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
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
Adverse Effects
Dermatologic Adverse Effects
Gastrointestinal Adverse Effects
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
Renal Adverse Effects
- Acute Kidney Injury (see Acute Kidney Injury, [[Acute Kidney Injury]]): due to intratubular deposition and obstruction
References