Biochemistry · Carbohydrate Metabolism (Glycolysis, Gluconeogenesis, Glycogen, HMP Shunt)

Glucose-6-phosphate dehydrogenase (G6PD) deficiency renders RBCs unable to maintain adequate NADPH levels. Which of the following drugs is SAFE to use in G6PD-deficient patients?

  • A Primaquine
  • B Ceftriaxone
  • C Dapsone
  • D Nalidixic acid
Correct answer: B. Ceftriaxone

Explanation

G6PD deficiency impairs the HMP shunt's NADPH production, reducing glutathione regeneration and rendering RBCs susceptible to oxidative hemolysis. Drugs causing hemolysis in G6PD deficiency include: primaquine, dapsone, nalidixic acid, nitrofurantoin, methylene blue, and high-dose aspirin. Ceftriaxone (a 3rd generation cephalosporin) does not generate oxidative stress and is safe in G6PD deficiency. Key triggers to remember: 8-aminoquinolines (primaquine), sulfones (dapsone), quinolones (nalidixic acid), and oxidant foods (fava beans). Infections themselves can also precipitate hemolysis.

Reference: Harper's Illustrated Biochemistry, 32nd ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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