FA Sulfonamides/dapsone/TMP

Question 1

Sulfonamides agents? 3

Answer 1

Sulfamethoxazole (SMX), sulfisoxazole, sulfadiazine

Question 2

Which enzyme inhibit sulfonamides and dapsone?

Answer 2

dihydropteroate synthase

Question 3

what agents inhibits dihydropteroate synthase?

Answer 3

sulfonamides and dapsone

Question 4

Which enzyme inhibit trimethoprim and pyrimethamine?

Answer 4

dihydrofolate reductase

Question 5

what agents inhibit dihydrofolate reductase?

Answer 5

trimethoprim and pyrimethamine

Question 6

mechanism of sulfonamides?

Answer 6

inhibit dihydropteroate synthase, thus inhibiting folate synthesis.

Question 7

sulfonamides static or cidal?

Answer 7

static;

cidal - when combined with trimethoprim

Question 8

Coverage of sulfonamides?

Answer 8

Gram+, gram -, nocardia.

TMP-SMX for simple UTI.

Question 9

sulfonamides adverse. skin? 3

Answer 9

hypersensitivity;
photosensitivity;
Stevens-Johnson syndrome

Question 10

sulfonamides adverse. infants?

Answer 10

kernicterus

Question 11

sulfonamides adverse. on albumin?

Answer 11

displace other drugs from albumin (eg warfarin)

Question 12

sulfonamides adverse. blood?

Answer 12

hemolysis if G6PD deficient

Question 13

sulfonamides adverse. kidney?

Answer 13

nephrotoxicity (tubulointerstitial nephritis)

Question 14

sufonamides resistance mechanism? 3

Answer 14

altered enzyme (bacterial dihydropteroate synthase), decr. uptake, or incr. PABA synthesis

Question 15

trimetoprim (TMP) mechanism?

Answer 15

inhibits bacterial dihydrofolate reductase

Question 16

trimetoprim (TMP) static or cidic?

Answer 16

static

Question 17

when used TMP-SMX, cause what inhibition?

Answer 17

cause sequential block of folate synthesis.

Question 18

combination of TMP-SMX used for what m/os?

Answer 18

UTIs;
Shigella;
Salmonella;
Pneumocystis jirovecii pneumonia treatment and prophylaxis;
toxoplasmosis prophylaxis

Question 19

TMP adverse? metabolites

Answer 19

hyperkalemia (high doses)

Question 20

TMP adverse? blood

Answer 20

megaloblastic anemia, leukopenia, granulocytopenia

Question 21

how to avoid blood adverse?

Answer 21

coadministration of leucovorin (folinic acid)

Question 22

TMP abbreviation?

Answer 22

TMP Treats Marrow Poorly

Question 23

Dapsone mechanism?

Answer 23

similar to sulfonamides (inhibits dihydropteroate synthase), but structurally distinct agent

Question 24

Dapsone use?

Answer 24

Leprosy (lepromatous and tuberculoid);

Pneumocystis jirovecii prophylaxis OR treatment when used in combination with TMP

Question 25

Dapsone advers?

Answer 25

hemolysis if G6PD (kaip ir sufonamiduose), methemoglobinemia, agranulocytosis