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Melissa's Pharm 2 > T3-Trimethoprim/Sulfamethoxazole > Flashcards

T3-Trimethoprim/Sulfamethoxazole Flashcards

1
Q

What is the MOA of trimethoprim/sulfamethoxazole?

A

Block the enzymes that help make folic acid (bacteria need folic acid to survive)

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2
Q

What blocks dihydropteroate syntheses?

A

Sulfamethoxazole

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3
Q

What blocks dihydrofolate reductase?

A

Trimethoprim

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4
Q

What are some common uses for SMZ/TMP?

A

Skin infections

Uncomplicated UTIs

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5
Q

Does SMZ/TMP treat the skin infection MRSA?

A

YES

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6
Q

What are the two types?

A

Single strength

Double strength

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7
Q

What is the amount of SMZ and TMP in the SS?

A

400/80, respectively

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8
Q

What is the amount of SMZ/TMP in the DS?

A

800/160, respectively

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9
Q

What are the adverse effects of SMZ?

A

Hypersensitivity
Hemolytic anemia
Kernicterus
Renal injury

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10
Q

What could happen with the hypersensitivity reaction of SMZ?

A

Hypersensitivity means increased risk of allergic reactions. With SMZ, this can progress to SJ, which has a mortality of 25%!

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11
Q

Why does hemolytic anemia happen?

A

Has to do with a genetic variant

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12
Q

What happens with hemolytic anemia and who is it more common in?

A

Become anemic, loose platelets

African americans and people from Mediterranean area

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13
Q

What is kernicterus?

A

Increase of biliruben in an infants brain

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14
Q

Why do SMZ’s have the adverse effect of kernicterus?

A

Biliruben and SMZ’s both are protein bound. Biliruben is on the protein and when you take a SMZ it knocks it off. Doing so causes the bilirubin to be able to cross into the brain in infants because they have an immature BBB. An increase in bilirubin can cause brain damage and death!

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15
Q

Who should NOT receive a SMZ because of the risk of kernicterus?

A

Infants younger than 2 months
Prigs after 32 weeks gestation
Those breastfeeding

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16
Q

Why does renal injury occur?

A

It is hard to dissolve this drug and the drug can precipitate in the kidneys (aka crystalize your nephrons)

17
Q

What is patient teaching regarding renal injury?

A

Drink 8-10 glasses of h20/d

18
Q

SMZ and TMP ___ each others effect (teamwork)

A

Potentiate

19
Q

Why is SMZ in a BIG IV bag?

A

It doesn’t dissolve easily

20
Q

The IV version of SMZ is bad for patients who have ____.

A

CHF; it comes in a big bag (aka a lot of fluid). We don’t want to have a lot of extra fluid given to patients with CHF

21
Q

TMP’s adverse effect is _____.

A

HYPERkalemia

22
Q

Who should not take TMP?

A

Patients taking:

  • Potassium supplements
  • ACE and ARBs
  • Potassium sparing diuretics
  • SGLT-2 Inhibitors

Melissa's Pharm 2 (32 decks)

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