Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.
Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
DRUG CLASS AND MECHANISM: Sulfamethoxazole is an anti- bacterial sulfonamide.
It prevents the formation of dihydrofolic acid, a compound that bacteria must be
able to make in order to survive. Although it was once a very useful antibiotic,
it is almost obsolete as a single agent today due to the development of
bacterial resistance to its effects. Sulfamethoxazole is now used primarily in
combination with trimethoprim, a combination product known as Bactrim or Septra.
Sulfamethoxazole was approved by the FDA in 1961. According to the FDA database,
all brand and generic formulations of sulfamethoxazole have been discontinued.
PRESCRIPTION: Yes
GENERIC AVAILABLE: Yes
PREPARATIONS: Tablets: 500 mg and 1 gm.
STORAGE: The tablets should be kept at room temperature, 15-30 C (59-86 F).
DOSING: Sulfamethoxazole usually is taken two or three times daily, with or
without meals. It should be taken with 6 to 8 ounces of liquid to prevent
crystals from forming in the urine. Persons with advanced kidney diseases may
require lower doses.
DRUG INTERACTIONS: Sulfamethoxazole can enhance the blood-thinning effects of
warfarin (Coumadin), possibly leading to bleeding. Sulfonamides such as
sulfamethoxazole can increase the metabolism (break-down and elimination) of
cyclosporine (causing loss of effectiveness of cyclosporine), and can add to the
kidney damage caused by cyclosporine. All sulfonamides can crystallize in urine
when the urine is acidic. Since methenamine (Hiprex, Urex, Mandelamine) causes
an acidic urine, it should not be used with sulfonamides.
PREGNANCY: The effects of the sulfonamide class of antibiotics on the fetus
have not been adequately studied. Therefore, physicians may use them if the
benefits are deemed to outweigh potential risks. On the other hand, use of
sulfonamides near term (that is, near the
ninth month of pregnancy) may cause
bilirubin to be displaced from proteins in the infant's blood. Displacement of
bilirubin can lead to a dangerous condition called kernicterus in which the
bilirubin damages the brain. For this reason, sulfonamides should not be used
near term birth.
NURSING MOTHERS: Sulfamethoxazole is excreted in breast milk and should not
be used in women who are breastfeeding. Sulfonamides can cause kernicterus in
nursing newborns.
SIDE EFFECTS: Sulfamethoxazole may cause dizziness, headache, lethargy,
diarrhea, anorexia, nausea, vomiting, and rash. Sulfamethoxazole should be
stopped at the first appearance of a skin rash since the rash may become severe.
Serious rashes include Stevens-Johnson syndrome (aching joints and muscles;
redness, blistering, and peeling of the skin); toxic epidermal necrolysis
(difficulty in swallowing; peeling, redness, loosening, and blistering of the
skin). Sulfamethoxazole therapy also can
cause extensive sunburn, following
exposure to sunlight. Patients receiving sulfamethoxazole should avoid excessive
exposure to sunlight and should wear
sunscreen.
Other rare side effects include liver damage, low white blood cell count, low
platelet count (thrombocytopenia), and anemia.
Sulfamethoxazole may form crystals in the urine which may damage the kidney
and cause bleeding into the urine. It is important to drink additional liquids
during sulfonamide therapy to prevent these side effects.
Urinary tract infection (UTI) is an infection of the kidney, ureter, bladder, and/or urethra. Not
everyone with a UTI has symptoms. Common symptoms include a frequent urge to
urinate and a painful, burning when urinating.
Pink eye, also called conjunctivitis, is redness or irritation of the conjunctivae, the membranes on the inner part of the eyelids and the membranes covering the whites of the eyes. These membranes react to a wide range of bacteria, viruses, allergy-provoking agents, irritants, and toxic agents.
Sexually transmitted diseases, or STDs,
are infections that are transmitted during any type of sexual exposure,
including intercourse (vaginal or anal), oral sex, and the sharing of sexual
devices, such as vibrators. Women can contract all of the STDs, but may have no symptoms, or have different symptoms than men do.
Chlamydia, a type of bacteria that causes an infection, is spread through sexual contact. Most of the time, women with chlamydia have no symptoms. Antibiotics are an effective treatment for chlamydia.
Malaria is an infectious disease transmitted by the bite of an infected Anopheles mosquito. Symptoms of malaria include chills, pain, fever, and sweating. Though mild cases of malaria can be treated with oral medication, severe cases require intravenous drug treatment and fluids.
Sexually transmitted diseases, or STDs, are infections that are transmitted during any
type of sexual exposure, including intercourse (vaginal or anal), oral sex, and
the sharing of sexual devices, such as vibrators. Although treatment exists for many STDs, others currently are
usually incurable, such as those caused by HIV, HPV, hepatitis B and C, and HHV-8.
Toxoplasmosis (toxo) is a parasitic infection that causes flulike symptoms, swollen lymph nodes, and muscle aches and pains that may last from a few days to several weeks. Toxoplasmosis can be contracted by touching the hands to the mouth after gardening, cleaning a cat's litter box, or anything that came into contact with cat feces. Toxoplasmosis can also be contracted by eating raw or partly cooked meat, especially pork or lamb, or touching the hands to the mouth after contact with raw or undercooked meat.
Pink eye, or conjunctivitis, is redness and inflammation of the membranes (conjunctiva) covering the whites of the eyes and the membranes on the inner part of the eyelids. These membranes react to a wide range of bacteria, viruses, allergy-provoking agents, irritants, and toxic agents, as well as to underlying diseases within the body. Viral and bacterial forms of conjunctivitis are common in childhood, but they occur in adults as well. Pink eye can occur in people of any age. Overall, however, there are many causes of pink eye. These can be classified as either infectious or noninfectious. Pink eye does not cause any changes in vision.
What infections cause pink eye, what are infectious pink eye symptoms, and how are they treated?
Viral pink eye
The leading cause of a red, inflamed eye is virus infection. Adenoviruses are the type of virus that are most commonly responsible for the infection. ...
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