Anti-Infective – Sulfonamides

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Outline

Overview

  1.        Overview

A.    Bacteriostatic agents

B.    Gram + / – organisms

C.     Types

1.     Sulfonamides

2.     Sulfisoxazole

3.     Sulfamethizole

4.     Sulfasalazine

5.     Trimethoprim / Sulfamethoxazole (TMP/SMX)

6.     Sulfadoxine / Pyrimethamine

7.     Silver Sulfadiazine

8.     Sulfanilamide

9.     Sulfacetamide

     II.         II. Mechanism of Action

A.    Preventing bacterial synthesis of folic acid

   III.         III. Indications

A.    Plasmodium and Toxoplasma spp

B.    Inflammatory bowel disease 

C.     Nocardiosis

D.    Urinary tract infections

E.     Malaria

F.     Burns

G.    Vaginitis

H.    Ocular infections

   IV.         IV. Contraindications

A.    Drug allergy

B.    Porphyria

C.     Pregnant women 

D.    Infants

    V.         V. Interactions

A.    Sulfonylureas

B.    Phenytoin

C.     Warfarin

D.    Cyclosporine

   VI.         VI. Side Effects

A.    Hematological

1.     Agranulocytosis

2.     Aplastic anemia

3.     Hemolytic anemia

4.     Thrombocytopenia

B.    Gastrointestinal

1.     Nausea

2.     Vomiting

3.     Diarrhea

4.     Pancreatitis

C.     Integumentary

1.     Epidermal necrolysis

2.     Exfoliative dermatitis

3.     Stevens-Johnson syndrome

4.     Photosensitivity

D.    Other

1.     Convulsions

2.     Crystalluria

3.     Toxic nephrosis

4.     Headache

5.     Peripheral neuritis

6.     Urticaria

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Transcript

Hey there, and today’s we are going to discuss sulfonamides, which are a certain type of antibiotic class.

Alright, quick overview. sulfonamides are bacteriostatic, meaning they stop bacteria from reproducing, while not necessarily killing them. The mechanism of action that causes these antibiotics to work is related to their ability to prevent the synthesis of folic acid – which is needed for cell growth. Sulfonamides are used to treat gram +/- organisms.

Sulfonamides all begin with SULF-, which is an easy way to remember this drug class.

Sulfonamides indications can be remembered as PINUMOBV, plasmodium / toxoplasma (parasites), IBD, nocardosis, UTI, malaria, ocular infections, burns and vaginitis.

Sulfonamides contraindications can be remembered by DIPP – drug allergy, infants (hyperbilirubinemia in neonates may cause kernicterus, porphyria – abnormalities in the chemical steps that lead to heme production), and pregnant women (as these drugs can cause birth defects).

Sulfonamides interactions include sulfonylurea, phenytoin, warfarin and cyclosporine. Interactions with warfarin cause increase in warfarin effects (SPWC).


Sulfonamides side effects are broken into four categories. The first one is hematologic and include – agranulocytosis, aplastic anemia, hemolytic anemia and thrombocytopenia.

The second category is GI and include N/V/D and pancreatitis.

The third category is integumentary and includes epidermal necrolysis (which is widespread erythema, necrosis, and bullous detachment of the epidermis and mucous membranes, resulting in exfoliation and possible sepsis), exfoliative dermatitis, Stevens-Johnson syndrome (severe skin reaction) and photosensitivity.

The fourth and final category is other and includes – Convulsions, crystalluria, toxic nephrosis, headache, peripheral neuritis and urticaria.

Priority nursing concepts for sulfonamides include pharmacology and infection control.

Alright, let’s review, sulfonamides being with SULF-. Indications include plasmodium / toxoplasma (parasites), IBD, nocardosis, UTI, malaria, ocular infections, burns and vaginitis (PINUMOBV). Contraindications include drug allergy, infants, porphyria (POUR-FEAR-IA) and pregnant women (DIPP). Interactions include sulfonylurea, phenytoin, warfarin and cyclosporine (SPWC). Side effects are broken down into four categories – heme (agranulocytosis, aplastic anemia, hemolytic anemia and thrombocytopenia) / GI (and include N/V/D and pancreatitis) / integumentary (epidermal necrolysis, exfoliative dermatitis, Stevens-Johnson syndrome and photosensitivity / other (convulsions, crystalluria, toxic nephrosis, headache, peripheral neuritis and urticaria).

