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Antibiotics Sulphonamides

Antibiotics Sulphonamides - (warn patient on long term...

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Antibiotics Sulphonamides Sulphonamides inhibit DNA synthesis – prevent folate synthesis First class to be discovered in the treatment of systemic infections. Now rarely used due to development of less toxic, more effective alternatives. Also problems with resistance in many organisms Used in tretament of UTIs Sulfadiazine – can be used to treat UTI due to e.coli but many strains are resistant. Co-trimoxazole ( sulphamethoxazole + trimethoprim) – due to its side effects mainly used to treat patients with pneumocystitis jiroveci pneumonia and toxoplasmosis. Diaminopyrimidines Diaminopyrimidines inhibit DNA synthesis – prevent folate synthesis Effectivness limited to some GRAM -ve bacteria namely e.coli, klebsiella and other coliforms. Trimethoprim Inhibits dihydrofolate reductase enzyme. Indications: UTI, rarely other infections Route/Dose: 200mg bd po Side effects: GI upset Rash Blood disorders – reduced glucose, agranulocytosis etc...(warn patient on long term therapy to
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Unformatted text preview: ..(warn patient on long term therapy to watch for fever, sore throat, rash, mouth ulcers, bleeding or bruising) Caution: • Low folate • Breast feeding • Pregnancy • Renal failure or in elderly. Contraindicated: • Blood disorders – megaloblastic anaemia Interactions: • Increases effects of warfarin and phenytoin • Increased risk of arrhythmias if on amiodarone. Others Nitrofurantoin – used in UTIs. SE's include lung effusions and fibrosis. Can give false +ve on urine dipstick for glucose and discolour urine. – used topically to treat bacterial conjuntivitis and oral/IV for typhoid fever/h.influenzae meningitis . SE's include bone marrow aplasia are usually fatal. Linezolid – newer drug. Active against MRSA and vancomycin resistant enterococcci. Adverse effects include peripheral neuropathy and bone marrow suppression....
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