{"id":104,"date":"2019-09-22T17:52:16","date_gmt":"2019-09-22T21:52:16","guid":{"rendered":"https:\/\/opentextbc.ca\/nursingpharmacology\/chapter\/3-9-sulfonamides\/"},"modified":"2023-03-07T12:41:48","modified_gmt":"2023-03-07T17:41:48","slug":"3-9-sulfonamides","status":"publish","type":"chapter","link":"https:\/\/opentextbc.ca\/nursingpharmacology\/chapter\/3-9-sulfonamides\/","title":{"raw":"3.10 Sulfonamides","rendered":"3.10 Sulfonamides"},"content":{"raw":"Sulfonamides are one of the oldest broad-spectrum antimicrobial agents that work by competitively inhibiting bacterial metabolic enzymes needed for bacterial function.\r\n\r\n<strong>Indications for Use:<\/strong> Sulfonamides are used to treat urinary tract infections, otitis media, acute exacerbations of chronic bronchitis, and travelers' diarrhea.\r\n\r\n<strong>Mechanism of Action:<\/strong> This mechanism of action provides bacteriostatic inhibition of growth against a wide spectrum of gram-positive and gram-negative pathogens.\r\n\r\n<strong>Nursing Considerations Across the Lifespan:<\/strong> Sulfonamides are safe for use in pregnancy and with paediatric clients. Dosing should be altered for any client with renal insufficiency.\r\n\r\n<strong>Specific Administration Considerations:<\/strong> Allergic reactions to sulfonamide medications are common and, therefore, clients should be monitored carefully for adverse effects including delayed hypersensitivity reactions. Sulfonamide medications increase the risk of crystalluria that can cause kidney stones or decreased kidney function; therefore, clients should increase their water intake while taking these medications.\r\n\r\n<strong>Client Teaching &amp; Education: <\/strong>The client should receive education to complete the full prescribed dose of medications and take measures to not skip doses.\u00a0 If a dose is missed, the client should take the missed dose as soon as possible unless it is near the next dosing time.\u00a0 The medication can cause increased photosensitivity, and clients should be educated to use sunscreen and protective clothing with sun exposure.\u00a0 The client should also report any rash, sore throat, fever, or mouth sores that might occur.\u00a0 Unusual bleeding or bruising should also be reported to the provider.\u00a0 If clients are receiving prolonged therapy, they may require platelet count monitoring.[footnote]uCentral from Unbound Medicine. <a href=\"https:\/\/www.unboundmedicine.com\/ucentral\" rel=\"noopener noreferrer\">https:\/\/www.unboundmedicine.com\/ucentral<\/a>[\/footnote]\r\n<h1>Sulfonamides Medication Card<\/h1>\r\nNow let's take a closer look at the medication card for trimethoprim-sulfamethoxazole.[footnote]Daily Med, <a href=\"https:\/\/dailymed.nlm.nih.gov\/dailymed\/index.cfm\" rel=\"noopener noreferrer\">https:\/\/dailymed.nlm.nih.gov\/dailymed\/index.cfm<\/a>, used for hyperlinked medications in this module. Retrieved June 27, 2019[\/footnote] Because information about medication is constantly changing, nurses should always consult evidence-based resources to review current recommendations before administering specific medication.\r\n<div class=\"textbox textbox--learning-objectives\"><header class=\"textbox__header\">\r\n<h2 class=\"textbox__title\">Medication Card 3.10.1: Sulfonamides (Trimethoprim\/Sulfamethoxazole)<\/h2>\r\n<\/header>\r\n<div class=\"textbox__content\">\r\n\r\n<strong>Class:<\/strong> Sulfonamides\r\n\r\n<strong>Prototypes: <\/strong>Trimethoprim\/Sulfamethoxazole, often referred to as \u201csulfa drugs\u201d\r\nExample: Septra, Co-trimoxazole (Bactrim)\r\n\r\n<strong>Mechanism: <\/strong>Bacteriostatic inhibition of growth against a wide spectrum of gram-positive and gram-negative pathogens.