Triple sulfa

Pharma as silver salt) as sodium salt) Triple Sulfas (Lederle)-... 

Sulfonamides, such as sulfadiazine, in combination with pyrimethamine, are considered the treatment of choice of symptomatic toxoplasmosis. Patients should be well hydrated to prevent crystalluria this problem may be reduced with the use of triple sulfas (trisulfapyrimidine). Some regimens have included a sulfonamide (sul-fadoxine) in combination with pyrimethamine (Fansidar) for the treatment of chloroquine-resistant malaria caused by P. falciparum. 

If the concentration of the sulfonamide is sufficiently high and its aqueous solubility is sufficiently low, the free drug or its metabolites may form crystals and cause bleeding or complete obstruction of the kidneys. Combinations of sulfa compounds have been developed for the purpose of lowering the dosage of individual components to reduce the chance of crystalluria (e.g., triple sulfas, such as the trisulfapyrimidines). 

Mixing different sulfonumidas to achieve an appropriate total dose. The solubilities of the sulfonamides are independent tvf each other, and more of a mixture of sulfanilamides cun stay in water solution at a given pH than can a single sulfonamide. Hence, trisulfapyrimidines. USP(triple sulfa), contain a mixture of sulfadiazine, sulfumerazine, and sulfamethazine. Such mix-... 

Triple Sulfa. Triple sulfa (sulfabenzamidc.. sulfaceu. midc. and sulfuthia/ole Femguard) is used as a vagiod cream in the treatment of Haemophilus vaginalis vaginitis... 

HPLC on pBondapak Ph column with UV detection at 280 nm has been used for the determination of sulfacetamide, sulfabenzamide and sulfathiazole in a triple sulfa cream. The mobile phase consists of a 7 3 mixture of 0.01 M ammonium hydrogen phosphate and methanol (pH 7.2). The proposed method has been shown to give better results for sulfacetamide assay compared with those of the USP method (97). Sulfacetamide, sulfadiazine, sulfamerazine and sulfamethazine in mixtures and in pharmaceuticals have been determined by HPLC using a nonpolar column with methanol-0.02 M potassium dihydrogen phosphate in water as the mobile phase and a variable wavelength UV detector. The method is precise with relative standard deviations of 2.1, 0.6,1.9 and 1.6% respectively for the four compounds. The preservatives do not interfere with the method (98). 

Sulfonamides having a free j )-amino group are readily assayed by titration with nitrous acid. The sulfonamide function may also be titrated with base, such as lithium methoxide. The majority of the sulfas listed in the U.S. Pharmacopeia XXII, however, are assayed by chromatographic methods, particularly high performance liquid chromatography (49). Sulfonamides for which assays are listed in the U.S. Pharmacopeia XXII-National Formulary XVII include the following sulfacetamide, sulfabenzamide, sulfadiazine, sulfadoxine, sulfamerazine, sulfamethazine, sulfamethizole, sulfamethoxazole, sulfapyridine, sulfasalazine, sulfathiazole, sulfinpyrazone, sulfis ox azole, sulfisoxazole acetyl, sulfisoxazole diolamine, sulfoxone, triple sulfa, dapsone, and various combinations with prednisolone, pyrimethamine, and trimethoprim. 

Sulfonamides Oral agents Sulfisoxazole Triple sulfa, sulfamethoxazole Sulfadiazine... 

Trisulfa -pyrimidines (Triple Sulfas) Therapeutic doses of sulfadiazine, sulfamerazine or sulfamethazine alone are likely to precipitate in the urine due to poor solubility. When the three drugs are combined (each at 1/3 of its therapeutic dose) the antimicrobial effects are additive but the urine solubility is independent. Thus a full" therapeutic dose of combined sulfonamides is delivered but the concentration of each is below the threshold required for precipitation. 

Sulfonamides are administered to food-producing species as additives to feed and drinking water, controlled-release oral boluses, and intrauterine infusions. These drugs are applied to the brood chambers of honeybee hives mixed with confectioners sugar or in syrup. The insoluble nature of sulfonamides is an important consideration. Highly insoluble sulfonamides such as phthalylsulfathiazole are absorbed from the gastrointestinal tract very slowly and are used to treat enteric infections. With triple sulfas for oral administration, the concentration of individual sulfonamides is limited by the drug s solubility, while efficacy reflects the additive activity of all three components. Sodium salts of sulfonamides, which are readily soluble in water, are available for intravenous administration. 

Trade names Sultrin Triple Sulfa, Trysul... 

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