Agents

Antibiotics

• Silver Sulfadiazine (Silvadene) (see Silver Sulfadiazine, [[Silver Sulfadiazine]])
• Sulfisomidine (also known as Sulfaisodimidine)
• Sulfacetamide (see Sulfacetamide, [[Sulfacetamide]])
• Sulfadoxine
• Sulfamethoxazole + Trimethoprim (Bactrim, Septra) (see Sulfamethoxazole-Trimethoprim, [[Sulfamethoxazole-Trimethoprim]])
• Sulfapyridine: no longer used in humans

Ophthalmologics

• Dichlorphenamide
• Dorzolamide

Diuretics

• Acetazolamide (see Acetazolamide, [[Acetazolamide]])
• Bumetanide (Bumex) (see Bumetanide, [[Bumetanide]])
• Chlorthalidone
• Clopamide
• Furosemide (Lasix) (see Furosemide, [[Furosemide]])
• Hydrochlorothiazide (HCTZ) (see Hydrochlorothiazide, [[Hydrochlorothiazide]])
• Indapamide
• Mefruside
• Metolazone (see Metolazone, [[Metolazone]])
• Xipamide

Anticonvulsants

• Ethoxzolamide
• Sultiame
• Zonisamide

Other

• Mafenide Acetate (see Mafenide Acetate, [[Mafenide Acetate]])
• Celecoxib (see Celecoxib, [[Celecoxib]])
• Darunavir (Prezista) (see Darunavir, [[Darunavir]])
• Probenecid
• Sulfasalazine (see Sulfasalazine, [[Sulfasalazine]])
• Sumatriptan (see Sumatriptan, [[Sumatriptan]])
• Tamsulosin (Flomax, Omnic) (see Tamsulosin, [[Tamsulosin]])

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Pharmacology

• Sulfonamides are structural analogs and competitive para-aminobenzoic acid (PABA) antagonists -> inhibit bacterial PABA utilization for the synthesis of folic acid (used in bacterial DNA synthesis)
  • Bacteriostatic
  • Folic acid is not synthesized in humans -> it is a dietary requirement
    • Therefore, sulfonamides are selectively toxic to bacterial cells
• Sulfamethoxazole (mechanism as above) + Trimethoprim (dihydrofolate reductase inhibitor): combination acts synergistically, exhibiting bactericidal action

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Adverse Effects

Dermatologic Adverse Effects

• Drug Rash with Eosinophilia and Systemic Symptoms (DRESS Syndrome) (see Drug Rash with Eosinophilia and Systemic Symptoms, [[Drug Rash with Eosinophilia and Systemic Symptoms]])
• Morbilliform Rash (see Exanthems, [[Exanthems]])

Gastrointestinal Adverse Effects

• Acute Pancreatitis (see Acute Pancreatitis, [[Acute Pancreatitis]])

Hematologic Advserse Effects

• Risk of Hemolysis in Patient with G6PD Deficiency (see Glucose-6-Phosphate Dehydrogenase Deficiency, [[Glucose-6-Phosphate Dehydrogenase Deficiency]] and Hemolytic Anemia, [[Hemolytic Anemia]])
  • Epidemiology
    • Definite risk: Sulfamethoxazole-Trimethoprim, Dapsone
    • Possible Risk: Sulfadiazine, Sulfamidine
    • Doubtful Risk: Sulfisoxazole, Sulfadiazine
• Methemoglobinemia (see Methemoglobinemia, [[Methemoglobinemia]])
  • Epidemiology: reported with xxxx

Pulmonary Adverse Effects

• Drug-Induced Pulmonary Esoinophilia (see Drug-Induced Pulmonary Eosinophilia, [[Drug-Induced Pulmonary Eosinophilia]])
• Drug Rash with Eosinophilia and Systemic Symptoms (DRESS Syndrome) (see Drug Rash with Eosinophilia and Systemic Symptoms, [[Drug Rash with Eosinophilia and Systemic Symptoms]])
• Hypersensitivity Pneumonitis (see Hypersensitivity Pneumonitis, [[Hypersensitivity Pneumonitis]]): has been reported with sulfapyridine

Renal Adverse Effects

• Acute Kidney Injury (see Acute Kidney Injury, [[Acute Kidney Injury]]): due to intratubular deposition and obstruction

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References

• xxx