Suggest treatment for high globulin and alkaline phophatase levels
Patient: I AM ON AKT4 FOR LAST 11 WEEKS AND HAVE TO UNDERTAKE IT FOR ANOTHER 13 WEEKS (TOTAL 24 WEEKS PROGRAMME).  AKT-4 IS TAKEN EMPTY STOMATCH.  I GOT MY LFT DONE RECENTLY AND THE UNFAVOURABLE RESULTS WERE AS UNDER :- Globulin  4 (1-3)- A/G Ratio .95 (1.2-2.0)- Alkaline Phasphatase 191 (60-170)Other results in the LFT tests were favourable.I am taking Pantocid as antacid with AKT-4.  Kindly suggest whether the treatment is going in a right direction or not.-HARI SINGH BISHT (FARIDABAD) Doctor: Hello,AKT 4 is having rifampicin, ethambutol, pyrazinamide and isoniazid. Amongst these four drugs, rifampicin, isoniazid and pyrazinamide are hepatotoxic (damages liver). Main hepatotoxic effects reflect as raised Bilirubin and Liver enzymes (SGPT and SGOT).Since, you are these reports are normal, no need to worry for AKT 4 induced hepatitis. Raised alkaline phosphatase (ALP) is seen with obstruction in biliary tract. So, it is better to get done ultrasound examination of abdomen to find out cause for raised ALP.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Kaushal Bhavsar