Sulfonamides


Agents

Antibiotics

Ophthalmologics

  • Dichlorphenamide
  • Dorzolamide

Diuretics

Anticonvulsants

  • Ethoxzolamide
  • Sultiame
  • Zonisamide

Other


Pharmacology

Sulfonamides are Structural Analogs and Competitive Antagonists of Para-Aminobenzoic Acid (PABA) for the Active Site of Dihydropteroate Synthase

  • Inhibition of Bacterial PABA Utilization for the Synthesis of Folate
    • Folate is Used in Bacterial DNA Synthesis
    • Note that Folate is Not Synthesized in Humans and, Therefore, is Required in the Diet: for this reason, sulfonamides are selectively toxic to bacterial cells
    • This Mechanism of Action is Similar to that of the Structurally Distinct Sulfone, Dapsone (see Dapsone)
  • Sulfonamides are Bacteriostatic
    • Sulfamethoxazole (Mechanism as Above) + Trimethoprim (Dihydrofolate Reductase Inhibitor): combination acts synergistically, exhibiting bactericidal action

Adverse Effects

Allergic Adverse Effects

Dermatologic Adverse Effects

Gastrointestinal/Hepatic Adverse Effects

Hematologic Advserse Effects

Infectious Adverse Effects

Pulmonary Adverse Effects

Renal Adverse Effects

  • Acute Kidney Injury (AKI) (see Acute Kidney Injury): due to intratubular deposition and obstruction

References