Foundation Pharmacist Recruitment Practice Test

Folate deficiency can be associated with certain medications due to their effects on metabolic processes or absorption in the body. Nitrofurantoin, an antibiotic, is known to interfere with folate metabolism. While it is effective against various infections, it can inhibit the enzyme dihydrofolate reductase, which plays a key role in the process of converting dihydrofolate to tetrahydrofolate — the biologically active form of folate necessary for DNA synthesis and repair. This can lead to lower levels of folate in the body and potentially result in deficiency, particularly with prolonged use.

In contrast, the other medication classes listed typically do not have a direct association with folate deficiency. Beta-blockers primarily affect cardiovascular functions, antidepressants target mood disorders and often have different side effects related to neurotransmitters, while ACE inhibitors mainly affect the renin-angiotensin system for hypertension and heart failure treatment. Therefore, they do not commonly interfere with folate metabolism in the manner that nitrofurantoin does. This makes the association of nitrofurantoin with folate deficiency notable in the context of this question.