Azulfidine - Sulfasalazine

Azmacort - Triamcinolone acetonide Azobicina Triamcin - Triamcinolone acetonide Azo Gantanol Sulfamethoxazole AzO Gantrisin - Sulfisoxazole Azolid Phenylbutazone Azolin - Tetrahydrozoline HCI Azubromaron - Benzbromarone Azulfidine Sulfasalazine... 

Sulfasalazine Azulfidine Azulfidine Entabs Sulfazine Sulfazine EC Immediate-release or enteric-coated tablets 500 mg 2-6 g Colon... 

Olsalazine (Dipentum) Pramoxine (Anusol Ointment, ProctoFoam-NS) Pramoxine w/ Hydrocortisone (Enzone, ProctoFoam-HC) Propantheline (Pro-Banthine) Sulfasalazine (Azulfidine, Azulfidine EN)... 

Sulfasalazine (Azulfidine, Azulfidine EN) [Anti-inflammatory/ Antirheumatic (DMARD)/Sulfonamide] Uses Ulcerative colitis, RA, juvenile RA, active Crohn Dz, ankylosing spondylitis, psoriasis Action Sulfonamide actions unclear Dose Adults. Initial, 1 g PO tid-qid T to a max of 8 g/d in 3 -5- doses maint 500 mg PO qid Feds. Initial 40-60 mg/kg/24 h PO -s- q4-6h maint 20-30 mg/kg/24 h PO q6h RA >6 y 30-50 mg/kg/d in 2 doses, start w/ 1/4-1/3 maint dose, T wkly until dose reached at 1 mo, 2 g/d max -i in renal failure... 

Sulfasalazine (Azulfidine) is approved for the treatment of rheumatoid arthritis and ulcerative colitis. It is also used to treat ankylosing spondylitis and Crohn s disease. Comparisons of sulfasalazine with other DMARDs suggest that it is more effective than hydroxychloroquine, azathioprine, and oral gold compounds. It is at least as effective as intramuscular gold and penicillamine. It has a greater degree of toxicity than hydroxychloroquine but less than gold compounds and penicillamine. After 5 years, approximately 75% of patients have discontinued sulfasalazine therapy, primarily because of a lack of efficacy as opposed to intolerable side effects. 

Parenteral 10 mg/mLforlV infusion Sulfasalazine (generic, Azulfidine)... 

Sulfasalazine Azulfidine Oral 0.5-1.0 g/d for the first week dose can be increased by 500 mg each week up to a maximum daily dose of 2-3 g/d. Relatively high toxicity may produce serious hypersensitivity reactions and blood dyscrasias. 

Sulfasalazine Azulfidine, others - Rheumatoid arthritis, inflammatory bowel disease... 

Clinical Use. Sulfasalazine (Azulfidine, other names) has unique properties, with some antibacterial characteristics similar to sulfonamide drugs (see Chapter 33) and some of anti-inflammatory characteristics similar to the salicylates (see Chapter 15). This drug is primarily used to suppress the immune response associated with rheumatoid arthritis and inflammatory bowel disease.38,61... 

The metabolism of a number of sulfonamides, such as sulfanilamide. sulfamethoxazole (Gantanol). sulfisoxa-zx>le (Gantrisin). sulfapyridine (major metabolite from azo reduction of sulfasalazine. Azulfidine), and sulfamethazine. " " occurs mainly by acetylation at the N-4 position. With sulfanilamide, acetylation also takes place at the sul-... 

Azulfidine, Colo-Pleon, Salazopyrin, Salisulf, Saridine, SAS-500, Sulfazine, Ulcol co-trimoxazole sulfisoxazole sulfasalazine sulfisoxazole sulfacetamide... 

Mesalamine (5-aminosalicylic acid asacol, others) is a salicylate that is used for its local effects in the treatment of inflammatory bowel disease (see Chapter 38). It currently is available as a suppository and rectal suspension enema (rowasa) for treatment of mild-to-moderate proctosigmoiditis Cl rectal suppository (canasa, others) for the treatment of distal ulcerative colitis, proctosigmoiditis, or proctitis. Oral formulations and controlled-release capsule that deliver drug to the lower intestine are efficacious in treatment of inflammatory bowel disease, in particular ulcerative colitis. Sulfasalazine (salicylazosulfapyridine azulfidine) contains mesalamine linked covalently to sulfapyridine (see Chapter 38) it is absorbed poorly after oral administration, but it is cleaved to its active components by bacteria in the colon. The drug is of benefit in the treatment of inflammatory bowel disease, principally because of the local actions of mesalamine. 

CHEMISTRY, MECHANISM OF ACTION, AND PHARMACOLOGICAL PROPERTIES First-line therapy for mild-to-moderate ulcerative colitis generally involves mesalamine (5-aminosalicylic acid, or 5-ASA). The archetype for this class of medications is sulfasalazine (azulfidine), which consists of 5-ASA linked to sulfapyridine by an azo bond. Sulfasalazine represents one of the first examples of an oral drug that is delivered effectively to the distal GI tract. The azo linkage in sulfasalazine prevents absorption in the stomach and small intestine, and the individual components are not liberated for absorption until colonic bacteria cleave the bond. 5-ASA is now regarded as the therapeutic agent, with little, if any, contribution by sulfapyridine. 

Sulfasalazine (azulfidine) is very poorly absorbed from the GI tract and is used in the therapy of ulcerative colitis and Crohn s disease (see Chapter 38). 

Sulfasalazine is a pro-drug that is not active in its ingested form. It is broken down by colonic bacteria into 5-aminosalicylic acid (5-ASA mesalamine) and sulfapyridine. Some controversy exists regarding which of these two products are responsible for the activity of azulfidine. 5-Aminosalicylic acid, however, is known to have a therapeutic benefit, although it is not clear whether sulfapyridine adds any further benefit. In the colon, the products created by the breakdown of sulfasalazine work as anti-inflammatory agents for treating colon inflammation. The beneficiai effect of sulfasalazine is believed to result from a local effect on the bowel, although there also may be a beneficial systemic immune-suppressant effect. Sulfasalazine was approved in 1950. 

The client with inflammatory bowel disease is prescribed sulfasalazine (Azulfidine), a sulfonamide antibiotic. Which intervention should the nurse implement when administering this medication ... 

---