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32 Cards in this Set

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What is the purpose in changing the side chains of sulfa drugs?
affects rate of absorption
excretion
and solubility in the urine
What is the essential portion of a sulfa drug?
free para amino group
In general, what do sulfa drugs do to bugs?
these are bacteriostatic
and inhibit growth of bacteria
How do you make sulfa drugs bacteriocidal?
high concentrations
What structure do sulfamides mimic?
PABA- which is required for synthesis* of bacterial folic acid
What enzyme does sulfamethoxazole inhibit?
Dihydropteroate synthase, this happens by competing with PABA
What enzyme does trimethoprim inhibit?
dihydrofolate reductase
What bugs do sulfa drugs typically affect?
G+ and G-
What individual bugs are very susceptible to sulfas?
E coli, Nocardia, Actinomyceate, Staph A, MRSA, Chlamydia< Toxoplasma gondii
What diseases are sulfas used to treat (5)
UTI's
Nocardia DOC
toxoplasmosis
trachoma
Pneumocystis carnii
What is Sulfasalazine?
this is a prodrug* used to treat UC
What is sulfasalazine made up of?
this is a combination of sulfapryidine, and 5-aminosalicyclic acid (mesalalmine)
What is the ONLY topical sulfa drug?
Silver Sulfadiazine
Can you use sulfas topically in general?
No you should not, they cause sensitization and allergic responses
How are sulfa drugs metabolized and excreted?
these are acetylated in the liver, and excreted by the kidney
What is dangerous about the metabolism of sulfa drugs?
these can cause crystalluria- due to the insolubility of acetylated sulfonamides
What is the drug interaction danger with sulfa drugs?
these do protein binding and may displace other things
What are the dangers of sulfa drugs while pregnant?
kernicterus in the nursing infant
What are the many toxicities of sulfa drugs?
Allergy
Blood dyscraisa
Kidney/Liver Damage
Peripheral nerve damage
Stevens Johnson Syndrome
Microscopic hematuria
Who should not get sulfa drugs?
infants less than 2 months of age
What makes of Co-trimoxazole (Bactrim)
This is TMP-SMX in a fixed ratio of 1:5
What bugs are Co-Trimoxazole very effective against?
P Jiroveci pneumonia
Urinary tract infections
prostatitis
What is TMP-SMX the drug of choice in treating*?
uncomplicated UTI's
Moraxella catarrhalis infections
What is Sulfadiazine combined with to treat toxoplasmosis?
pyrimethamine
What complication is Sulfadiazine likely to cause?
crystalluria
What is trimethoprim used to treat?
recurrent urinary tract infections
What bugs is trimethoprim effective against?
both G+ and G-
Who should NOT get trimethoprim?
this is teratogenic, and should not be used during pregnancy (because this inhibits dihydrofolate reducatase0
What is Silver Sulfadiazine?
this is a topical antiinfective agent to treat second and third degree burns
How does silver sulfasiazine prevent infections?
this does NOT affect folic acid synthesis- rather it damages cell walls/ membranes
What is Pyrimethamine and Sulfadoxine?
this was malaria prophylaxis, but is no longer recommended**
What does pyrimethamine do?
this inhibits parasite dihydrofolate reductase