Sulfonamides specific agents

Altered excretion Drugs may act on the kidney to reduce excretion of specific agents (e.g., probenecid competes with sulfonamides for the same carrier, increasing the risk of sulfonamide toxicity). 

Carbonic anhydrase inhibitors were the forerunners of modern diuretics. They were discovered when it was found that bacteriostatic sulfonamides caused an alkaline diuresis and hyperchloremic metabolic acidosis. With the development of newer agents, carbonic anhydrase inhibitors are now rarely used as diuretics, but they still have several specific applications that are discussed below. The prototypical carbonic anhydrase inhibitor is acetazolamide. 

Pyrimethamine may also be combined with other antimalarials such as artemisinin derivatives, but these regimens should only be used if the malarial parasites are not resistant to the specific drugs in the regimen.13 Pyrimethamine can also be combined with a sulfonamide drug such as dapsone, sulfadiazine, or sulfamethoxazole to treat protozoal infections that cause toxoplasmosis, or fungal infections that cause Pneumocystis pneumonia.These agents are administered orally. 

Some ADRs are caused by most or all medications in a class, while others are agent specific. Nausea, vomiting, and diarrhea have been observed with most antibiotics, yet only chloramphenicol and certain sulfonamide antibiotics have been consistently implicated as causes of aplastic anemia. Some pharmacological effects, such as sedation from an antihistamine, may be considered adverse effects when they are... 

Albumin is a protein polypeptide. Albumin has a molecular weight of 66.5 kDa and is the most abundant plasma protein, which is present in the concentration of 35-50 g/L in human serum and is synthesized in the liver. Human serum albumin (HSA) has a half-life of 19 days. It acts as a solubilizing agent for long chain fatty acids and is therefore essential for the transport and metabolism of lipids. It binds very well to penicillins, sulfonamides, indole compounds, benzodiazepines, copper, and nickel in a specific and calcium and zinc in a relatively nonspecific manner. It is responsible for osmotic pressure of the blood. 

Sulfonyl chlorides are important precursors of sulfonamides, many of which are chemotherapeutic agents, such as the sulfa drugs discovered in 1932 (Section 9-11). Sulfonamides are derived from the reaction of a sulfonyl chloride with an amine. Sulfa drugs specifically contain the 4-aminobenzenesulfonamide (sulfanilamide) function. Their mode of action is based on their structural similarity with the central fragment of folic acid. The sulfanilamide interferes with the bacterial enzymes that help to synthesize folic acid (Real Life 25-3), thereby depriving them of an essential nutrient and thus causing bacterial... 

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