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Pharmacology

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Antibiotics Part-1

Question
7 out of 86
 

A girl on sulphonamides developed abdominal pain and presented to emergency with seizure. What is the probable cause?



A Acute intermittent porphyria

B Congenital erythropoietic porphyria

C Infectious mononucleosis

D Kawasaki’s disease

Ans. A Acute intermittent porphyria

a. Acute intermittent porphyria is an autosomal dominant disorder.

b. Acute intermittent porphyria, which causes abdominal pain and neurologic symptoms, is the most common acute porphyria.

c. Sulmonamides and barbuitures are most common agents precipitating acute intermittent porphyria.

d. Acute intermittent porphyria is due to a deficiency of the enzyme porphobilinogen deaminase (also known as hydroxymethylbilane synthase) that leads to accumulation of the heme precursors delta-aminolevulinic acid and porphobilinogen initially in the liver.

e. The disorder is inherited due to a single abnormal gene from one parent.

f. Abdominal pain is the most common symptom, is usually steady and poorly localized, but may be cramping.

g. Tachycardia, hypertension, restlessness, fine tremors, and excess sweating may be due to sympathetic overactivity.

h. Other manifestations include nausea and vomiting; constipation; pain in Peripheral neuropathy in AIP is primarily motor, results from axonal degeneration, and does not develop in all patients with acute attacks, even when abdominal symptoms are severe.

i. Rarely, neuropathy develops apart from abdominal symptoms. Weakness The central nervous system can be involved. Anxiety, insomnia, depression, disorientation, hallucinations, and paranoia may develop.

j. Seizures can occur as well.

DRUGS CONSIDERED UNSAFE AND SAFE IN ACUTE INTERMITTENT AND VARIEGATE PORPHYRIA AND HEREDITARY COPROPORPHYRIA

UNSAFE

SAFE

Barbiturates

Narcotic analgesics

Sulfonamide antibiotics

Aspirin

Meprobamate(also mebutamate, tybutamate)

Acetaminophen

Carisoprodol

Phenothiazines

Glutethimide

Penicillin and derivatives

Methyprylon

Streptomycin

Ethchlorvynol

Glucocorticoids

Phenytoin

Bromides

Mephenytoin

Gabapentin

Succinimides (ethosuximide, methsuximide)

Insulin

Carbamazepine

Atropine

Clonazepam

Cimetidine

Primidone

Ranitidine

Valproic acid

Erythropoietin

Pyrazolones (aminopyrine, antipyrine)

? Estrogens

Griseofulvin

Ergots

Metoclopramide

Rifampin

Pyrazinamide

Diclofenac and possibly other NSAIDs

Progesterone and synthetic progestins

Danazol

Alcohol

Antibiotics Part-1 Flashcard List

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