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Sulfonamides

  1. Broad spectrum
  2. Bacteristatic
  3. Water-soluble

MAO

  1. PABA analogues; sulphonamides inhibit folate synthesis competitively
  2. Discovered by Domagk’ 1938
  3. Termed as antifolate antibiotics 

MOR

  1. PABA overproduction

p/k

  1. Water soluble
     
    i. Sulfisoxazole is lipid soluble
  2. Poor absorbed
  3. Undergo acetylation
  4. Do not enter blood brain barrier

Cotrimoxazole (Septran)

  1. Fixed dose combination of
     
    i. Sulphamethoxazole+trimethoprim (5:1)

MAO

  1. Produced sequential block
    1. Bactericidal
    2. Enters blood brain barrier
    3. Lipid soluble

Uses (DOC)

  1. Pneumocystis                        
  2. Nocardiosis                          
  3. Cystitis        
  4. Pneumonia in children          
  5. MRSA                                  
  6. Pseudomonal infections         
  7. Cholera in children                        
  8. Shigella (Ampicillin is an alternative)                    
  9. Reserve drug fir salmonella          
  10. Listeria meningitis (In case of ampicillin allergy)           
  11. Actinomycetes   

S/E

  1. MC-sulpha allergy                        
  2. Hyperkalemia              
  3. Agranulocytosis
  4. Bone marrow depression              
  5. Renal stones
    1. Hydration must be adequate
    2. Sulfisoxazole is free from renal stones




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