f. There is a low incidence of adverse reactions with these agents. Some of the
more common are large varieties of skin rashes, serum sickness, drug fever, acute
disorders of the hematopoietic system, and disturbances of the urinary tract.
g. Sulfonamides should be used with caution in the presence of renal and
hepatic dysfunction. Periodic complete blood counts should be done to monitor the
patient for any possible blood disorders. They should be used cautiously in the
presence of other highly protein binding drugs and in patients that are glucose-6-
phosphate dehydrogenase (G-6-PD) deficient. Patients should maintain adequate fluid
intake to prevent cystalluria in less soluble compounds.
h. Sulfonamide preparations.
(1)
Sulfisoxazole (Gantrisin)
(a) This is a short acting compound with good solubility and is the first
drug of choice for urinary tract infections. The initial dose ranges from 2 to 4 grams,
with maintenance dose ranging from 4 to 8g daily.
(b) Sulfisoxazole is indicated as a prophylactic for rheumatic fever in
patients allergic to penicillin.
(c)
Other sulfonamide preparations include:
1 Sulfamethizole (Thiosulfil Forte).
2 Sulfadiazine (Microsulfan).
3 Sulfamethoxazole (Gantanol).
(2)
Bactrim, Septra.
(a) These agents are derived from a combination of trimethoprim and
sulfamethoxazole.
(b) There are many uses for this product. Its major use is in the
treatment of chronic urinary tract infections. It is also indicated in the treatment of acute
otitis media in children and the treatment of shigellosis and resulting enteritis if it is
resistant to ampicillin and tetracycline.
(c)
The dose for this drug depends on its strength and how it is to be
utilized.
MD0808
3-16