Sulfonamides, Trimethoprim, Nitrofurantoin

adverse effects of bactrim (4)

- GI - Rash - Hyperkalemia -Stevens Johnson syndrome

nitrofurantoin adverse effects

- Gastrointestinal effects - Pulmonary reactions: Acute and subacute - Hematologic effects - Peripheral neuropathy: Demyelinization and nerve degeneration can occur and may be irreversible - Hepatotoxicity - Birth defects - Other; renal impairment

drug interactions with sulfonamides

- Metabolism-related interactions - Cross-hypersensitivity (thiazide diuretics)

Methenamine Drug Interactions

- Urinary alkalinizers; decreases effectiveness - Sulfonamides; insoluble urinary precipitates

stevens johnson syndrome

- blood dyscrasias - kernicterus (brain damage) - renal damage (crystalluria)

UTI antiseptics (2)

- nitrofurantoin - methenamine

typical dose of bactrim

160 mg twice a day

A patient who sustained second- and third-degree burns has been prescribed mafenide. Which statement about mafenide does the nurse identify as true? A.Use of mafenide can cause alkalosis. B.Mafenide is painful upon application. C.A blue-green to gray discoloration of the skin occurs with mafenide therapy. D.Mafenide exerts its therapeutic effect by the release of free silver.

B

Which patient would most likely need intravenous antibiotic therapy to treat a urinary tract infection? A.A patient with an uncomplicated urinary tract infection caused by Escherichia coli B.A patient with pyelonephritis with symptoms of high fever, chills, and severe flank pain C.A patient with acute cystitis who complains of dysuria, frequency, and urgency D.A patient with acute bacterial prostatitis with a mild fever, chills, and nocturia

B

Sulfamethoxazole/trimethoprim

Bactrim

A patient who takes warfarin has been prescribed sulfadiazine. When teaching the patient about this drug, which statement will the nurse include? A."If you become pregnant, it is safe to take sulfadiazine." B."You should limit your fluid intake while taking sulfadiazine." C."Avoid prolonged exposure to sunlight, wear protective clothing, and apply a sunscreen to exposed skin." D."You will most likely need to have an increase in the dose of warfarin while taking sulfadiazine."

C

Which drug does the nurse identify as a urinary tract antiseptic? A.Ciprofloxacin B.Ceftriaxone C.Nitrofurantoin D.Ceftazidime

C

Which patient does the nurse identify as most likely to need treatment with trimethoprim/sulfamethoxazole [Bactrim] for a period of 6 months? A.A female patient with acute pyelonephritis B.A male patient with acute prostatitis C.A female patient with recurring acute urinary tract infections D.A male patient with acute cystitis

C

A patient who was taking sulfonamides develops Stevens-Johnson syndrome. Upon assessment, the nurse expects to find what? A.Hypotension B.Bronchospasm C.Temperature of 35.5°C D.Widespread skin lesions

D

primary use of sulfonamides

UTI

uses of trimethoprim

UTI

diseases bactrim is used for

UTI, PCP treatment & prophylaxis, meningitis (Listeria), salmonella, yersiniosis, typhoid fever, toxoplasmosis, pertussis

nitrofurantoin uses

UTIs

how is resistance acquired?

acquired by spontaneous mutation or by transfer of plasmids that code for antibiotic resistance (R factors)

what diseases show high resistance to sulfonamides?

gonococci, meningococci, streptococci, and shigellae

trimethoprim supresses

bacterial synthesis of DNA, RNA, and proteins

nitrofurantoin at high concentrations is

bacteriocidal

is trimethoprim okay to use during pregnancy?

no -> only lactation

methenamine is contraindicated in

renal and liver failure

silvadine and mafenide use

suprress bacterial colonization in patients with second and third degree burns

what does bactrim inhibit?

tetrahydrofolic acid

what is bactrim dosing based on?

timethropin component

are bacteria resistant to sulfonamides?

yes

nitrofurantoin at low concentrations is

bacteriostatic

spectrum

broad