Outline 12, Sulfonamides And Related Agents

Front 1

What is the MOA of sulfonamides and related agents?

Back 1

Inhibition of tetrahydrofolate synthesis by inhibition of the enzyme dihydropteroate synthase.

Front 2

True or False
Bacteria biosynthesize folate from the environment.

Back 2

True

Front 3

PABA competitively inhibits the enzyme ___________ as well as folic acid.

Back 3

Dihydropteroate synthase.

Front 4

True or False
There are 3 groups of sulfonamides and dosing adjustments must be made with renal failure.

Back 4

True

Front 5

What four ways does sulfonamide resistance occur as a result of mutations?

Back 5

1. Overproduction of PABA.
2. [Folic acid-synthesizing enzyme] with low affinity for sulfonamides.
3. Impaired permeability to sulfonamides.
4. Plasmid mediated dihydropteroate synthase resistance.

Front 6

True or False
Sulfonamides can be used to treat Rickettsia.

Back 6

False.
Sulfonamides appear to stimulate re-growth of these organisms.

Front 7

This side effect of sulfonamides occurs in 30-60% of HIV positive patients, but only 3% of healthy patients.

Back 7

Hypersensitivity

Front 8

Severe rash associated in 1% of patients taking sulfonamides. Results in skin cell death; the epidermis separates from the dermis.

Back 8

Stevens Johnson Syndrome

Front 9

How can crystalluria associate with sulfonamide treatment be treated?

Back 9

Increasing hydration or treating the patient with an agent that makes the urine more alkaline.

Front 10

Sulfonamide used to treat bacterial conjunctivitis caused by chlamydial eye infections.

Back 10

Sulfacetamide Sodium

Front 11

Sulfonamide that is a vaginal cream used to treat bacterial vaginosis.

Back 11

Sulfanilamide

Front 12

True or False
Sulfamethizole is a long-acting sulfonamide used to treat minor UTIs.

Back 12

False.
Short-acting

Front 13

Sulfonamide used to treat infections in wounds and burns but if absorbed can cause metabolic acidosis due to inhibition of carbonic anhydrase. May cause pain and rash.

Back 13

Mafenide acetate

Front 14

Sulfonamide used to treat infections in wounds and burns but not associated with metabolic acidosis. When in combo with pyrimethamine is 1st line of treatment of toxoplasmosis.

Back 14

Silver Sulfadiazine

Front 15

True or False
Sulfasalazine is a prodrug hydrolyzed to sulfapyridine.

Back 15

True

Front 16

This drug inhibits dihydrofolate reductase which is needed to synthesize tetrahydrofolate.

Back 16

Trimethoprim

Front 17

True or False
Trimethoprim is 50000 times less effective at inhibiting the bacterial enzyme than the human enzyme.

Back 17

False.
Human enzyme than the bacterial enzyme.

Front 18

What are the four methods bacteria confer resistance to benzylpyrimidines?

Back 18

1. Overproduction of dihydrofolate reductase.
2. [Folic acid-synthesizing enzyme] with low affinity for sulfonamides.
3. Impaired permeability to sulfonamides.
4. Plasmid mediated dihydrofolate reductace resistance.

Front 19

Which is more lipid soluble trimethoprim or sulfamethoxazole?

Back 19

Trimethoprim

Front 20

Is TM-SMZ primarily excreted in the urine?

Back 20

Yes

Front 21

TM-SMZ is contraindicated in what patients?

Back 21

Near term pregnancy
Nursing and new borns.

Front 22

Drug that is more selective for protozoal dihydrofolate reductase rather than mammalian.

Back 22

Pyrimethamine

Front 23

True or False
Pyrimethamine decreases carnitine levels leading to mental changes.

Back 23

True

Front 24

Sulfadoxine and pyramethamine can be used as a 2nd line of treatment for what disease?

Back 24

Malaria

Front 25

What drug is used to treat jiroveci pneumonia in AIDS patients for those intolerant to sulfas?

Back 25

Trimetrexate Glucoronate.

Front 26

True or False
Trimetrexate Glucuronate inhibits dihydrofolate reductase.

Back 26

True

Front 27

This folate synthesis inhibitor interacts with antacids and H2-blocker to decrease absorption and can be combined with rifampin and clofazimine to treat leprosy.

Back 27

Dapsone

Front 28

A prodrug. Activated intermediates generate a superoxid anion that reacts with ribosomal proteins to decrease synthesis of proteins/DNA/RNA/ and cell wall synthesis.

Back 28

Nitrofurantoin

Front 29

This is an alternate for UTI; you can give it with vitamin C to make it more effective.

Back 29

Methanamine

Front 30

This drug inhibits phosphoenolpyruvate transferase- the enzyme that catalyzes formation of diphosphate-N-acetylmuramic acid.

Back 30

Fosfomycin Tromethamine

Front 31

True or False
Antacids and food increase absorption of fosfomycin.

Back 31

False
Decrease.