Sulfamethoxazole hemolytic anemia with

The answers are 484-k 485-j. (tlardman, pp 1061-1062, 1682-1685.) Sulfonamides can cause acute hemolytic anemia. In some patients it mayr be related to a sensitization phenomenon, and in other patients the hemolysis is due to a glucose-6-phosphate dehydrogenase deficiency Sulfamethoxazole alone or in combination with trimethoprim is used to treat UTls. The sulfonamide sulfasalazine is employed in the treatment of ulcerative colitis. Daps one, a drug that is used in the treatment of leprosy, and primaquine, an anti mala rial agent, can produce hemolysis, particularly in patients with a glucose-6-phosphate dehydrogenase deficiency. 

Hematologic Megaloblastic anemia, leukopenia, and thrombocytopenia may occur all of these effects may be reversed by the concurrent administration of folinic acid (see p. 379), which protects the patient and does not enter the microorganism. Hemolytic anemia may occur in patients with glucose-6-phosphate deficiency due to the sulfamethoxazole (see p. 351). 

Hematologic A 10-year-old boy with acute leukemia developed an immune hemolytic anemia after taking co-trimoxazole for 3 days for Pneumocystis jirovecii prophylaxis [117 ]. A direct antiglobulin (Coombs ) test was strongly positive for IgG and C3, and an indirect antibody test was strongly positive in the presence of co-trimoxazole and trimethoprim, but not sulfamethoxazole alone trimethoprim-dependent erythrocyte antibodies were detected by flow cytometry. 

Chisholm-Burns MA, Patanwala AE, Spivey CA, Aseptic meningitis, hemolytic anemia, hepatitis, and orthostatic hypotension in a patient treated with trimethoprim-sulfamethoxazole. Am J Health Syst Pharm 2010 67(2) 123-7. 

---