsible for the metabolism of risperidone, many reports suggest that CYP3A may be involved too. Rifampin, a potent CYP3A inducer, has been known to markedly decrease plasma concentrations of various drugs, which are concomitantly administered during treatment.. To examine the effect of rifampin on plasma concentrations of a single oral dose of risperidone in healthy Thai male volunteers.. In an open, randomized two-phase crossover study, separated by a 2-week period, 10 healthy Thai male volunteers received a single oral dose of 4-mg risperidone alone or with 600 mg rifampin, orally once daily for 5 days. Serial blood samples were collected at specific time points for a 48-h period. Risperidone was measured in plasma using high performance liquid chromatography with ultraviolet detection. Pharmacokinetic parameters were determined by using non-compartmental analysis.. Co-administration with 600-mg rifampin once daily for 5 days was associated with a significant decrease in risperidone area under the curve (AUC(0-48)) and maximal concentration (C(max)) by 72% (157 x 49 +/- 48 x 80 vs. 42 x 66 +/- 7 x 81 ng/L/h; P<0 x 01) and 50% (32 x 44 +/- 6 x 05 vs. 16 x 16 +/- 2 x 73 ng/mL; P<0 x 05), respectively when compared with risperidone alone.. Rifampin when used concurrently with risperidone significantly decreases the plasma concentration of risperidone. Our results provide in vivo evidence of the involvement of CYP3A in the metabolism of risperidone, in addition to CYP2D6. Thus, co-administration of risperidone with CYP3A inducer(s), including rifampin should be recognized or avoided in clinical practice.

Topics: Administration, Oral; Adult; Antibiotics, Antitubercular; Antipsychotic Agents; Area Under Curve; Capsules; Chromatography, High Pressure Liquid; Cross-Over Studies; Cytochrome P-450 CYP3A; Cytochrome P-450 Enzyme System; Dizziness; Drug Interactions; Half-Life; Headache; Humans; Male; Nasal Obstruction; Rifampin; Risperidone; Spectrophotometry, Ultraviolet; Tablets; Time Factors

Leprosy is a rare disease and unfamiliar to many people. A 55-year-old woman was presented to our hospital complaining of nasal obstruction and anosmia. Nasal endoscopic examination revealed reddish-colored exophytic, nonulcerative masses in both nasal cavities. The authors performed endoscopic sinus surgery which involved endoscopic mass removal and synechiolysis. A biopsy sample stained with acid-fast stain and a rapid silver stain showed numerous filamentous organisms infiltrating macrophages, consistent with lepromatous leprosy. The patient was treated with a triple drug regimen of rifampin and dapsone with clofazimine. Herein, the authors present a case of nasal leproma as a differential diagnosis of a nasal cavity mass.

Topics: Biopsy; Clofazimine; Dapsone; Diagnosis, Differential; Endoscopy; Female; Follow-Up Studies; Humans; Leprostatic Agents; Leprosy, Lepromatous; Middle Aged; Nasal Cavity; Nasal Obstruction; Olfaction Disorders; Rifampin; Tissue Adhesions

Topics: Aged; Antitubercular Agents; Drug Therapy, Combination; Ethambutol; Female; Humans; Isoniazid; Maxillary Sinusitis; Mycobacterium tuberculosis; Nasal Obstruction; Nasal Polyps; Pyrazinamide; Rifampin; Tuberculosis

Primary tuberculosis of the nose is very rare. We report a case of a 35-year-old woman who presented with bilateral nasal obstruction and epistaxis of 3 months' duration but who was otherwise healthy. She was diagnosed with primary nasal septal tuberculosis and was treated with antituberculosis DOTS (directly observed treatment, short course) therapy for 6 months with complete recovery. Given the resurgence of tuberculosis in recent times, it is important that clinicians remain aware of this rare and treatable clinical entity.

Topics: Adult; Antitubercular Agents; Drug Therapy, Combination; Epistaxis; Female; Humans; Isoniazid; Nasal Obstruction; Pyrazinamide; Rhinitis; Rifampin; Sinusitis; Tuberculosis