Ch 88: Sulfonamides and Trimethoprim Flashcards
How do sulfonamides and trimethoprim work?
They inhibit bacterial synthesis of folic acid.
p. 1063
What are sulfonamides and trimethoprim used for primarily?
Treatment of UTI’s
p. 1063
What are the 4 principle adverse effects of sulfonamides?
1) hypersensitivity reactions ranging from photosensitivity to Stevens-Johnson syndrome
2) hemolytic anemia
3) kernicterus
4) renal damage
(p. 1063)
What are the principal adverse effects of trimethoprim?
hyperkalemia and possible birth defects
p. 1063
Trimethoprim/sulfamethoxazole (TMP/SMZ) inhibits __________ steps in _________ _____ ____ _________, and therefore is more ________ than TMP or SMZ _____.
sequential; bacterial folic acid synthesis;
powerful; alone
(p. 1063)
TMP/SMZ is one of the _________ _____ for ____, and is the drug of choice for ____________ _________ in patients with ____.
preferred drugs; UTIs; pneumocystis pneumonia; AIDS
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What is one important issue when applying mafenide [Sulfamylon] to burn areas?
Premedicate the patient for pain.
p. 1061
What instructions should patients be given when taking oral sulfonamides?
Oral sulfonamides should be taken on an empty stomach and with a full glass of water. To minimize the risk of renal damage, adults should maintain a daily urine output of 1200 mL.
(p. 1060)
Trimethoprim should be avoided in patients who…
…are likely to be deficient in folate (e. g. alcoholics, pregnant women, debilitated patients).
(p. 1061)
What adverse effect is associated with use of mafenide [Sulfamylon]?
Acidosis; this is because mafenide is metabolized to a compound that can suppress renal excretion of acid, causing acidosis.
(p. 1061)
What is the mortality rate of Stevens-Johnson syndrome?
What symptoms would you expect to see?
25%
widespread lesions of the skin and mucous membranes, combined with fever, malaise, and toxemia
(p. 1059)
What symptoms might you see in sulfonamide-induced hemolytic anemia?
fever, pallor, and jaundice
p. 1060
