Drug that causes B12 Deficiency

[DMBFan]

I know that B12 is very hard to be deficient in, but I don't know if I am going crazy, but I swear there was some drug that caused B12 deficiency. I Wikipedia'ed it - and found that chloroamphenical reduces it, but I'm not sure if that's the one that I saw somewhere and Goljan mentioned....Can anyone help me out? I may be wrong about a drug causing this reaction,t hough.

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[lilnoelle]

Maybe your talking about B6 and Isoniazid?

 

[hmgcoa]

all that comes to mind is phenytoin and folic acid (correct me if i'm wrong. just took the test a few days ago and my mind is mush right now...)

something about how it blocks intestinal conjugase thereby preventing the conversion of poly to mono folic acid?

 

[osli]

valproic acid does something similar.

Halothane causes megaloblastic anemia... not sure of the mechanism...?

Nothing comes to mind for B12.

 

[LUBDUBB]

all that comes to mind is phenytoin and folic acid (correct me if i'm wrong. just took the test a few days ago and my mind is mush right now...)

something about how it blocks intestinal conjugase thereby preventing the conversion of poly to mono folic acid?

Megaloblastic Anemia can be due to a bunch of drugs.

Folate def due to intestinal conjugase block by EtOH and OCP (according to RR Goljan)

 

[f1re11]

Id guess a proton pump inhibitor like Omeprazole

 

[Nicholaus]

I know that B12 is very hard to be deficient in, but I don't know if I am going crazy, but I swear there was some drug that caused B12 deficiency. I Wikipedia'ed it - and found that chloroamphenical reduces it, but I'm not sure if that's the one that I saw somewhere and Goljan mentioned....Can anyone help me out? I may be wrong about a drug causing this reaction,t hough.

Quite difficult to get B12 def considering you have many years supply stored in the liver. However, folate def is much more common and can be caused by a whole host of drugs (i.e. DHFR inhibitors, etc.).

 

[crazy_cavalier]

Are you sure it's a drug you're thinking of?? Because D. lattum (fish tapeworm) can cause B12 deficiency. Maybe that's the one you're thinking of.

 

[phospho]

I know that B12 is very hard to be deficient in, but I don't know if I am going crazy, but I swear there was some drug that caused B12 deficiency. I Wikipedia'ed it - and found that chloroamphenical reduces it, but I'm not sure if that's the one that I saw somewhere and Goljan mentioned....Can anyone help me out? I may be wrong about a drug causing this reaction,t hough.

i'm just a premed, but the diabetes medication, metformin, may interfere with B12 dietary absorption (from wiki)

 

[GynGuy1983]

Are you sure it's a drug you're thinking of?? Because D. lattum (fish tapeworm) can cause B12 deficiency. Maybe that's the one you're thinking of.

+1

I've never heard of any meds causing B12 deficiency. If there is, I would expect that it would be very low yield to begin with.

 

[blake44]

you might be thinking of phenytoin. (it interferes with vitb12 metabolism --> megaloblastic anemia).

wow... that made me come out of lurking. i was just studying, and i saw that, and i thought immediately of this post. now i hope it's on my exam

 

[DMBFan]

I was thinking of Isonazid and B6...Thanks. So many things in my head, I can't even remember even basic things

 

[GynGuy1983]

I was thinking of Isonazid and B6...Thanks. So many things in my head, I can't even remember even basic things

It happens to the best of us. Just keep in mind that you need to supplement the TB patient with B6 otherwise they're more likely to suffer from neuropathy (more so than hepatotoxicity).

Keep your head up!

 

[doctorFred]

I know that B12 is very hard to be deficient in, but I don't know if I am going crazy, but I swear there was some drug that caused B12 deficiency.

therapeutic injection of diphylobothrium eggs directly into your eyeballs. it also causes blindness for some reason.

 

[GynGuy1983]

In UW, wasn't there an alcoholic patient that only became deficient in B12 after 2 years or so?

I'd prefer a direct injection of Loa Loa to my eye, at least then I might make it on one of those stupid medical shows.

 

[ijcMD]

In UW, wasn't there an alcoholic patient that only became deficient in B12 after 2 years or so?

I'd prefer a direct injection of Loa Loa to my eye, at least then I might make it on one of those stupid medical shows.

yes, i saw that question yesterday... it was a homeless patient though

 

[Aseptic Pimp]

You are definitely talking about Phenytoin. In the FA 2006 version it says Phenytoin causes Vit B12 def, however Goljan states that Phenytoin actually cuases a deficiency in folic acid.