problemy z wit D przy rifa

[franiolek1]

Rifampin users may need extra D, in addition to more of certain
medications (Rifabutin is a longer acting Rifampin):

1: Ann Clin Microbiol Antimicrob. 2008 Jan 28;7:3.Click here to read
Click here to read Links
Osteomalacia in an HIV-infected man receiving rifabutin, a
cytochrome P450 enzyme inducer: a case report.
Bolland MJ, Grey A, Horne AM, Thomas MG.

Department of Medicine, University of Auckland, Private Bag 92 019,
Auckland 1020, New Zealand. [e-mail]

INTRODUCTION: People infected with human immunodeficiency virus are
frequently treated with medications that can induce or inhibit
cytochrome P450 enzymes. CASE PRESENTATION: A 59 year old man
treated with zidovudine, lamivudine, indinavir, and ritonavir for
infection with human immunodeficiency virus volunteered to take part
in a study of bone loss. He was found to have vitamin Di
insufficiency with secondary hyperparathyroidism and received
vitamin D and calcium supplementation. He suffered a recurrence of
infection with Mycobacterium avium intracellulare for which he
received treatment with ciprofloxacin, rifabutin, and ethambutol.
Subsequently, he developed worsening vitamin D deficiency with
hypocalcaemia, secondary hyperparathyroidism and elevated markers of
bone turnover culminating in an osteomalacic vertebral fracture.
Correction of the vitamin D deficiency required 100,000 IU of
cholecalciferol monthly.Rifabutin is a cytochrome P450 inducer, and
vitamin D and its metabolites are catabolised by cytochrome P450
enzymes. We therefore propose that treatment with rifabutin led to
the induction of cytochrome P450 enzymes catabolising vitamin D,
thereby causing vitamin D deficiency and osteomalacia. This process
might be mediated through the steroid and xenobiotic receptor (SXR).

CONCLUSION: Treatment with rifabutin induces the cytochrome P450
enzymes that metabolise vitamin D and patients treated with
rifabutin might be at increased risk of vitamin D deficiency. In
complex medication regimens involving agents that induce or inhibit
cytochrome P450 enzmyes, consultation with a clinical pharmacist or
pharmacologist may be helpful in predicting and/or preventing
potentially harmful interactions.

[zazule]

Krótkie streszenie jest w watku o rifampicynie

[franiolek1]

oops! nie zauwazylam!

[zazule]

To mysle wazna informacja wiec zasługuje na osobny wątek