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Sulfonamides (such as sulfanilamide, sulfamethoxazole, and mafenide), thiazolesulfone, methylene blue, and naphthalene should also be avoided by people with G6PD deficiency as they antagonize folate synthesis, as should certain analgesics (such as phenazopyridine and acetanilide) and a few non-sulfa antibiotics (nalidixic acid, nitrofurantoin ...
Methylene blue is a monoamine oxidase inhibitor (MAOI) [51] and, ... It causes hemolytic anemia in carriers of the G6PD enzymatic deficiency. [53] Chemistry
Genetically induced chronic low-level methemoglobinemia may be treated with oral methylene blue daily. Also, vitamin C can occasionally reduce cyanosis associated with chronic methemoglobinemia, and may be helpful in settings in which methylene blue is unavailable or contraindicated (e.g., in an individual with G6PD deficiency). [22]
G6PD deficient red cells in combination with high levels of oxidants causes a cross-linking of sulfhydryl groups on globin chains which causes a denaturing and formation of Heinz body precipitates. [8] Heinz bodies can also be found in chronic liver disease. [9] Alpha-thalassemia. Normal adult hemoglobin is composed of two alpha and two beta ...
Yeast G6PD is inhibited by long chain fatty acids according to two older publications [14] [15] and might be product inhibition in fatty acid synthesis which requires NADPH. G6PD is negatively regulated by acetylation on lysine 403 (Lys403), an evolutionarily conserved residue. The K403 acetylated G6PD is incapable of forming active dimers and ...
Notably, methylene blue is used as the main treatment for methemoglobinemia, however in G6PD individuals, methylene blue may cause further oxidative stress and that may induce or worsen hemolysis in those with methemoglobinemia. [1] Hemolytic anemia may also occur secondarily due to thrombotic microangiopathy after exposure to certain drugs.
The most common and successful treatment used to treat patients with high levels of methemoglobinemia is the antidote methylene blue. Methylene blue is already recognized as a product of the reversible reaction fueled by NAPHD methemoglobin reductase, catalyzed by leukcomethylene, to reduce methemoglobin to hemoglobin.
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