Summary: Phamarcology

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• 1 ANTIBACTERIALS

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• What is the antibacterial spectrum of these drugs?

  These drugs have a broad spectrum, including:
  

  • Gram-positive cocci (including MRSA)
  • Neisseria gonorrhoeae
  • Haemophilus influenzae
  • Escherichia coli
  • Proteus mirabilis
  • Shigella sp.
  • Salmonella sp.
  • Pneumocystis carinii
  • Brucella sp.

• What are some adverse effects of the sulphonamide component in Co-trimoxazole?

  The sulphonamide component can cause rashes and, less commonly, Stevens–Johnson syndrome, renal failure, and blood dyscrasias. It competes for hepatic enzyme-binding sites, affecting drug clearance.

• What limits the use of this effective antibiotic?

  Although an effective antibiotic, the risk of severe reactions such as Stevens–Johnson syndrome has previously limited the use of this drug.

• What is the ratio of sulphamethoxazole to trimethoprim in Co-trimoxazole?

  Co-trimoxazole contains a sulphonamide, sulphamethoxazole (sulfamethoxazole), and trimethoprim in the ratio 5:1. These drugs are bactericidal.

• What adverse effects can trimethoprim cause?

  Trimethoprim can also cause rashes, impaired haemopoiesis, and gastrointestinal symptoms. There may be risk of teratogenesis in malnourished pregnant patients treated with trimethoprim in the first trimester.

• How is the use of this drug changing and for what conditions?

  Its use is again increasing as an alternative for urinary and respiratory tract infection, particularly in patients at higher risk of C. difficile. It remains the drug of choice in treating pneumonia caused by Pneumocystis carinii.

• What is the title of the document?

  The title of the document is "Metabolic Pathway Inhibitors."

• How do sulphonamides inhibit folic acid synthesis in bacteria?

  Bacterial cells are impermeable to folic acid and synthesize their own from p-aminobenzoic acid. Sulphonamides have a strong similarity, causing competitive inhibition of folic acid synthesis.

• What caution should be taken when using Co-trimoxazole in certain patients?

  Should be used with caution in acute kidney injury. In the newborn, sulphonamides can displace bilirubin from protein-binding sites and cause kernicterus.

• What is the spectrum and indication of Sodium fucidate?

  Sodium fucidate has a narrow spectrum and is indicated only in combination with another anti-staphylococcal drug for the treatment of penicillin-resistant staphylococcal infections, e.g. those of bone.