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phenobarbitone_precipitate_acute_intermittent_porphyria [2025/02/11 01:48] – adminphenobarbitone_precipitate_acute_intermittent_porphyria [2025/02/11 05:20] (current) – admin
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 **Phenobarbitone can precipitate acute intermittent porphyria (AIP)**  **Phenobarbitone can precipitate acute intermittent porphyria (AIP)** 
  
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 +  * Phenobarbital acts as a potent inducer of hepatic cytochrome P450 enzymes, which in turn can increase the activity of ALA synthase, leading to overproduction of porphyrins.
   * by inducing cytochrome P450 enzymes it increasing heme synthesis, and accumulating toxic precursors (ALA and PBG).    * by inducing cytochrome P450 enzymes it increasing heme synthesis, and accumulating toxic precursors (ALA and PBG). 
   * This triggers acute attacks with severe abdominal pain, neuropsychiatric symptoms, autonomic dysfunction, and muscle weakness.    * This triggers acute attacks with severe abdominal pain, neuropsychiatric symptoms, autonomic dysfunction, and muscle weakness. 
-  * Other porphyrinogenic drugs (phenytoin, carbamazepine, valproate) should also be avoided.  +  * Safe alternatives include benzodiazepines (lorazepam, diazepam) for seizures and gabapentin for neuropathic pain. 
-  * Safe alternatives include benzodiazepines (lorazepam, diazepam) for seizures and gabapentin for neuropathic pain.  +    
-  * Diagnosis is confirmed by increased urinary PBG.  +  
-  * Treatment includes glucose, hemin, and avoiding triggers. +
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