DrVirgo
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16. A 31-year-old black man with acute sinusitis requires antibiotic therapy. He says that several family members have developed hemolysis after taking drugs. Which of the following antimicrobial drugs should be avoided in this patient?
A) Ciprofloxacin
B) Erythromycin
C) Penicillin
D) Sulfisoxazole
E) Tetracycline
Explain.
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| yasmeen
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C PENICILLIN
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| robin082006
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D
maybe G6PD deficiency.
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| r_albayunen
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D
g6pd def (his black, hemolysis .. )
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| drpkaur
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D-sulfa drugs ,may be due to G6PD deficiency(black man with family history of hemolysis too indicates it)
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| mjl1717
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many antimalarials and my favorite LASIX - has a sulphur moiety
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| DrVirgo
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Thanks. I agree with D. 
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| Allison
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D
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| Allison
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D Sulfonamides precipitate hemolysis in another group of people. These people are deficient in G6PD, which is required in producing NADPH to keep the GSH (glutathione) in the reduced state. This gene is recessive and is primarily on the X-chromosome. GSH provides the major reducing equivalents for the cells and the G6PD pathway is extremely important in RBCs since they do not have mitochondria. If these cells lack G6PD and cannot produce enough NADPH, proteins are then oxidized and the membranes of the RBCs are damaged, leading to hemolysis.
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