Sulfonamides

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

  • xxx