phenytoin

[viper]

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Phenytoin causes megaloblastic anemia. Is this due to folate problem or b12 problem. FA says on p303 that its b12. Goljan says folate - problem with making monoglutamate form to absorb. Which is it???

thanks

 

[idq1i]

2 second search on pubmed -> it's the folate

 

[dynx]

I may be pulling this out of my a$$. But isn't there an association of phenytoin and neural tube defects in pregnant mothers? (I know there are more common defects associated but Im pretty sure NT is in the mix) Don't take my word for it but since I seem to remember this from somewhere I think its folate too.

 

[idq1i]

I may be pulling this out of my a$$. But isn't there an association of phenytoin and neural tube defects in pregnant mothers? (I know there are more common defects associated but Im pretty sure NT is in the mix) Don't take my word for it but since I seem to remember this from somewhere I think its folate too.

NTD - sometimes. Everything else - frequently.

Look it up under fetal hydantoin syndrome if you are interested

Edit:
1. Microcephaly
2. Growth delay
3. Mental ******ation and developmental delay
4. Craniofacial dysmorphic features
- Flat nasal bridge
- Epicanthic folds
- Prominent upper lip over wide mouth
5. Distinguishing characteristics
- Nail and distal phalanx hypoplasia
- Hypertelorism

DDx of FAS
http://www.fpnotebook.com/OB143.htm (I love this site)

 

[Idiopathic]

phenytoin inhibits intestinal conjugase, which is required to prepare folate for absorption.