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Pharm - Ch. 87

Sulfonamides and Trimethoprim

QuestionAnswer
The sulfonamide prototype is called _____ Sulfamethoxazole
Describe the mechanism of action of sulfamethoxazole Suppresses bacterial growth by inhibiting synthesis of DNA/RNA precursor known as folate/folic acid
Why is folic acid so important to bacteria? Bacteria must synthesize folate to survive. Mammalian cells get folate from environment.
How does sulfa resistance develop? From altering target enzyme structure, increasing competition for target enzyme, decreased drug uptake
True or false: sulfamethoxazole and trimethoprim can be given together in a fixed dose True
What are the uses of sulfonamides/trimethoprim? Uncomplicated UTI, pneumocystis carinii
True or false: sulfonamides/trimethoprim act as anti-metabolites True. Antimetabolites destroy normal cell functions of metabolism that go into building DNA/RNA/proteins
List the MILD and COMMON adverse effects of sulfa hypersensitivity Rash, fever, photosensitivity
List the severe hypersensitivity effects of sulfa Stevens-Johnson's syndrome (low incidence, high mortality). In peds/young adults: major skin/mucous lesions, fever, malaise, toxemia
Why is sulfamethoxazole contraindicated in pregnancy and lactating mothers? Concern of kernicterus (bilirubin deposits in brain). Contraindicated for infants under 2 months, category C drug
What are the adverse effects of SMZ&TMP? Same as with the sulfamethoxazole alone
True or false: trimethoprim on its own is generally well tolerated with most common SE being rash, pruritis True. Less common are GI effects (nausea, epigastric distress, nausea/vomiting, glossitis, stomatitis)
What type of patients are particularly susceptible to SE? AIDs pts
Created by: choel
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