SulfasTMPantibiotics actiing on Folic acid synthesis and DNA synthesis
Most potent Sulfa drug
Commonly used in combination with TMP
Used parentally only
Penetrates Blood brain barrier
Crystalluria common side effects
Increased PABA concentrations decrease their effectiveness
Inhibit the dihydrofolate enzyme
Work synergistically with TMP
Prevents the formation of folic acid
Bacteriocidal
Gram negative rods
Streptococcus
Staphylococcus
E Coli.
Chlamydiae
Excreted by the kidney
Acetylated in the liver (loss of antimicrobial effect but not toxicity)
Most Commonly used orally
Very short halflife
Binds to serum albumin
Sulfadiazene
Sulfamethoxazole
Sulfathalidine
Sulfasoxazole
Sulfacetamide
Most are given IV
Excreted by the kidney primarily
Acetylated in the liver
Half-life about 6 hours
Some are used topically and opthallamically
Crystalluria
Leukopenia and agranulocytosis
Cross allergy with furosemide
Ototoxicity
Hemolytic anemia (favism)
Steven's Johnson's syndrome
Inflammation of the airway
Increased patient tolerance
Increased used with TMP
They are both used topically for burns
Mafenide is painless
They are both absorbed systemically after topical application
The Silver adds the the antimicrobial effect
Sulfamethoxazole
Sulfazoxazole
Sulfacetamide
Salacylazosulfapyridine
Sulfadiazine
Sulfasalazine
Sulfacetamide
Sulfadiazene
Salacylazosulfapyridine
Sulfasoxazole
Effect is caused in bloodstream
Most of the effect is due to the sulfa drug
Greatly absorbed from GI tract
Not used in inflamed bowel disease
NSAID causes non-inflammatory effect
Oral anticoagulants
Parenteral anticoagulants
Oral hypoglycemics
Parenteral hypoglycemics
Albumin
Penetrates the CNS
Halflife is about 6 hours
Used with sulfadiazine in combination often
Resistant organisms lack dihydrofolate reductase
Human dyhidrofolate enzyme is much less sensitive to TMP inhibition
Humans do not metabolize PABA
Sulfa drugs cause TMP to work on bacteria alone
Dihydropteroate synthase enzyme is selective for TMP
Contraindicated in pregnancy
Leukopenia due to decreased folic acid
Liver damage
Renal damage
Ototoxicity
Anemic children
Immunocompromised patients
AIDS patients
Elderly
Infants
HAemophilus
UTIs
Klebsiella Pneumo
Pneumocystis jurivicii
Mycoplasma
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