Sulfonamides

Question 1

Silver sulfadiazine are used for

Answer 1

Topical for burns

Question 2

To treat Ulcerative colitis you use:

Answer 2

Sulfasalazine, Mesalamine

Question 3

Sulfonamide adverse effects

Answer 3

Allergic reactions because they have sulfur– fever, rash, etc, stevens johnson syndrome

Should not be given to patients with G6PDH deficiency since sulfonamides decrease DNA synthesis, it will cause HEMOLYTIC ANEMIA because new RBC’s won’t be formed

Kernicterus in newborns - high plasma protein binding, babies cannot conjugate, bilirubin gets displaced from albumin.

Crystalluria - the regular drug is water soluble, but once it is conjugated to be excreted, it actually becomes LESS water soluble and causes RENAL STONES

Question 4

Trimethoprim-Sulfamethoxazole

Answer 4

Combination is often bactericidal
DOC in Nocardia

Gm-ve Infections
(E.Coli, Salmonella,Shihella)

Gm+ve Infections
( Staph, Strepto, H. Influenzae )

Fungus: Pneumocystis jiroveci pneumonia (PCP)

Protozoa : Toxoplasma Gondii (Sulfadiazine + Pyrimethamine)

Question 5

Adverse Effects of Trimethoprim

Answer 5

Megaloblastic anemia, leukopenia, granulocytopenia

Treat with folinic acid

Question 6

DNA Gyrase inhibitors - Fluoroquinolones

Answer 6

NALIDIXIC ACID
NORFLOXACIN
CIPROFLOXACIN
LEVOFLOXACIN
GATIFLOXACIN
SPAROFLOXACIN
MOXIFLOXACIN
TROVAFLOXACIN

Question 7

What is the Mechanism of action of Levofloxacin (or any quinolone)?

Answer 7

Inhibits DNA replication

[by inhibiting DNA gyrase (Topoisomerase II)& IV]

Question 8

Fluoroquinolones adverse effects

Answer 8

Phototoxicity & rashes (other drugs?)

All quinolone ↑ QT interval

Connective tissue disorders including tendonitis or tendon rapture (in adults), myalgia & leg cramps (in children)

Do not use during pregnancy or in children

Question 9

Example 1st Generation:

Answer 9

norfloxacin; activity against common pathogens that cause urinary tract infections; similar to nalidixic acid

Question 10

4th Generation:

Answer 10

moxifloxacin, Gemifloxacin; broadest spectrum fluoroquinolones with good activity against anaerobes

Question 11

Examples of 3rd Generation:

Answer 11

levofloxacin, gatifloxacin; less activity against gram-negative bacteria but greater activity against some gram-positive cocci, such as S. pneumoniae, entercocci, and MRSA; good for many drug-resistant respiratory tract infections

Question 12

Examples of 2nd Generation:

Answer 12

ciprofloxacin, ofloxacin; excellent activity against gram-negative bacteria, including gonococcus, Chlamydia, many gram-positive cocci, mycobacteria, and Mycoplasma pneumoniae

Question 13

You use Sulfonamides in combination with?

Answer 13

Dihydrofolate reductase inhibitors

Question 14

Two good combinations for sulfanomides and dihydrofolate reducatase inhibitors are?

Answer 14

Trimethroprim - and sulfamethoxazole

Question 15

Pyrimethamine and sulfadiazine are used in treatment of?

Answer 15

Protozoa: Toxoplasmosis gondii

Question 16

Trimethroprim - and sulfamethoxazole side effect?

Answer 16

BM suppression