You know now the important details regarding sulfonamides. Now, go out and be your best self today and as always, Happy Nursing!

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Pharm 1

Concepts Covered:

  • Test Taking Strategies
  • Learning Pharmacology
  • Medication Administration
  • Dosage Calculations
  • Adult
  • Emergency Care of the Cardiac Patient
  • Cardiac Disorders
  • Cardiovascular Disorders
  • Vascular Disorders
  • Hematologic Disorders
  • Acute & Chronic Renal Disorders
  • Disorders of Pancreas
  • Female Reproductive Disorders
  • Immunological Disorders
  • Urinary System
  • Central Nervous System Disorders – Brain
  • Pregnancy Risks
  • Neurological
  • Disorders of the Posterior Pituitary Gland
  • Shock
  • Male Reproductive Disorders
  • Urinary Disorders

Study Plan Lessons

12 Points to Answering Pharmacology Questions
The SOCK Method – Overview
The SOCK Method – S
The SOCK Method – O
The SOCK Method – C
The SOCK Method – K
Basics of Calculations
Dimensional Analysis Nursing (Dosage Calculations/Med Math)
IV Infusions (Solutions)
Complex Calculations (Dosage Calculations/Med Math)
Interactive Practice Drip Calculations
Pediatric Dosage Calculations
ACLS (Advanced cardiac life support) Drugs
Amiodarone (Pacerone) Nursing Considerations
Adenosine (Adenocard) Nursing Considerations
Procainamide (Pronestyl) Nursing Considerations
Anti-Platelet Aggregate
Clopidogrel (Plavix) Nursing Considerations
Coumarins
Warfarin (Coumadin) Nursing Considerations
Thrombin Inhibitors
Enoxaparin (Lovenox) Nursing Considerations
Heparin (Hep-Lock) Nursing Considerations
Thrombolytics
Alteplase (tPA, Activase) Nursing Considerations
Streptokinase (Streptase) Nursing Considerations
Antidiabetic Agents
Glipizide (Glucotrol) Nursing Considerations
Metformin (Glucophage) Nursing Considerations
Insulin
Insulin – Rapid Acting (Novolog, Humalog) Nursing Considerations
Insulin – Short Acting (Regular) Nursing Considerations
Insulin – Intermediate Acting (NPH) Nursing Considerations
Insulin – Mixtures (70/30)
Insulin – Long Acting (Lantus) Nursing Considerations
Essential NCLEX Meds by Class
Renin Angiotensin Aldosterone System
Sympatholytics (Alpha & Beta Blockers)
Atenolol (Tenormin) Nursing Considerations
Metoprolol (Toprol XL) Nursing Considerations
Propranolol (Inderal) Nursing Considerations
ACE (angiotensin-converting enzyme) Inhibitors
Captopril (Capoten) Nursing Considerations
Enalapril (Vasotec) Nursing Considerations
Lisinopril (Prinivil) Nursing Considerations
Angiotensin Receptor Blockers
Losartan (Cozaar) Nursing Considerations
Calcium Channel Blockers
Amlodipine (Norvasc) Nursing Considerations
Diltiazem (Cardizem) Nursing Considerations
Nifedipine (Procardia) Nursing Considerations
Verapamil (Calan) Nursing Considerations
Cardiac Glycosides
Digoxin (Lanoxin) Nursing Considerations
Diuretics (Loop, Potassium Sparing, Thiazide, Furosemide/Lasix)
Furosemide (Lasix) Nursing Considerations
Hydrochlorothiazide (Hydrodiuril) Nursing Considerations
Spironolactone (Aldactone) Nursing Considerations
Mannitol (Osmitrol) Nursing Considerations
Glucagon (GlucaGen) Nursing Considerations
HMG-CoA Reductase Inhibitors (Statins)
Atorvastatin (Lipitor) Nursing Considerations
Magnesium Sulfate
Nitro Compounds
Nitroglycerin (Nitrostat) Nursing Considerations
Nitroprusside (Nitropress) Nursing Considerations
Vasopressin
Epinephrine (EpiPen) Nursing Considerations
Norepinephrine (Levophed) Nursing Considerations
Vasopressin (Pitressin) Nursing Considerations
Anti-Infective – Sulfonamides
Trimethoprim-Sulfamethoxazole (Bactrim) Nursing Considerations
Insulin Drips