confused b/w nitrites, sulfa drugs, g6pd deficiency and methbemia

[aspiringmd1015]

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can someone clear this up for me, confused b/w sulfa drugs and all. Sulfa drugs cause sulfa allergies, but do they also produce oxidants when metabolized? so if so they could cause g6pd and metHBemia? Nitrites can also produce methemoglobinemia correct?

 

[Phloston]

can someone clear this up for me, confused b/w sulfa drugs and all. Sulfa drugs cause sulfa allergies, but do they also produce oxidants when metabolized? so if so they could cause g6pd and metHBemia? Nitrites can also produce methemoglobinemia correct?

I would say the sulfa aspect of a drug doesn't directly relate to whether it will yield a net oxidative effect because sulfur-containing drugs can have either reductive and oxidative roles. Thiol groups (-SH) are reducing agents. Disulfide bonds (-S--S-) are oxidizing agents. Drugs like N-acetylcysteine (reduces oxidized glutathione back to -SH state) and Mesna (neutralizes acrolein) have thiol groups.

Since the liver has phase 1 (which includes oxidation/reduction) and phase 2 (conjugation) metabolic capacity, I'd say phase 1 manipulation, independent of whether the drug happens to contain a sulfur atom, is a better predictor of whether an oxidizing agent might be produced.

And nitrates and nitrites both cause methaemologlobin. There's articles that discuss both.