\r\n<h3>Therapeutic Effects:<\/h3>\r\n<ul>\r\n \t<li>Monitor for systemic signs of infection:\r\n<ul>\r\n \t<li>WBC<\/li>\r\n \t<li>Temperature<\/li>\r\n \t<li>Culture results<\/li>\r\n<\/ul>\r\n<\/li>\r\n \t<li>Monitor site of infection for improvement<\/li>\r\n<\/ul>\r\n<h3>Administration<\/h3>\r\n<ul>\r\n \t<li>Rarely used due to resistance<\/li>\r\n \t<li>Allergic reactions common<\/li>\r\n \t<li>PO: 1-4hr (Peak)<\/li>\r\n \t<li>IV: immediate onset<\/li>\r\n<\/ul>\r\n<h3>Indications<\/h3>\r\n<ul>\r\n \t<li>Broad spectrum<\/li>\r\n \t<li>Gram + and \u2013<\/li>\r\n \t<li>UTIs* really good<\/li>\r\n \t<li>Resp tract infections<\/li>\r\n \t<li>General prophylaxis<\/li>\r\n \t<li>useless in infections with \u2018pus\u2019<\/li>\r\n<\/ul>\r\n<h3>Contraindications<\/h3>\r\n<ul>\r\n \t<li><strong>Sulfonylureas. sulfonamine, or thiazide diuretics<\/strong><\/li>\r\n \t<li>Hypersensitivity<\/li>\r\n \t<li>Cyclosporin<\/li>\r\n \t<li>Pregnancy\/ lactating<\/li>\r\n \t<li>Kid &lt;2yr<\/li>\r\n \t<li>Geriatric<\/li>\r\n \t<li>Phenytoin<\/li>\r\n \t<li>Warfarin<\/li>\r\n \t<li>Hx kidney stones or renal disease<\/li>\r\n<\/ul>\r\n<h3>Side Effects<\/h3>\r\n<ul>\r\n \t<li>\u201csulfa allergy\u201d \u2013 starts with fever \uf0e0 rash<\/li>\r\n \t<li>photosensitivity \uf0e0rash<\/li>\r\n \t<li>anemia<\/li>\r\n \t<li>Stevens-Johnson<\/li>\r\n \t<li>GI: N\/V, Diarrhea, anorexia, abdo pain<\/li>\r\n \t<li>CNS: Convulsions, Headache<\/li>\r\n \t<li>GU: Crystalluria, Toxic nephrosis, Hyperkalemia<\/li>\r\n \t<li>Pancreatitis<\/li>\r\n \t<li>Bone marrow depression<\/li>\r\n \t<li>folate deficiency<\/li>\r\n<\/ul>\r\n<h3>Nursing Considerations<\/h3>\r\n<ul>\r\n \t<li>take with trimethoprim for synergistic effects<\/li>\r\n \t<li>Monitor skin<\/li>\r\n \t<li>Monitor bowels<\/li>\r\n \t<li>monitor labs<\/li>\r\n \t<li>*must take with LOTS of water<\/li>\r\n \t<li>Tobutamide, tolazamide, glyburide, glipizide, chlorpropamide - \u2191 Risk of hypoglycemia<\/li>\r\n \t<li>Cyclosporines - \u2191 Risk of nephrotoxicity<\/li>\r\n<\/ul>\r\n<\/div>\r\n<\/div>\r\n<div class=\"textbox textbox--key-takeaways\"><header class=\"textbox__header\">\r\n<p class=\"textbox__title\">Clinical Reasoning and Decision-Making Activity 3.9a<\/p>\r\n\r\n<\/header>\r\n<div class=\"textbox__content\">\r\n\r\n<strong>Using the above information, consider the following clinical scenario question:<\/strong>\r\n\r\nA nurse is caring for an elderly diabetic client who has been prescribed trimethoprim-sulfamethoxazole for a urinary tract infection.\u00a0 What nursing interventions will be implemented prior to medication administration?\r\n\r\nNote: Answers to the Critical Thinking activities can be found in the \"<a href=\"https:\/\/opentextbc.ca\/nursingpharmacology\/chapter\/chapter-3\/\">Answer Key<\/a>\" sections at the end of the book.\r\n\r\n<\/div>\r\n<\/div>","rendered":"<p>Sulfonamides are one of the oldest broad-spectrum antimicrobial agents that work by competitively inhibiting bacterial metabolic enzymes needed for bacterial function.<\/p>\n<p><strong>Indications for Use:<\/strong> Sulfonamides are used to treat urinary tract infections, otitis media, acute exacerbations of chronic bronchitis, and travelers&#8217; diarrhea.<\/p>\n<p><strong>Mechanism of Action:<\/strong> This mechanism of action provides bacteriostatic inhibition of growth against a wide spectrum of gram-positive and gram-negative pathogens.<\/p>\n<p><strong>Nursing Considerations Across the Lifespan:<\/strong> Sulfonamides are safe for use in pregnancy and with paediatric clients. Dosing should be altered for any client with renal insufficiency.<\/p>\n<p><strong>Specific Administration Considerations:<\/strong> Allergic reactions to sulfonamide medications are common and, therefore, clients should be monitored carefully for adverse effects including delayed hypersensitivity reactions. Sulfonamide medications increase the risk of crystalluria that can cause kidney stones or decreased kidney function; therefore, clients should increase their water intake while taking these medications.