Pyridoxine in clinical toxicology: a review

  title={Pyridoxine in clinical toxicology: a review},
  author={Philippe ER Lheureux and Andr{\'e}a Penaloza and Mireille Gris},
  journal={European Journal of Emergency Medicine},
Pyridoxine (vitamin B6) is a co-factor in many enzymatic pathways involved in amino acid metabolism: the main biologically active form is pyridoxal 5-phosphate. Pyridoxine has been used as an antidote in acute intoxications, including isoniazid overdose, Gyromitra mushroom or false morrel (monomethylhydrazine) poisoning and hydrazine exposure. It is also recommended as a co-factor to improve the conversion of glyoxylic acid into glycine in ethylene glycol poisoning. Other indications are… 

B6 and Bleeding: A Case Report of a Novel Vitamin Toxicity

A first case of a patient with pyridox(am)ine-5-phosphate oxidase deficiency and mild hemophilia A, whose bleeding symptoms were exacerbated by the vitamin B6 therapy essential for his epileptic disorder is presented.

The beneficial effect of metadoxine (pyridoxine-pyrrolidone-carboxylate) in the treatment of fatty liver diseases

The abnormal accumulation of fat in parenchymal organs, including the liver, is called fatty transformation or steatosis, and it is not a genuine disease; in most cases it is associated with a noxious state or other pathologic process.

Antidotes to coumarins, isoniazid, methotrexate and thyroxine, toxins that work via metabolic processes.

This review focuses on four examples, coumarin anticoagulants, isoniazid, methotrexate and thyroxine from the context of management of overdose as seen in acute general hospitals, where treatment dose is based on symptoms resulting from the overdose.

Pyridoxine toxicity courtesy of your local health food store

Pyridoxine or vitamin B6 is a highly water-soluble vitamin that plays an important part in the functioning of many enzymes, especially those involved in amino acid metabolism. A normal adult will

Non-P450 aldehyde oxidizing enzymes: the aldehyde dehydrogenase superfamily.

What is currently known about each member of the human ALDH superfamily, composed of NAD(P)+-dependent enzymes that catalyze aldehyde oxidation, is presented including the pathophysiological significance of these enzymes.

Isoniazid poisoning: Pharmacokinetics and effect of hemodialysis in a massive ingestion

A 20‐year‐old female migrant who presented with recurrent seizures after ingesting 25 g of isoniazid was treated with activated charcoal, repeated doses of midazolam for the seizures, and given multiple doses of pyridoxine, limited by availability.

Effects of Pyridoxine Deficiency on Hippocampal Function and Its Possible Association with V-Type Proton ATPase Subunit B2 and Heat Shock Cognate Protein 70

Pyridoxine deficiency causes cognitive impairments and reduction in 5-HT and DA levels, which may be associated with a reduction of ATP6V1B2 and elevation of HSC70 levels in the hippocampus.



Vitamin B6 Safety Issues

Preclinical and clinical data on pyridoxine neurotoxicity are updated to determine whether a more quantitative estimate of risk can be derived based on available data, and recent human and animal data showing lack of teratogenicity for pyrIDoxine are summarized.

Depression of vitamin B6 levels due to theophylline.

Pyridoxine supplementation resulted in higher averagePLP levels but did not prevent death in animals with profoundly low PLP levels, suggesting B6 deficiency may contribute to chronic theophylline toxicity; however, pyridOxine administration in the dosage used may not prevent toxicity.

Role of Pyridoxine in Oxalate Metabolism

The role of pyridoxine in oxalate metabalism is discussed and the molecular mechanism(s) of hyperoxaluria in pyrIDoxine deficiency is illustrated using the results of the studies over the past several years.

Auto-immune complications of D-penicillamine--a possible result of zinc and magnesium depletion and of pyridoxine inactivation.

  • M. Seelig
  • Medicine, Biology
    Journal of the American College of Nutrition
  • 1982
Reports of myasthenia gravis--a disease with abnormalities of the thymus and of T-cells, as a side effect of penicillamine--suggest that zinc, magnesium, and pyridoxine might be the agents most likely to be protective.

Acute isoniazid intoxication: seizures, acidosis and coma.

A case of acute overdose of INH is reported, followed by a review of the literature, which indicates that pyridoxine-therapy can be useful as well in cases of chronic ingestion of higher than therapeutic doses of InH.

Pyridoxine as therapy in theophylline-induced seizures.

Serum theophylline levels and plasma PLP levels showed significant negative correlation prior to pyridoxine infusion, suggesting that pyridine may partially reverse theophyLLine-induced central nervous system toxicity.

Intravenous pyridoxine-induced metabolic acidosis.

A transient increase in base deficit occurs after the infusion of 5 g of pyridoxine in normal volunteers, and this infusion would result in transient worsening of acidosis.

Therapeutics of monomethylhydrazine intoxication.