Sulfa drug are antibacterial consisting of any of several synthetic organic compound capable of inhibiting the growth of bacteria that require p- aminobenzoice acide (paba) to dihydroptetrate, which bacteria needs for folate synthesis and ultimately purine and dna synthesis. They differ from each other not only in their chemical and physical properties but also in their pharmacokinetics.
Adverse efffects
This can result from oral and sometimes topical sulforcamide: effects include;
Hypersensitivity reaction : hypersensivity reactions such as angipedema stevens- johnson syndrome, serum sickness, fever is relatively common and reactions involving the skin may include rashes, pruritis, photosensivity reactions, exfoliative dermatitis, and erythema noosum. Severe, potentially fatal, skin reactions including toxic epidermal necrolysus, particularly exacerbation of pre- existing disease has been reported.
Nephrotoxic reaction- these reactions develop as a result of crystalluria and include intestitical nephritis and tubular necrosis which may result in renal failure have been attributed to hypersensitivity to sulfamethoxazole. Lumber pain, heamatusia, oliguria, and anuria may also occur due to crystallization in the urine of sulfamethoxazole or its less soluble acetylated metabolite. The risk of crystalluria can be reduced by the administration of fluids to maintain a high urine output. If necessary alkalinisation of the urine by administration of sodium bicarbonate may increase solubility and aid the elimination of sulfonamides.
Contrandications: sulfanamides should not be administered to pregnant women (at terms due to the danger of kernictenus) newborns and infants. It should not be given to patients receiving methenamine for urinary track infections because sulfonamides condense with fformaldehyde.
Hemopoietic disturbance- hematologic reactions such as agranulocytosis, thrombocytopenia and patients with glucose-6- phosphate hemolytic anemia are usually encountered. Many of these effects on the blood may result from hypersensitivity reactions and may really cause cyanosis due to methaemoglobinaemia.
Drug potentiation- transient potentiation of the hypoglycemic effect of tolbutamide or the anticoagitlant effect of war faminar of bishydroxycoamanin result from their displacement from binding site on serum albumin. Free methotretrate levels may also arise through displacement.
Kernicterus- sulfonamides may displace serum-bound biluribiin from binding sites on albumin.allowing the free passage of bilirubin into the central nervous system resulting in jaundice and kernicterus in premature neonates.
as with other antimicrobials, sulfamethoxazole may cause alteration of bacterial flora in the gastrointestinal tract. There is, therefore, the possibility, although it appear to bbe small, that pseudomembranous colitis may occur.
Adverse efffects
This can result from oral and sometimes topical sulforcamide: effects include;
Hypersensitivity reaction : hypersensivity reactions such as angipedema stevens- johnson syndrome, serum sickness, fever is relatively common and reactions involving the skin may include rashes, pruritis, photosensivity reactions, exfoliative dermatitis, and erythema noosum. Severe, potentially fatal, skin reactions including toxic epidermal necrolysus, particularly exacerbation of pre- existing disease has been reported.
Nephrotoxic reaction- these reactions develop as a result of crystalluria and include intestitical nephritis and tubular necrosis which may result in renal failure have been attributed to hypersensitivity to sulfamethoxazole. Lumber pain, heamatusia, oliguria, and anuria may also occur due to crystallization in the urine of sulfamethoxazole or its less soluble acetylated metabolite. The risk of crystalluria can be reduced by the administration of fluids to maintain a high urine output. If necessary alkalinisation of the urine by administration of sodium bicarbonate may increase solubility and aid the elimination of sulfonamides.
Contrandications: sulfanamides should not be administered to pregnant women (at terms due to the danger of kernictenus) newborns and infants. It should not be given to patients receiving methenamine for urinary track infections because sulfonamides condense with fformaldehyde.
Hemopoietic disturbance- hematologic reactions such as agranulocytosis, thrombocytopenia and patients with glucose-6- phosphate hemolytic anemia are usually encountered. Many of these effects on the blood may result from hypersensitivity reactions and may really cause cyanosis due to methaemoglobinaemia.
Drug potentiation- transient potentiation of the hypoglycemic effect of tolbutamide or the anticoagitlant effect of war faminar of bishydroxycoamanin result from their displacement from binding site on serum albumin. Free methotretrate levels may also arise through displacement.
Kernicterus- sulfonamides may displace serum-bound biluribiin from binding sites on albumin.allowing the free passage of bilirubin into the central nervous system resulting in jaundice and kernicterus in premature neonates.
as with other antimicrobials, sulfamethoxazole may cause alteration of bacterial flora in the gastrointestinal tract. There is, therefore, the possibility, although it appear to bbe small, that pseudomembranous colitis may occur.