Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0043167 (pertussis)
 19,595 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The elimination of phenytoin from blood was significantly decreased in rats pretreated 24 hr previously with Bordetella pertussis vaccine or the synthetic polynucleotide poly(rI.rC.). Phenytoin half-life was increased about 4-fold by both agents. In microsomes prepared from rats pretreated with B. pertussis vaccine or poly(rI.rC) the hydroxylation of phenytoin in vitro was decreased by 36 nad 53%, respectively. The addition of these agents to normal microsomal suspensions had no effect on phenytoin hydroxylation, demonstrating that the decrease in biotransformation was not due to direct enzyme inhibition. The decrease in phenytoin hydroxylation and elimination rate resulted from depressed levels of cytochrome P-450 in the hepatic endoplasmic reticulum of rats treated with B. pertussis vaccine or poly(rI.rC).
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PMID:The deleterious effect of Bordetella pertussis vaccine and poly(rI.rC) on the metabolism and disposition of phenytoin. 76 60

Similar movement disorders developed in two 8-year-old retarded children while they were receiving phenytoin. Seizures subsequent to a diphtheria-pertussis-tetanus immunization had developed in each child at 1 to 2 months of age. A static encephalopathy ensued, characterized by mental retardation, ataxia, spasticity, and a mixed seizure disorder. Intermittent dystonia and choreoathetosis developed insidiously while serum phenytoin concentrations were in the therapeutic range. Sustained dystonia and choreoatheosis developed 2 hours after an oral provocation with phenytoin. The baseline abnormalities on the electroencephalogram remained unchanged during the choreoathetosis. Recognizable metabolic abnormalities known to be associated with similar movement disorders were excluded. It was concluded from these studies that the movement disorder is secondary to phenytoin and can occur at therapeutic serum concentrations. Phenytoin is a central anticholinergic agent and a central stimulant of serotonin, and may induce movement disorders as a result of altering these neurotransmitters in the brain. The variable expression of these movement disorders may relate to the nature of the preexisting striatal insult.
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PMID:Phenytoin-induced dystonia and choreoathetosis in two retarded epileptic children. 94 1