The results reported here strongly favour the theory that phenytoin (diphenylhydantoin, ` Dilantin ', Epanu- tin ') causes folate
Folic Acid
Folic acid is the man-made form of folate. Folate is a B-vitamin naturally found in some foods. It is needed to form healthy cells, especially red blood cells.
Does phenytoin cause folate deficiency?
The results reported here strongly favour the theory that phenytoin (diphenylhydantoin, ` Dilantin ', Epanu- tin ') causes folate deficiency by preventing the absorption of the major component of dietary folate polyglutamates.
Does folic acid deficiency cause phenytoin-induced seizure disorders?
A case of a patient who developed symptomatic phenytoin-induced folic acid deficiency is reported. Folate supplementation of 5 mg/d was followed by a decrease of serum phenytoin concentration to a subtherapeutic level with a breakthrough seizure.
What does diphenylhydantoin do to folate?
Phenytoin (diphenylhydantoin, 'Dilantin', Epanutin ') inhibits folate absorption from folate polyglutamates, a major component of food folate, and inhibits the activity of folate conjugase from human jejunal mucosa at a pharmacological concentration in vitro.
What drugs can cause folate deficiency?
Drugs such as methotrexate, phenytoin, sulfasalazine, and trimethoprim can antagonize folate utilization, inhibit its absorption or conversation to its active form resulting in folate deficiency. Congenital deficiencies of enzymes required in folate metabolism can lead to folate deficiency.
How does phenytoin affect folic acid?
Phenytoin (PHT) therapy to control seizures decreases serum folate levels in half of epileptic patients, thus increasing the risk of folate depletion. Supplementation with folic acid prevents deficiency but also changes PHT pharmacokinetics.
How does anticonvulsant cause folate deficiency?
Anticonvulsant drugs are known to have inducing properties, and since folate is required as a cofactor in drug hydroxylations it is suggested that folate depletion results from increased demand for the cofactor after induction of drug-metabolizing enzymes.
Does Dilantin cause folic acid deficiency?
The present study concluded that the Folate and Vitamin B12 deficiency was directly proportional to the duration of Phenytoin treatment. A long-term treatment was significantly affecting the Folate and Vitamin B12 concentrations among Epileptic patients vigorously.
What type of Anaemia does phenytoin cause?
The use of phenytoin is associated with 3.5 fold increased risk of aplastic anemia.
Why do epileptics take folic acid?
Abstract. Most experts agree that folic acid supplementation is a key preconception intervention, particularly in women with epilepsy who take anti-epileptic drugs (AEDs). Primary prevention of neural tube defect through folic acid supplementation results in reduction of risk in an otherwise healthy population.
Does antiepileptic drugs cause folate deficiency?
Commonly used antiepileptic drugs (AEDs) can cause vitamin B12 or folate deficiency, which is, in turn, associated with hyperhomocysteinemia, new research published in Annals of Neurology has found.
Why is vitamin B complex is given in phenytoin?
Supplementation of phenytoin with folic acid or combination of these vitamins may be recommended for the purpose of ameliorating the adverse biochemical changes which are associated with phenytoin therapy.
Does phenytoin affect B12 levels?
Phenytoin (PHT), as older-generation AEDs, remains one of the most commonly prescription in clinic. Several studies revealed that PHT could reduce serum levels of folate and vitamin B12,[11,12] while folic acid and vitamin B12 are cofactors to support the converting of homocysteine to methionine.
How does phenytoin affect vitamin D?
Calcium and vitamin D metabolism were evaluated in 5 adult epileptic patients before and during treatment with phenytoin. Significant decreases occurred in serum concentrations of calcium, albumin, and 25-hydroxy-cholecalciferol. The decreases in serum calcium paralleled those in serum albumin.
Why does phenytoin cause megaloblastic anemia?
Similarly, phenytoin and other anticonvulsants that bear structural resemblances to folate may cause a decrease in serum folate levels by reducing the transport of folate.
Which anticonvulsant causes megaloblastic anemia?
Badenoch2 in 1954 was the first to suggest a causal relationship between megaloblastic anemia and anticonvulsant medication in two case reports. Diphenylhydantoin, primidone (Mysoline), and barbiturates either singly or in combination have been shown capable of inducing megaloblastic anemia.
What are the adverse effects of phenytoin?
Side effects of phenytoinHeadaches. Make sure you rest and drink plenty of fluids. ... Feeling drowsy, sleepy or dizzy. As your body gets used to phenytoin, these side effects should wear off. ... Feeling nervous, unsteady or shaky. ... Feeling or being sick (nausea or vomiting) ... Constipation. ... Sore or swollen gums.
Which antiepileptic drug causes megaloblastic anemia?
Diphenylhydantoin, primidone (Mysoline), and barbiturates either singly or in combination have been shown capable of inducing megaloblastic anemia.
