Sulfonamides

Sulfonamides

1. SULFONAMIDES Prepared by, Mrs. Rijo Lijo

2. INTRODUCTION Sulfonamides is the first effective chemotherapeutic agents to be employed systematically for the prevention and cure of bacterial infection in man . Sulfonamides or sulpha drugs are the basis of several group of drugs. This original anti-bacterial sulfonamide are synthetic antimicrobial agent that contain the sulfonamide group . Sulfonilamide is first synthesized by a German chemist Bayer in 1908.

3. PHARMACOKINETIC Route of administration: Oral (well absorbed from upper GIT). Disribution : CSF, Placenta(widely disributed ) 20-90 percent drugs protein bound. Metabolism : Liver (acetylation). Excretion: Kidney (tubular secretion & glumerular filtration ).

4. MECHANISM OF ACTION Folic Acid is very essential for the growth of bacteria as it is crucial for nucleic acid synthesis. Many bacteria synthesize their own folic acid from PABA. Sulfonamides are structural analogues of PABA , enters the sequence in place of PABA. Sulfonamides compete for enzyme dihydropteroic acid synthase to create a non-functional analogue of folic acid. This is of no use to bacteria hence. GROWTH CEASES (BACTERIOSTATIC ACTION)

5. CLASSIFICATION OF SULFONAMIDES

6. INDICATION Typhoid and paratyphoid fever. Acute & chronic urinary tract infection. Tropical application for infected burn. Meningococcal meningitis(sulfadiazine). Bacillary dysentery. Uncomplicated gonorrhea. Dermatitis. Gut sterilization.

7. CONTRAINDICATION Pregnancy. Premature infant. Renal impairment. Dehydration.

8. ADVERSE REACTIONS OF SULFONAMIDES

9. ADVERSE EFFECTS RENAL SYSTEM Sulfonamides precipitates in acidic urine & form crystal which pass the urine . Renal irritation. Crystalluria . S pasmodic pain(renal colic). Haematuria renal tubular necrosis. Oliguria. Anuria.

10. HAEMOPOIETIC SYSTEM Bone marrow depression, Aplastic anaemia . Acute haemolytic anaemia . Thrombocytopenia. Eosinophilia. Agranulocytosis.

11. Gastrointestinal tract Anorexia. Nausea. Vomiting. Diarrhoea .

12. Hypersensitivity reaction Skin rashes. Photosensitivity. Exfoliative dermatitis. Contact dermatitis. Anaphylaxis. Steven johnson syndrome ( Stevens-Johnson syndrome which includes symptoms like aching joints, aching muscles, redness, blistering , and peeling of the skin).

13. Kernicterus in Neonates.( Can be precipitated especially in premature infants since their blood brain barrier is not fully developed SULFONAMIDES Displaces bilirubin from protein binding site Bilirubin passes through BBB Deposited in Basal Ganglia + Subthalamic nuclei).

14. ADVANTAGES OF SULFONAMIDES

15. DISADVANTAGES OF SULFONAMIDES Giving comparatively small doses of each component of a mixture of sulfonamides, the danger of intrarenal drug precipitation should be only as great as if each compound had been administered alone.

16. NURSES RESPONSIBILITY Inform doctor about all medical conditions you have — especially kidney, liver, or blood disorders — before taking a sulfonamide . Sulfonamides may cause blood problems, especially if they're taken for a long period of time . These medicines can also cause a serious, even life-threatening, skin rash. Inform the doctor right away if you notice a rash or unusual skin changes . carefully monitor your body's response to this medicine with frequent observation.

17. These medicines shouldn't be given to infants under 2 months old . These drugs may make the skin more sensitive to the sun. Avoid unnecessary exposure to sunlight, and wear sunscreen and protective clothing while outdoors.