Sulfonamides NUR 210 Unit 10 (2023) Galen PPP.pptx

Sulfonamides NUR 210 Unit 10  Uses Synergistic effect Sulfonamides- Both drugs together in one compound cause Trimethoprim- bacterial resistance to develop much more slowly. Sulfamethoxazole Seeing it u...

Sulfonamides NUR 210 Unit 10  Uses Synergistic effect Sulfonamides- Both drugs together in one compound cause Trimethoprim- bacterial resistance to develop much more slowly. Sulfamethoxazole Seeing it used for MRSA Urinary infections (also in chapter 48) Alternative therapy for patients allergic to penicillin Route Oral, IV, topical, ophthalmic  Side effects/adverse reactions Sulfonamides- GI distress, stomatitis Photosensitivity Trimethoprim- Sulfamethoxazole Hypoglycemia Blood dyscrasias-RBC’s, WBC’s, platelets Crystalluria can lead to Renal failure Stevens-Johnson syndrome  Contraindications Renal or liver disease Anemia Sulfonamides- Caution Trimethoprim- Older adults Sulfamethoxazole Diabetes Interactions Increase bleeding with warfarin Increases effect of hypoglycemic Increases digoxin level  Assessment Sulfonamides- Trimethoprim- Vital signs Sulfamethoxazole Renal function – Urine output/labs as available Medical history/medication history Allergies CBC (baseline)  Nursing Interventions Sulfonamides- Obtain C & S Administer with full glass of water Trimethoprim- Increase fluid intake to at least 2000 mL/day. Sulfamethoxazole Monitor I & O Monitor VS Monitor for bleeding, CBC, and renal function. Monitor for rash, superinfection. Avoid during third trimester. Best given on an empty stomach  Teaching Increase fluids to several quarts a day Do not take antacids with med Warn patient if allergic to other sulfa Sulfonamides- drugs may be allergic to this one (oral hypoglycemics – sulfonylureas) Trimethoprim- Teach to side effects and how to Sulfamethoxazole minimize them Teach to adverse reactions to report such as bruising or bleeding Wear sunglasses and sunblock when outdoors How do we know it worked?  Topical and Topical use of sulfonamides can cause Ophthalmic hypersensitivity reactions; they are Sulfonamides infrequently used. Silver sulfadiazine: Used in the treatment of burns and sometimes skin ulcers  When teaching a patient about trimethoprim- sulfamethoxazole (TMP-SMZ), the nurse gives highest priority to teaching the patient to Practice Question A. increase fluid intake. #1 B. report signs of ringing in the ears or loss of hearing. C. expect the color of their urine to change to a reddish orange. D. take this drug with dairy products or antacids to protect the stomach.  Answer: A Rationale: Fluid intake should be increased to at Practice Question least 2000 mL/day when taking sulfonamides to #1 prevent crystalluria. Ototoxicity is not a common adverse effect of sulfonamides. The urine will not change colors. Dairy products or antacids should not be taken at the same time as sulfonamides because they decrease absorption  A patient is ordered to receive co- trimoxazole/TMP-SMZ (Bactrim). This medication is a combination of two Practice Question medications that are #2 A. antagonistic. B. additive. C. synergistic. D. contraindicated. Practice Question Answer: C #2 Rationale: A synergistic effect results in increasing the desired drug response  Which statement about sulfonamide therapy is true? A. When used with sulfonylureas, sulfonamides Practice Question decrease the hypoglycemic effect. #3 B. When sulfonamides are used with warfarin, the anticoagulant effect is decreased. C. Sulfonamides must be taken with antacids to prevent gastric ulceration. D. Patients on sulfonamide therapy need to increase their fluid intake.  Answer: D Rationale: Patients taking sulfonamides need to Practice Question drink several quarts of fluid daily to avoid the #3 complication of crystalluria. These drugs increase the hypoglycemic effect of sulfonylureas, increase the anticoagulant effect of warfarin, and should not be taken with antacids because antacids decrease the absorption rate of the drug.