Question-230

Which of the following anti tuberculous drug should not be used in first trimester?


a. Isoniazid
b. Streptomycin
c. Ethambutol
d. Rifampicin.

Isoniazid.
Causes Hemolytic anemia in G6PD deficient babies and probably congenital malformations as well.

Sorry the correct answer is streptomycin

Tuberculosis and Pregnancy

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Streptomycin should not be used in pregnancy

http://www.ncbi.nlm.nih.gov/pubmed/11444726

Treatment
Latent TB Infection (LTBI) – Isoniazid (INH) administered either daily or twice weekly for 9 months is the standard regimen for the treatment of LTBI in pregnant women. Women taking INH should also take pyridoxine (vitamin B6) supplementation. The 12-dose regimen of INH and Rifapentine (RPT) is not recommended for pregnant women or women expecting to be pregnant within the next 3 months.
Contraindications
The following antituberculosis drugs are contraindicated in pregnant women:

•Streptomycin
•Kanamycin
•Amikacin
•Capreomycin
•Fluoroquinolones
Women who are being treated for drug-resistant TB should receive counseling concerning the risk to the fetus because of the known and unknown risks of second-line antituberculosis drugs.

Breastfeeding
Breastfeeding should not be discouraged for women being treated with the first-line antituberculosis drugs because the concentrations of these drugs in breast milk are too small to produce toxicity in the nursing newborn. For the same reason, drugs in breast milk are not an effective treatment for TB disease or LTBI in a nursing infant. Breastfeeding women taking INH should also take pyridoxine (vitamin B6) supplementation.

For More Information
•CDC. Treatment of tuberculosis. MMWR 2003; 52 (No. RR–11).

http://www.cdc.gov/tb/publications/factsheets/specpop/pregnancy.htm

b