Folic acid metabolism is inhibited by : a) Sulfonamides b) Methotrexate c) Nitrous oxide d) Trimethoprim e) 5–Flucytosine
**Core Concept**
Folic acid metabolism is crucial for DNA synthesis and cell division. Inhibition of folate metabolism disrupts purine and pyrimidine synthesis, leading to impaired cell proliferation. Key drugs interfere with folate metabolism either by blocking its synthesis or by antagonizing its active form (tetrahydrofolate).
**Why the Correct Answer is Right**
Sulfonamides (a) inhibit dihydropteroate synthase, reducing folic acid synthesis. Trimethoprim (d) inhibits dihydrofolate reductase, blocking the conversion of dihydrofolate to tetrahydrofolate. Methotrexate (b) is a potent antifolate that inhibits dihydrofolate reductase, depleting active folate. Nitrous oxide (c) does not directly inhibit folate metabolism; it may interfere with vitamin B12 metabolism but not folic acid. 5-Flucytosine (e) is a nucleoside analog that acts on fungal RNA synthesis and is not involved in folate metabolism. Thus, sulfonamides, methotrexate, and trimethoprim all inhibit folate pathways.
**Why Each Wrong Option is Incorrect**
Option C: Nitrous oxide does not directly inhibit folic acid metabolism; it primarily affects vitamin B12 and oxygenation, not folate.
Option E: 5-Flucytosine is a fungal antifungal agent that is metabolized to 5-fluorouracil and acts on RNA synthesis, not folic acid metabolism.
**Clinical Pearl / High-Yield Fact**
Methotrexate and sulfonamides are classic antifolates used in cancer and infections, respectively. The combination of sulfonamides and trimethoprim (co-trimoxazole) provides synergistic folate inhibition, commonly used in bacterial infections.
✓ Correct Answer: B. abd