A reason for adverse response to depakote or cephalosporins

[Guest guest]

Listmates,

I just thought this article might be of interest if anyone's child had

problems with these drugs, and some others listed below. The association

with carnitine is also of interest.

Owens

5: J Inherit Metab Dis. 2003;26(2-3):147-69.

Carnitine transport: pathophysiology and metabolism of known molecular defects.

Tein I.

Division of Neurology, Department of Pediatrics, The Hospital for Sick

Children,

Toronto, Canada. ingrid.tein@...

Early-onset dilatative and/or hypertrophic cardiomyopathy with episodic

hypoglycaemic coma and very low serum and tissue concentrations of carnitine

should alert the clinician to the probability of the plasmalemmal high-affinity

carnitine transporter defect. The diagnosis can be established by demonstration

of impaired carnitine uptake in cultured skin fibroblasts or lymphoblasts and

confirmed by mutation analysis of the human OCTN2 gene in the affected

child and

obligate heterozygote parents. The institution of high-dose oral carnitine

supplementation reverses the pathology in this otherwise lethal autosomal

recessive disease of childhood, and carnitine therapy from birth in

prospectively screened siblings may altogether prevent the development of the

clinical phenotype. Heterozygotes may be at risk for cardiomyopathy in later

adult life, particularly in the presence of additional risk factors such as

hypertension and competitive pharmacological agents. OCTN2 belongs to a family

of organic cation/carnitine transporters that function primarily in the

elimination of cationic drugs and other xenobiotics in kidney, intestine, liver

and placenta. The high- and low-affinity human carnitine transporters,

OCTN2 and

OCTN1, are multifunctional polyspecific organic cation transporters; therefore,

defects in these transporters may have widespread implications for the

absorption and/or elimination of a number of key pharmacological agents such as

cephalosporins, verapamil, quinidine and valproic acid. A third organic/cation

carnitine transporter with high specificity for carnitine, Octn3, has been

cloned in mice. The juvenile visceral steatosis (jvs) mouse serves as an

excellent clinical, biochemical and molecular model for the high-affinity

carnitine transporter OCTN2 defect and is due to a spontaneous point

mutation in

the murine Octn2 gene on mouse chromosome 11, which is syntenic to the human

locus at 5q31 that harbours the human OCTN2 gene.

Publication Types:

Review

Review, Tutorial

PMID: 12889657 [PubMed - indexed for MEDLINE]

Cephalosporins

http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202119.html#Brands

* Ancef4

* Ceclor1

* Ceclor CD1

* Cedax16

* Cefadyl22

* Cefditoren77

* Cefizox17

* Cefobid9

* Cefotan11

* Ceftin19

* Cefzil14

* Ceptaz15

* Claforan10

* Duricef2

* Fortaz15

* Keflex20

* Keftab20

* Kefurox19

* Kefzol4

* Mandol3

* Maxipime6

* Mefoxin12

* Monocid8

* Omnicef5

* Rocephin18

* Tazicef15

* Tazidime15

* Vantin13

* Velosef23

* Zinacef19

In Canada—

* Ancef4

* Apo-Cefaclor1

* Apo-Cephalex20

* Ceclor1

* Cefizox17

* Cefotan11

* Ceftin19

* Cefzil14

* Ceporacin21

* Ceptaz15

* Claforan10

* Duricef2

* Fortaz15

* Keflex20

* Keflin21

* Kefurox19

* Kefzol4

* Mandol3

* Maxipime6

* Mefoxin12

* Novo-Lexin20

* Nu-Cephalex20

* PMS-Cephalexin20

* Rocephin18

* Suprax7

* Tazidime15

* Zinacef19

Note:

For quick reference, the following cephalosporins are numbered to match the

corresponding brand names.

This information applies to the following medicines:

1. Cefaclor (SEF-a-klor)‡

2. Cefadroxil (sef-a-DROX-ill)‡

3. Cefamandole (sef-a-MAN-dole)

4. Cefazolin (sef-A-zoe-lin)‡

5. Cefdinir (sef–DI–neer)‡

6. Cefepime (SEF-e-pim)

7. Cefixime (sef-IX-eem)*

8. Cefonicid (se-FON-i-sid)†

9. Cefoperazone (sef-oh-PER-a-zone)†

10. Cefotaxime (sef-oh-TAKS-eem)

11. Cefotetan (SEF-oh-tee-tan)

12. Cefoxitin (se-FOX-i-tin)

13. Cefpodoxime (sef-pode-OX-eem)†

14. Cefprozil (sef-PROE-zil)

15. Ceftazidime (SEF-tay-zi-deem)

16. Ceftibuten (sef-TYE-byoo-ten)†

17. Ceftizoxime (sef-ti-ZOX-eem)

18. Ceftriaxone (sef-trye-AX-one)

19. Cefuroxime (se-fyoor-OX-eem)‡

20. Cephalexin (sef-a-LEX-in)‡

21. Cephalothin (sef-A-loe-thin)*

22. Cephapirin (sef-a-PYE-rin)†

23. Cephradine (SEF-ra-deen)‡†

77. Cefditoren (sef-da-TOR-en)†

‡ Generic name product may be available in the U.S.

§ Generic name product may be available in Canada

* Not commercially available in the U.S.

† Not commercially available in Canada