Overview of the folate antagonist: Sulfonamides and Trimethoprim $A.State the antimicrobial mechanism of action of sulfonamides and of trimethoprim and explain why their effects on susceptible bacteria do not affect human cells at the same time.B.Describe the primary uses for sulfonamides, trimethoprim, and the combination of the two drugs. Explain the clinical and biochemical rationales for the common combination of sulfamethoxazole with trimethoprim.C.Recognize the link between sulfonamides and Stevens-Johnson syndrome, hemolytic anemia, and kernicterus. Describe the patient populations at highest risk for these potentially serious disorders. State how one might recognize Stevens-Johnson syndromeor hemolytic anemia; list their major signs and symptoms in the context of how nurses should be monitoring for these untoward responses. Describe drug classes that are chemically related to sulfonamides.D.Explain the general way that sulfonamide-induced crystalluria occurs and state two simple yet usually effective and appropriate ways to reduce the risks.Urinary Tract antiseptics/antimicrobialsA.Recognize Escherichia colias the main cause of uncomplicated, community-acquired UTIs and the cause of less than 50% of hospital-acquired UTIs.B.Discuss methenamine (Hiprex) & nitrofurantoin (Macrobid): indication, treatment regimen, monitoring, ADRs, cautions and contraindications.Antimycobacterial DrugsA.Describe the first-line drugs used for tuberculosis (TB): what they are, their individual and collective risks of toxicity to the host, and drug interactions likely to be encountered. (The “RIPE” drugs: Rifampin, isoniazid, pyrazinamide, ethambutol)B.Understand that majority of the drugs (which drugs?) within drug regimen used for active TB can cause hepatotoxicity and it is expected to have elevated LFT levels due tothe benefits of drug treatment for this multi-drug resistant infection. What are the common drugs used in active TB; what should be monitored and major ADRs for each drug.C.Recognize that rifampin induces hepatic-metabolizing enzymes, including those responsible for its own inactivation. Discuss the other drugs rifampin affects by induction of cytochrome P450 enzymes.