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Phenytoin
87%
3530/4054
Cephalexin
1%
46/4054
Simvastatin
4%
157/4054
Glipizide
156/4054
Allopurinol
143/4054
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Phenytoin is an anticonvulsant which has been found to increase the risk of osteoporosis and, subsequently, nontraumatic fractures. Possible mechanisms explaining the association between anticonvulsants and bone loss include hepatic induction of cytochrome P450 enzymes (increases vitamin D catabolism), direct osteoblast inhibition, impaired calcium absorption, elevated homocysteine, inhibition of response to PTH, hyperparathyroidism, reduced reproductive sex hormones, and reduced vitamin K level. Lee et al. found that anticonvulsant use (phenobarbital, carbamazepine, phenytoin, and valproate) increases the risk of osteoporosis, and also increases the risk of fracture by 1.2 to 2.4 times. Jette et al. found an increased fracture risk for carbamazepine, clonazepam, gabapentin, phenobarbital, and phenytoin. Odds ratios ranged from 1.24 (clonazepam) to 1.91 (phenytoin). Incorrect Answers: Answers 2-5: These medications do not place a patient at a significant risk for non-traumatic hip fracture.
3.7
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