What is fetal anticonvulsant syndrome?
Foetal anticonvulsant syndrome is a group of malformations that can affect some babies if they are exposed to certain medicines, known as antiepileptic drugs (AEDs), while in the womb. Malformations include spina bifida, cleft palate, heart defects, learning problems and autism spectrum disorder.
Is folate a two way drug?
The nutrient-drug interaction between folate and phenytoin is a two-way interaction. Folate deficiency resulting from long-term phenytoin therapy is a common occurrence, but progression of the deficiency to a megaloblastic anemia is rare.
Is phenytoin a folate deficiency?
Folate deficiency resulting from long-term phenytoin therapy is a common occurrence, but progression of the deficiency to a megaloblastic anemia is rare. However, there are data to suggest nonanemic folate deficiency may be detrimental to the patient.
How to treat folate deficiency?
Treatment of folate deficiency. Treatment involves increasing the dietary intake of folate. You can also take a folate or folic acid supplement. Those with a genetic mutation that affects folate absorption, known as MTHFR, need to take methylated folate in order to avoid deficiency.
What are the complications of folic acid deficiency?
Folate is required for the normal production of RBCs. Complications of a deficiency may include: megaloblastic anemia, which means the RBCs are larger than normal and not fully developed. low levels of white blood cells and platelets.
Why is folate important?
Folate is particularly important in women of childbearing age. A folate deficiency during pregnancy can lead to birth defects. Most people get enough folate from food. Many foods now have additional folate in the form of folic acid, a synthetic version of folate, to prevent deficiency.
What foods contain folate?
Eat a nutritious diet to prevent folate deficiency. Foods that contain high amounts of folate include: leafy, green vegetables, such as broccoli and spinach. Brussels sprouts. peas. citrus. fruits, such as bananas and melons. tomato juice.
What is the best way to get folate?
It helps to: If you don’t have enough folate in your diet, you may end up with a folate deficiency. Certain drinks and foods, such as citrus juices and dark green vegetables, are particularly good sources of folate.
Why do we need to take folate?
It dissolves in water and isn’t stored in your fat cells. This means that you need to keep taking folate, as your body can’t develop a reserve. People release excess amounts of water-soluble vitamins in their urine. The causes of folate deficiency include:
Is folic acid good for fetal growth?
Folate is critical for normal fetal growth. Shop for prenatal vitamins now. If you have MTHFR, you should avoid foods that are fortified with folic acid. Certain variants of this genetic mutation prevent the breakdown of folic acid to methylfolate.
How to get folate?
For most people, eating a balanced diet will provide all the folate their body’s need. A balanced diet must include foods that are good sources of folate. The body is not able to store unused folate, so folate-rich foods should be eaten daily. Without getting enough folate in the diet, a person can become folate deficient within a few weeks. Folate-rich foods that are commonly available include:
What is a PCA in home health?
Personal Care Assistant (PCA) services through Diversity Home Health Group are provided by trained and caring individuals who are supervised by a Registered Nurse. PCA services are available to people who aren’t able to do all the things they once were able to do for themselves. PCA’s can help with grocery shopping, meal preparation, going to medical appointments, picking up prescription medications and many other tasks that are required for living an independent and healthy life. Diversity Home Health Group offers several PCA service options that are designed to meet your unique needs efficiently and effectively.
How to prevent folate deficiency?
The most effective way to prevent and treat folate (folic acid) deficiency is with a healthy diet. Diversity Home Health Group offers Medical Nutrition Therapy (MNT) services that can help. A Registered Dietician can help you design a nutrition program that is tailor-made for you. When helping you make a plan, we will take into account factors such as your medical history, your current health needs, your dietary restrictions, and many others. Through the MNT services offered by Diversity Home Health Group, you can make better food choices, eat healthier portions and learn delicious ways to enjoy a healthier lifestyle.
Can folate deficiency cause anemia?
Complications resulting from folate (folic acid) deficiency can be severe and permanent. If a deficiency goes untreated, it will eventually lead to anemia. Remember that folate helps the body to produce red blood cells. The purpose of red blood cells is to carry oxygen to every organ and to all tissues throughout the entire body. Without enough oxygen, the organs and tissues are damaged and die. Anemia is a condition in which the blood doesn’t contain enough red blood cells to carry an adequate supply of oxygen to all parts of the body.
Does folate help a pregnant woman?
This increases the amount of folate the woman needs during pregnancy. If you are planning to become pregnant, it is best to inform your primary care doctor so that steps are taken to increase your intake of folate and folic acid even before becoming pregnant.
Can folate be passed from generation to generation?
Some people are born with bodies that are unable to normally absorb folate from food or folic acid from supplements. This genetic trait can be passed from generation to generation. When infants are diagnosed with this genetic trait, they must begin treatments right away in order to avoid long-term health risks.
