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29 Cards in this Set
- Front
- Back
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What is the MOA for sulfonamides?
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complete with PABA for the enzyme dihydropteroate synthesase in the bacterial synthesis of folic acid. Without folic acid, the bacteria can’t make amino acids
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Why ate sulfonamides bacteriostatic?
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because they inhibit the production of bacteria but do not kill the existing bacteria
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Why are sulfonamides selective for bacterial cells?
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because bacteria and human cells obtain folate in different ways
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Spectrum for sulfonamides
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some gram negative and some gram positive bacteria, enteric bacteria (E coli), pneumocystis, Nocardia, Stenotrophomonas, S. hemolyticus
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Uses for sulfonamides
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UTI, topical for burns, prophylaxis for otitis media, UC, PCP
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What are the three groups of sulfonamides based on pharmacokinetics?
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oral absorbable, oral and nonabsorbable, and topical
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Do sulfonamides cross the BBB?
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yes, as well as the placental barrier
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How are sulfonamides eliminated?
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the kidneys
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When sulfonamides are acetylated by the liver unto a product that can crystallize at neutral or acid pH, there is a risk of developing what?
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atone formation
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How do you prevent stone formation?
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by adequate hydration and urine alkalinization
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What are the hypersensitivity reactions with sulfonamides?
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rashes, angioedema, and Stevens-Johnson Syndrome
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What is Stevens-Johnsons Syndrome?
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severe drug eruption classified as a bullous erythema multiforme--skin mucous membranes, and eye- as well as fever, malaise, and joint pains--lasts 4-6 wks--can cause blindness and be fatal
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What meds should G6PD patients avoid?
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sulfonamides, antimalarials, and aspirin due to propensity for hemolytic anemia
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Why are sulfonamides contraindicated in children under 2 mths and pregnant women bear end of term?
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due to kernicterus (bilirubin displacement)
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Biggest place n therapy for Trimethoprim (similar spectrum to sulfa drugs, but not)
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used in conjunction with sulfamethoxazole
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Where does Trimethoprim concentrate?
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in prostatic and vaginal fluids
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MOA for Trimethoprim
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inhibits bacterial dihydrofolate reductase
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What are the adverse effects of Trimethoprim?
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folate deficiency- causes megaloblastic anemia, leukopenia, and granulocytopenia
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Hows is the combo agent of Sulfamethoxazole and Trimethoprim (Septra or Bactrim) dosed?
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usually dosed on the TMP component
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Is resistance to Septra more or less than single agent?
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less resistance than single agent
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What are the two drugs of choice for Prostatitis?
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Septra or FQ
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Which is DOC and which alternate for tx of Shigella?
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DOC- FQ, ALt- Septra
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What is the COD for PJP?
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Septra IV
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What is the MC opportunistic infection in AIDS?
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PJP
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Use for Sulfisoxazole (Gantrisin)
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DOC for otitis media prophylaxis- not effective against active infections
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Use for Silver Sulfdiazine
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topical for 2nd and 3rd degree burns, DOC for noninfected burns
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Use for Mafenide (Sulfamylon)
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topical for 2nd and 3rd degree burns
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DOC (2) for IBD
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Sulfasalazine (Azufidine) and Mesalamine (Asacol)
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What is the use for Sultrin Vaginal Cream?
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Alternate for Gardnerella vaginalis vaginitis
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