<\/p>\n<p><strong>Client Teaching &amp; Education: <\/strong>The client should receive education to complete the full prescribed dose of medications and take measures to not skip doses.\u00a0 If a dose is missed, the client should take the missed dose as soon as possible unless it is near the next dosing time.\u00a0 The medication can cause increased photosensitivity, and clients should be educated to use sunscreen and protective clothing with sun exposure.\u00a0 The client should also report any rash, sore throat, fever, or mouth sores that might occur.\u00a0 Unusual bleeding or bruising should also be reported to the provider.\u00a0 If clients are receiving prolonged therapy, they may require platelet count monitoring.<a class=\"footnote\" title=\"uCentral from Unbound Medicine. https:\/\/www.unboundmedicine.com\/ucentral\" id=\"return-footnote-104-1\" href=\"#footnote-104-1\" aria-label=\"Footnote 1\"><sup class=\"footnote\">[1]<\/sup><\/a><\/p>\n<h1>Sulfonamides Medication Card<\/h1>\n<p>Now let&#8217;s take a closer look at the medication card for trimethoprim-sulfamethoxazole.<a class=\"footnote\" title=\"Daily Med, https:\/\/dailymed.nlm.nih.gov\/dailymed\/index.cfm, used for hyperlinked medications in this module. Retrieved June 27, 2019\" id=\"return-footnote-104-2\" href=\"#footnote-104-2\" aria-label=\"Footnote 2\"><sup class=\"footnote\">[2]<\/sup><\/a> Because information about medication is constantly changing, nurses should always consult evidence-based resources to review current recommendations before administering specific medication.<\/p>\n<div class=\"textbox textbox--learning-objectives\">\n<header class=\"textbox__header\">\n<h2 class=\"textbox__title\">Medication Card 3.10.1: Sulfonamides (Trimethoprim\/Sulfamethoxazole)<\/h2>\n<\/header>\n<div class=\"textbox__content\">\n<p><strong>Class:<\/strong> Sulfonamides<\/p>\n<p><strong>Prototypes: <\/strong>Trimethoprim\/Sulfamethoxazole, often referred to as \u201csulfa drugs\u201d<br \/>\nExample: Septra, Co-trimoxazole (Bactrim)<\/p>\n<p><strong>Mechanism: <\/strong>Bacteriostatic inhibition of growth against a wide spectrum of gram-positive and gram-negative pathogens.<\/p>\n<h3>Therapeutic Effects:<\/h3>\n<ul>\n<li>Monitor for systemic signs of infection:\n<ul>\n<li>WBC<\/li>\n<li>Temperature<\/li>\n<li>Culture results<\/li>\n<\/ul>\n<\/li>\n<li>Monitor site of infection for improvement<\/li>\n<\/ul>\n<h3>Administration<\/h3>\n<ul>\n<li>Rarely used due to resistance<\/li>\n<li>Allergic reactions common<\/li>\n<li>PO: 1-4hr (Peak)<\/li>\n<li>IV: immediate onset<\/li>\n<\/ul>\n<h3>Indications<\/h3>\n<ul>\n<li>Broad spectrum<\/li>\n<li>Gram + and \u2013<\/li>\n<li>UTIs* really good<\/li>\n<li>Resp tract infections<\/li>\n<li>General prophylaxis<\/li>\n<li>useless in infections with \u2018pus\u2019<\/li>\n<\/ul>\n<h3>Contraindications<\/h3>\n<ul>\n<li><strong>Sulfonylureas. sulfonamine, or thiazide diuretics<\/strong><\/li>\n<li>Hypersensitivity<\/li>\n<li>Cyclosporin<\/li>\n<li>Pregnancy\/ lactating<\/li>\n<li>Kid &lt;2yr<\/li>\n<li>Geriatric<\/li>\n<li>Phenytoin<\/li>\n<li>Warfarin<\/li>\n<li>Hx kidney stones or renal disease<\/li>\n<\/ul>\n<h3>Side Effects<\/h3>\n<ul>\n<li>\u201csulfa allergy\u201d \u2013 starts with fever \uf0e0 rash<\/li>\n<li>photosensitivity \uf0e0rash<\/li>\n<li>anemia<\/li>\n<li>Stevens-Johnson<\/li>\n<li>GI: N\/V, Diarrhea, anorexia, abdo pain<\/li>\n<li>CNS: Convulsions, Headache<\/li>\n<li>GU: Crystalluria, Toxic nephrosis, Hyperkalemia<\/li>\n<li>Pancreatitis<\/li>\n<li>Bone marrow depression<\/li>\n<li>folate deficiency<\/li>\n<\/ul>\n<h3>Nursing