FA Sulfonamides/dapsone/TMP Flashcards
Sulfonamides agents? 3
Sulfamethoxazole (SMX), sulfisoxazole, sulfadiazine
Which enzyme inhibit sulfonamides and dapsone?
dihydropteroate synthase
what agents inhibits dihydropteroate synthase?
sulfonamides and dapsone
Which enzyme inhibit trimethoprim and pyrimethamine?
dihydrofolate reductase
what agents inhibit dihydrofolate reductase?
trimethoprim and pyrimethamine
mechanism of sulfonamides?
inhibit dihydropteroate synthase, thus inhibiting folate synthesis.
sulfonamides static or cidal?
static;
cidal - when combined with trimethoprim
Coverage of sulfonamides?
Gram+, gram -, nocardia.
TMP-SMX for simple UTI.
sulfonamides adverse. skin? 3
hypersensitivity;
photosensitivity;
Stevens-Johnson syndrome
sulfonamides adverse. infants?
kernicterus
sulfonamides adverse. on albumin?
displace other drugs from albumin (eg warfarin)
sulfonamides adverse. blood?
hemolysis if G6PD deficient
sulfonamides adverse. kidney?
nephrotoxicity (tubulointerstitial nephritis)
sufonamides resistance mechanism? 3
altered enzyme (bacterial dihydropteroate synthase), decr. uptake, or incr. PABA synthesis
trimetoprim (TMP) mechanism?
inhibits bacterial dihydrofolate reductase
trimetoprim (TMP) static or cidic?
static
when used TMP-SMX, cause what inhibition?
cause sequential block of folate synthesis.
combination of TMP-SMX used for what m/os?
UTIs; Shigella; Salmonella; Pneumocystis jirovecii pneumonia treatment and prophylaxis; toxoplasmosis prophylaxis
TMP adverse? metabolites
hyperkalemia (high doses)
TMP adverse? blood
megaloblastic anemia, leukopenia, granulocytopenia
how to avoid blood adverse?
coadministration of leucovorin (folinic acid)
TMP abbreviation?
TMP Treats Marrow Poorly
Dapsone mechanism?
similar to sulfonamides (inhibits dihydropteroate synthase), but structurally distinct agent
Dapsone use?
Leprosy (lepromatous and tuberculoid);
Pneumocystis jirovecii prophylaxis OR treatment when used in combination with TMP
Dapsone advers?
hemolysis if G6PD (kaip ir sufonamiduose), methemoglobinemia, agranulocytosis