Nucleic Acid Synthesis Inhibitors Flashcards
SULFONAMIDES
compete with PABA
(-) DIHYDROPTEROATE SYNTHASE
bacteriostatic
Silver Sulfadiazine
- BURN INFECTIONS
- silver - bactericidal
- sulfa - bacteriostatic
Mafenide Acetate
*can cause metabolic acidosis and can penetrate eschar
SULFONAMIDES
(-) bacterial synthesis of DIHYDROFOLIC ACID
Sulfamethoxazole (SMX) - inhibits DIHYDROPTEROATE SYNTHASE
SULFONAMIDES
-) bacterial production of TETRAHYDROFOLIC ACID (THF
Trimethoprim (TMP) - inhibits DIHYDROFOLATE REDUCTASE
Cotrimoxazole
TMP-SMX
Cotrimazine
TMP-Sulfadiazine
DOC for infections caused by:
Stenotrophomonas maltophilia
Burkholderia cepacia
Pneumocystis jiroveci
Toxoplasma gondii
Co-Trimoxazole (TMP-SMX)
TMP-SMX Adverse Effects
Crystalluria – bleeding and kidney obstruction
- acidic urine
- high urinary concentration of the drugs
- low solubility of the drug
Hemolytic anemia – G6PD deficient patients
Rashes - hypersensitivity reaction
Agranulocytosis or thrombocytopenia
N/V
KERNICTERUS - toxic encephalopathy (brain damage caused by excessive jaundice)
Steven’s Johnson’s Syndrome
Sulfonamide used for ONLY LOWER UTI
Sulfisoxazole
Sulfonamide that is the DOC for TOXOPLASMOSIS
Sulfadiazine-Pyrimethamine
Sulfonamide used for LOWER UTI
Trimethoprim
Sulfonamide co-administered with Leucovorin to limit bone marrow toxicity
Pyrimethamine
Toxicities of Sulfonamides
Hypersensitivity - EM, SJS/TEN, PAN, exfoliative dermatitis
GI Distress
Hepatotoxicity
- granulocytopenia, thrombocytopenia, aplastic anemia
- G6PD deficiency – acute hemolysis
Nephrotoxicity
2nd line agent for malaria
Sulfadoxine-Pyrimethamine