Considerations<\/h3>\n<ul>\n<li>take with trimethoprim for synergistic effects<\/li>\n<li>Monitor skin<\/li>\n<li>Monitor bowels<\/li>\n<li>monitor labs<\/li>\n<li>*must take with LOTS of water<\/li>\n<li>Tobutamide, tolazamide, glyburide, glipizide, chlorpropamide &#8211; \u2191 Risk of hypoglycemia<\/li>\n<li>Cyclosporines &#8211; \u2191 Risk of nephrotoxicity<\/li>\n<\/ul>\n<\/div>\n<\/div>\n<div class=\"textbox textbox--key-takeaways\">\n<header class=\"textbox__header\">\n<p class=\"textbox__title\">Clinical Reasoning and Decision-Making Activity 3.9a<\/p>\n<\/header>\n<div class=\"textbox__content\">\n<p><strong>Using the above information, consider the following clinical scenario question:<\/strong><\/p>\n<p>A nurse is caring for an elderly diabetic client who has been prescribed trimethoprim-sulfamethoxazole for a urinary tract infection.\u00a0 What nursing interventions will be implemented prior to medication administration?<\/p>\n<p>Note: Answers to the Critical Thinking activities can be found in the &#8220;<a href=\"https:\/\/opentextbc.ca\/nursingpharmacology\/chapter\/chapter-3\/\">Answer Key<\/a>&#8221; sections at the end of the book.<\/p>\n<\/div>\n<\/div>\n<hr class=\"before-footnotes clear\" \/><div class=\"footnotes\"><ol><li id=\"footnote-104-1\">uCentral from Unbound Medicine. <a href=\"https:\/\/www.unboundmedicine.com\/ucentral\" rel=\"noopener noreferrer\">https:\/\/www.unboundmedicine.com\/ucentral<\/a> <a href=\"#return-footnote-104-1\" class=\"return-footnote\" aria-label=\"Return to footnote 1\">&crarr;<\/a><\/li><li id=\"footnote-104-2\">Daily Med, <a href=\"https:\/\/dailymed.nlm.nih.gov\/dailymed\/index.cfm\" rel=\"noopener noreferrer\">https:\/\/dailymed.nlm.nih.gov\/dailymed\/index.cfm<\/a>, used for hyperlinked medications in this module. Retrieved June 27, 2019 <a href=\"#return-footnote-104-2\" class=\"return-footnote\" aria-label=\"Return to footnote 2\">&crarr;<\/a><\/li><\/ol><\/div>","protected":false},"author":90,"menu_order":10,"template":"","meta":{"pb_show_title":"on","pb_short_title":"","pb_subtitle":"","pb_authors":[],"pb_section_license":""},"chapter-type":[50],"contributor":[],"license":[],"class_list":["post-104","chapter","type-chapter","status-publish","hentry","chapter-type-numberless"],"part":70,"_links":{"self":[{"href":"https:\/\/opentextbc.ca\/nursingpharmacology\/wp-json\/pressbooks\/v2\/chapters\/104","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/opentextbc.ca\/nursingpharmacology\/wp-json\/pressbooks\/v2\/chapters"}],"about":[{"href":"https:\/\/opentextbc.ca\/nursingpharmacology\/wp-json\/wp\/v2\/types\/chapter"}],"author":[{"embeddable":true,"href":"https:\/\/opentextbc.ca\/nursingpharmacology\/wp-json\/wp\/v2\/users\/90"}],"version-history":[{"count":9,"href":"https:\/\/opentextbc.ca\/nursingpharmacology\/wp-json\/pressbooks\/v2\/chapters\/104\/revisions"}],"predecessor-version":[{"id":1633,"href":"https:\/\/opentextbc.ca\/nursingpharmacology\/wp-json\/pressbooks\/v2\/chapters\/104\/revisions\/1633"}],"part":[{"href":"https:\/\/opentextbc.ca\/nursingpharmacology\/wp-json\/pressbooks\/v2\/parts\/70"}],"metadata":[{"href":"https:\/\/opentextbc.ca\/nursingpharmacology\/wp-json\/pressbooks\/v2\/chapters\/104\/metadata\/"}],"wp:attachment":[{"href":"https:\/\/opentextbc.ca\/nursingpharmacology\/wp-json\/wp\/v2\/media?parent=104"}],"wp:term":[{"taxonomy":"chapter-type","embeddable":true,"href":"https:\/\/opentextbc.ca\/nursingpharmacology\/wp-json\/pressbooks\/v2\/chapter-type?post=104"},{"taxonomy":"contributor","embeddable":true,"href":"https:\/\/opentextbc.ca\/nursingpharmacology\/wp-json\/wp\/v2\/contributor?post=104"},{"taxonomy":"license","embeddable":true,"href":"https:\/\/opentextbc.ca\/nursingpharmacology\/wp-json\/wp\/v2\/license?post=104"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}