Risk Factors of Acute Intermittent Porphyria #1 - Medication

Acute Intermittent Porphyria (AIP) is an inherited disease, which either one or both of the parents who carried the detective gene and passed it to the next generation. However, most of the carriers of AIP never develop symptoms. Basically, certain factors that increase the synthesis of hepatic heme may precipitate symptoms of AIP and caused an acute attack. Exposure to these factors are possibly trigger its earlier occurrence, such as medication (Metha, Rath, Padhy, Marda, Mahajan, & Dash, 2010). 

Figure 11. Medication

There are some of the unsafe and illicit prescribed drugs that proved to be provoke the occurrence of AIP, for example, barbiturates, sulphonamides, progestogens and methyldopa (Lopes, Valle, Taguti, Taguti, Betonico, & Medeiros, 2008).  These drugs will inhibit the secretion of hepatic porphobilinogen deaminase as well as depletion in heme pool enzymes which results in the induction of aminolevulinic acid synthase (ALAS), precipitate the occurrence of acute attack (Hift, Thunell, & Brun, 2011). 

Figure 12. Methyldopa

Commonly, the drugs are applied via topical administration would not caused an acute attack (Hift, Thunell, & Brun, 2011). There are examples of drugs that trigger attack in animals but not in human, and this also works in the opposite way, as the differences in metabolic rate across the species (Kannan & Gowri, 2015). 

In short, drugs served as the most common factors that provoke an acute attack. Usage of medication should be referring to the professional advice.

Figure 13. Use medication under doctors' advice