Megaloblastic Anaemia Occurring During Primidone Therapy

Effect of Intraluminal pH on the Absorption of Pteroylmonoglutamic Acid

“…The mechanism by which folate metabolism is disturbed under these circumstances is uncertain. It has been suggested that competitive inhibition occurs at some stage in the folate metabolic pathway (Girdwood and Lenman, 1956;Newman and Sumner, 1957;Herbert and Zalusky, 1962). Dietary deficiency seems unlikely, since some of the patients have been well nourished (Hawkins and Meynell, 1958).…”

Anaemia associated with phenobarbitone

“…It has been suggested that anticonvulsant drugs act as competitive inhibitors of cellular enzyme systems which normally involve folic acid, by virtue of structural similarity (Girdwood and Lenman, 1956). Sherwin and his colleagues draw attention to the fact that it is difficult to determine the relative importance of anticonvulsant drugs and dietary deficiency.…”

Mindert eine Folsäuresubstitution die Teratogenität von Antiepileptika?

“…Der Mechanismus, der der Reduktion der Folatkonzentrationen durch Antiepileptika zugrunde liegt, ist jedoch nicht bekannt. Eine Vielzahl von Mechanismen, durch die diese Medikamente eine Folatminderung induzieren könnten, wurde postuliert: die Induktion von Leberenzymen [42], die Beeinträchtigung der Folatabsorption [34], eine kompetitive Interaktion zwischen Folatkoenzymen und Medikamenten [29] und zunehmende Anforderungen an Folat als einem Kofaktor in der Hydroxylierung von Antikonvulsiva [35].…”