Intentional isoniazid overdosage among southwestern American Indians

A 30-month study explored the degree to which self-destructive behavior compromised tuberculosis therapy and prophylaxis among southwestern American Indians. The frequency of isoniazid (INH) overdosage paralleled the extent of INH usage in each tribe and the entent to which INH was perscribed for each tuberculosis category. The authors recommend the careful selection of patients for INH prophylaxis, the dispensing of small amounts at short intervals, the close monitoring of patient compliance with the prescribed drug regimen, and, possiblly, the dispensing of individually wrapped tablets to inhibit the impulsive ingestion of massive amounts of the drug.