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Sulfas

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Which sulfa is usually preferred for treatment of UTI's ?
sulfisoxazole
Which sulfas can be administered topically ?
sulfacetamide (Sulamyd)
What would be aware of when prescribing a topical sulfa ?
greater risk of hypersensitivity reactions.
-reserved for opthalmic infections, vaginitis, burns
What is THE major side effect with sulfas ?
Stevens Johnson syndrome
What are the signs and symptoms of Stevens Johnson syndrome ?
widespread lesions of skin and mucous membranes, fever, malaise, toxemia
What are some other adverse side effects of sulfas ?
Hematologic problems
hemolytic anemia in those with G6PD
-kernicterus if given to babies < 2 months and to pregnant women
-renal damage from the drug crystallizing in the urine
Stevens Johnson syndrome is more likely with what type of sulfa?
longer acting, less soluble sulfas that are no longer on the market
How do sulfas work ?
Folic acid inhibition at PABA
Are sulfas bacteriostatic or cidal ?
they are bacterioSTATIC
What is the spectrum of the sulfa drugs ?
gram positive cocci;
gram negative bacilli
chlamydia, toxoplasma, plasmodia
What are the two groups of sulfas ?
sulfas for systemic use and sulfas for local effects
Short acting sulfas are used primarily to treat ????
UTI's ==>high water solubility==>less crystallization risk
Intermediate acting sulfa (Sulfamethoxazole) is used to treat ????
used primarily in combination with trmethoprim for chronic UTI's
The two topical sulfas are sulfacetamide and silver sulfadiazine
and are usedto treat superficial eye infections AND
burns
Sulfas are metabolized where >
in the liver by acetylazation
Excreted by the kidneys.

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