The seizures were generalized and very difficult to control. The child became acidotic and after a few hours was placed in a barbiturate coma. No, but isoniazid does. The child became awake and alert after phenobarbital was discontinued, within 7 hours of pyridoxine administration. Pyridoxine is routinely prescribed in conjunction with isoniazid in the treatment of tuberculosis.
Intravenous pyridoxine is the antidote for isoniazid poisoning.
Carbon monoxide was appropriately considered in the differential by the triage nurse in consultation with the poison center. The windows of the house were opened and the children were referred for ED evaluation. Incompletely burned hydrocarbons, including gasoline, produce carbon monoxide. In the summer boats and automobiles are common sources. The sudden onset of severe toxicity in these children, without any symptoms in their caretakers, is not classic for CO poisoning.