What is a slow Acetylator?

What is a slow Acetylator?

Slow acetylators are people whose liver cannot completely detoxify reactive drug metabolites. For example, patients with sulfonamide-induced toxic epidermal necrolysis have been shown to have a slow acetylator genotype that results in increased production of sulfonamide hydroxylamine via the P-450 pathway.

What medications does isoniazid prevent peripheral neuritis?

Vitamin B6 (pyridoxine) supplementation during isoniazid (INH) therapy is necessary in some patients to prevent the development of peripheral neuropathy.

How do I reduce the side effects of isoniazid?

Your doctor may also want you to take pyridoxine (e.g., Hexa-Betalin, vitamin B 6) every day to help prevent or lessen some of the side effects of isoniazid.

What are slow acetylators and fast Acetylators?

The rate of drug acetylation is influenced by genetic factors. Individuals who are phenotypically slow acetylators are homozygous for the recessive allele, while fast acetylators are either heterozygous or homozygous for a dominant allele of the hepatic acetyltransferase gene.

What are Acetylators?

: an organism that acetylates a substance during metabolism —used especially to describe the rate at which a person acetylates certain drugs (such as isoniazid, hydralazine, or sulfamethazine) in the body People known as slow acetylators, for instance, take a longer time than fast acetylators to clear certain drugs …

How is isoniazid neuropathy treated?

A recent report from the Tuberculosis Chemotherapy Centre, Madras, showed that a vitamin-B-complex preparation containing a small amount of pyridoxine (as well as aneurine hydrochloride, riboflavine, nicotinamide, panthenol and cyanocobalamin) was effective in the treatment of peripheral neuropathy caused by daily high …

What is the effect of slow acetylation on the effectiveness of isoniazid?

The defect in slow acetylators of isoniazid and similar amines appears to be caused by the synthesis of less enzyme rather than an abnormal form of it. The rate of acetylation does not significantly alter the effectiveness of isoniazid. Slow acetylation may lead to higher blood levels of the drug and thus, to an increase in toxic reactions.

What is the difference between rapid and slow acetylation?

Slow acetylation may lead to higher blood levels of the drug and thus, to an increase in toxic reactions. The average concentration of isoniazid in the plasma of rapid acetylators is about one third to one half of that in slow acetylators, and average half-lives are less than 1 hour and 3 hours, respectively.

What is the pathophysiology of isoniazid metabolism?

Pharmacokinetics: Isoniazid is metabolized primarily by acetylation by liver N-acetyltransferase. The rate of acetylation is genetically determined. Approximately 50 percent of African Americans and Caucasians are “slow acetylaters”, and the rest are “rapid acetylaters”; the majority of Eskimos and Asians are “rapid acetylaters.”

What are The racial predilections of slow acetylaters?

Approximately 50 percent of African Americans and Caucasians are “slow acetylaters”, and the rest are “rapid acetylaters”; the majority of Eskimos and Asians are “rapid acetylaters.” The defect in slow acetylators of isoniazid and similar amines appears to be caused by the synthesis of less enzyme rather than an abnormal form of it.

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