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MOA : Inhibition of Cellular

Metabolism
Sulfonamides
• Also called Sulfa drugs
• Drugs that inhibit folic acid synthesis. Folic
acid is necessary for the synthesis of purine
and pyrimidine which are precursors of DNA
and RNA
• Not used much anymore because of the
emergence of resistant bacteria
• They remain as an inexpensive and
effective treatment for UTI and trachoma
• Examples are Sulfadiazine, sulfisoxazole,
sulfasalazine ( ulcerative colitis and Crohn
disease )
Cotrimoxazole

• Is a combination drug that contains


sulfamethoxazole and trimethoprim,
another antibacterial drug
• Effective in the treatment of UTI,
Otitis media, bronchitis and
pneumonitis caused by pneumocystis
carinii
Pharmacokinetics

• The sulfonamides are absorbed from


the GIT, metabolized in the liver and
excreted in the urine
• Are teratogenic, distributed into
breast milk and should not be used
during pregnancy and lactation
Contraindications and
Cautions
• With any known allergy to
sulfonamides, sulfonylureas or to
thiazide diuretics
• Can cause kernicterus and birth
defects
• Used with caution in kidney disease.
ADVERSE EFFECTS
• GI effects such as nausea, vomiting,
diarrhea, abd pain, anorexia,
somatitis and hepatic injury
• Renal effects such as crystalluria,
hematuria, proteinuria
• CNS effects- headache, dizziness
ataxia
• Bone marrow depression
• dermatological
Drug-drug Interactions

• Risk of hypoglycemia with


tolbutamide, tolazamide, glyburide,
glipizide, acetohexamide,
chlorpropamide