Question

Anti-malarial drugs, such as primaquine, may induce oxidative stress and are thus contraindicated in patients with G6PD deficiency. What is the reason for this contraindication?

1) Primaquine can cause hemolysis in G6PD-deficient individuals
2) Primaquine can increase the risk of malaria in G6PD-deficient individuals
3) Primaquine can cause liver damage in G6PD-deficient individuals
4) Primaquine can lead to drug resistance in G6PD-deficient individuals

Answer 1

Primaquine is contraindicated in individuals with G6PD deficiency because it can cause hemolysis, leading to hemolytic anemia due to oxidative stress facilitated by this condition.

Step-by-step explanation:

The reason why anti-malarial drugs like primaquine are contraindicated in patients with G6PD deficiency is because primaquine can cause hemolysis in these individuals. G6PD deficiency affects the pentose phosphate pathway, which leads to a reduction in the antioxidant glutathione in red blood cells. Without sufficient glutathione, these cells are more vulnerable to the oxidative stress caused by primaquine's metabolites. When all the available glutathione is consumed, red blood cell components, including hemoglobin, are at risk of damage, which can lead to hemolytic anemia. Therefore, primaquine is contraindicated due to its potential to induce a hemolytic crisis in G6PD-deficient patients.