42yo F has anxiety and chronic abdominal pain worsening with fasting or occasional alcohol. She is finally found to have elevated serum and urine porphobilinogen. Which of the following medications may be implicated in the patient’s presentation? #foamtox @DallasEMed @DallasTXTox
Answer here is: 𝗣𝗵𝗲𝗻𝗼𝗯𝗮𝗿𝗯𝗶𝘁𝗮𝗹. The root of the problem is acute intermittent porphyria - deficiency of porphobilinogen deaminase in the heme synthesis. Medications that induce ALA synthase leads to build up of prophobilinogen and acute crises. #foamtox @DallasEMed 
List of drugs causing acute intermittent porphyria. #foamtox @DallasTXTox @DallasEMed @jakupsko @amrhaynes @toxiferoustales
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