Saturday, March 14, 2009

38 - glucose 6 phosphate dehydrogenase deficiency - hemolysis causing drugs


1. all of the following drugs cause definite hemolysis in a glucose-6-phosphate dehydrogenase deficient patient except ?

a. primaquine
b. nitrofurantoin
c. naphthalene
d. ciprofloxacin

answer: d . ciprofloxacin . 

u have to memorise the following drugs to answer questions related to this topic.

Drugs which carry a definite risk of hemolysis in a patient with glucose-6-phosphate dehydrogenase deficiency :

1. antimalarials : primaquine, dapsone/chlorproguanil
2. sulphonamides/sulphones : sulphamethoxazole and others, dapsone
3. antibacterial/antibiotics : cotrimoxazole, nalidixic acid, nitrofurantoin, niridazole
4. antipyretic/analgesics : acetanilide, phenazopyridine (pyridium)
5. other drugs : naphthalene, methylene blue

Drugs which carry a possible risk of hemolysis in a patient with glucose-6-phosphate dehydrogenase deficiency :

1. antimalarials : chloroquine
2. sulphonamides : sulfasalazine, sulfadimidine
3. antibacterials/antibiotics : ciprofloxacin, norfloxacin
4. antipyretic/analgesics : acetylsalicylic acid high dose ( greater than 3 g/d )
5. other drugs : vitamin K analogues, ascorbic acid greater than 1 gram and rasburicase

Drugs which carry a doubtful risk of hemolysis in a patient with glucose-6-phosphate dehydrogenase deficiency :

1. antimalarials : quinine
2. sulphonamides/sulphones : sulfisoxazole, sulfadiazine
3. antibacterial/antibiotics : chloramphenicol, p-aminosalicylic acid
4. antipyretic/analgesics : acetyl salicylic acid less than 3 g/d, acetaminophen, phenacetin
5. other drugs : doxorubicin, probenecid .

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