Brand name: Bactrim

Generic name: Sulfamethoxazole, Trimethoprim, Co-trimoxazole

Drug Classification: Antibiotics (Antibacterial)
Indication: Resp tract, renal GIT, GUT. Osteomyelitis, pneumocystis carinii pneumonia,
toxoplasmosis, actinomycetoma, acute brucellosis, nocardiosis
Mechanism of action: Interferes with bacterial growth by inhibiting bacterial folic acid synthesis
through competitive antagonism of PABA.
Dose: Tab 2 tab Forer tab. 1 tab infant & children TM 6 mg &SMZ 30 mg/kg body wt daily. To be
given in bid. Gonorrhea 5 tab bid or 2 ½ forte tab bid for 1 day.
Contraindication: Marked liver parenchymal damage; severe renal impairment; pregnancy.
Hypersensitivity.
Special Precaution: Hematological disorders; elderly; pregnancy; lactation; G6PD deficiency,
folate deficiency; impaired renal function, porphyria, thyroid dysfunction, history of
allergy or asthma.
Adverse Reactions:
CNS: fatigue, hallucinations, headache, insomnia, mental depression
GI: hepatic necrosis, nausea, vomiting, diarrhea, stomatitis
GU: crystalluria
Derm: toxic epidermal necrolysis, rashes, photosensitivity
Hemat: agranulocytosis, leukopenia, megaloblastic anemia, thrombocytopenia
 Local: phlebitis at IV site
Misc: allergic reactions including erythema multiforme, Stevens - Johnson syndrome,
fever.
Drug Interaction: Increased incidence of thrombocytopenia w/ thiazide diuretics in elderly. May
require dosage reduction of warfarin, phenytoin, digoxin, oral hypoglycemic agents. May
displace methitrexate from plasma protein –binding sites. Possible megaloblastic anemia
w/ high dose of pyrimethamine. Potentiates nephrotoxicity of cyclosporine (reversible).
Amantadine.
Form: Tablet- 80mg TMP/400mg SMZ, 160mg TMP/800mg SMZ;
Syrup- 40mg TMP/ 200mg SMZ per 5 mL;
Injection: 80mg TMP/ 400mg SMZ per 5mL in 5-, 10-, 20- and 30- mL vials
Pregnancy Risk Category: C; D if used near term.
Nursing Responsibilities:
 Assess for infection (vital signs; appearance of wound, sputum, urine, and stool;
WBC) at beginning and during therapy.
 Obtain specimens for culture and sensitivity before initiating therapy.
 Inspect IV site frequently. Phlebitis is common.
 Monitor CBC and urinalysis periodically during therapy.