Familiar to all sulfonamides have proven themselves since ancient times, because they were discovered even before the advent of penicillin. At the present time, these drugs in medical practice have somewhat lost their value, since they have been replaced by more effective modern medicines. However, they are still indispensable for the treatment of certain diseases.
What are sulfonamides?
Sulfanilamides are antimicrobial drugs manufactured using modern technologies and related to sulfanilic acid derivatives.
This short-acting antibiotic is a streptocide. It is one of the first representatives of this group of antibacterial agents. Has a wide spectrum of action. The drug is synthesized as a white crystalline powder, odorless and tasteless, the aftertaste is sweet.
An antibiotic can also be found in the form of sodium sulfanilamide, a white powder that is highly soluble in water. Alsois issued in the form of tablets. Sulfanilamide sodium is able to inhibit the vital functions of rods and cocci, affect malaria, proteus, nocardia, plasmodia, toxoplasma, chlamydia, has a bacteriostatic effect. Sulfanilamide drugs are used to treat diseases caused by antibiotic-resistant pathogens.
Classification of sulfonamides
Sulfanilamides are drugs that are inferior in their activity to modern antibacterial drugs. They are highly toxic, which means that their range of indications is very limited. Sulfanilamide preparations, depending on the properties and pharmacokinetics, are classified into 4 groups:
Sulfanilamide preparations, which are quickly and easily absorbed from the gastrointestinal tract. They are used for systemic antibiotic therapy of infectious diseases caused by microorganisms sensitive to sulfonamides: Sulfadimethoxin, Etazol, Sulfadimizin, Sulfacarbamide, Sulfametizol
- Sulfanilamides, which are slowly and incompletely absorbed from the gastrointestinal tract, while creating a high concentration in the small and large intestines: "Ftazin", "Sulgin", "Etazol-sodium", "Ftalazol".
- Sulfanilamides, which are applied superficially or externally to obtain a local effect. For the treatment of eye diseases, they have proven themselves: sulfacyl sodium ("Sulfacetamide", "Albucid"), silver sulfadiazine ("Dermazin"), "Streptocid ointment10%”, “Mafenide acetate ointment 10%”.
- Salazosulfonamides, which are nitrogen compounds of sulfonamides and salicylic acid: "Salazomethoxin", "Sulfasalazine". The list of sulfonamide drugs is quite extensive.
Main mechanisms of action
The choice of a drug for the treatment of a patient is determined by the properties of the pathogen, because the main mechanism of action of sulfonamides is to inhibit sensitive microorganisms in cells that synthesize folic acid. It is because of this that some drugs, such as Metionomiks or Novakon, cannot be combined with them, because they can weaken the effect of sulfonamides. The key action is the disruption of the metabolism of microorganisms, as well as the blocking of their growth and reproduction.
Issue Forms
All sulfonamide preparations have the same formula, but different pharmacokinetics depending on the structure. There are release forms in the form of a solution for intravenous administration: Streptocid, Sodium Sulfacetamide. Some are intended for intramuscular injection: "Sulfadoxin", "Sulfalen". Combined dosage forms of sulfonamides can be administered in both ways. Children are prescribed topical sulfa drugs or in the form of tablets: Cotrifarm, Co-trimoxazole-Rivopharm.
Indications
The main indications for the use of the sulfonamide group are:
- acne rash (acne vulgaris), inflammation of the hair follicle, erysipelasinflammation;
- 1st and 2nd degree burns;
- streptococcal impetigo;
- pyoderma, boils, carbuncles;
- infected wounds of various nature;
- purulent-inflammatory skin diseases;
- tonsillitis;
- eye diseases;
- bronchitis.
List of sulfa drugs
Sulfanilamides are drugs that, depending on the period of circulation, are divided into drugs: fast, medium, long-term (long-term) and extra-long-acting. It is very difficult to compile a list of all drugs in this group, so below we will give a table with only long-acting sulfonamides:
"Argedin" - the main active substance: silver sulfadiazine. Indications for use are superficial infected burns and wounds, skin grafts, abrasions
- "Argosulfan" - the main active substance: silver sulfadiazine. Burns of various etiologies and all degrees, purulent wounds, frostbite, abrasions, cuts, infected dermatitis, bedsores, trophic ulcers.
- "Norsulfazol" - the main active substance: norsulfazol. Infectious diseases caused by pneumococcus, staphylococcus, hemolytic streptococcus, E. coli, gonococcus, gonorrhea, pneumonia, dysentery, cerebral meningitis.
- "Oriprim" - the main active substance: sulfamethoxazole. Indications - infectious diseases of the genitourinary organs, ENT organs, gastrointestinal tract, respiratory organs, skin and softfabrics.
- "Pyrimethamine" - the main active substance: pyrimethamine. Preventive and curative therapy of malaria, primary polycythemia, toxoplasmosis.
- "Prontosil" (red streptocide) - the main active substance: sulfanilamide. Indications are puerperal sepsis, streptococcal pneumonia, erysipelas of the epidermis.
List of combined sulfa drugs
The use of sulfonamides is quite common. Many strains of microorganisms have learned to mutate and adapt to antibiotics. And therefore, representatives of medicine have created combined sulfa drugs, in which the main active ingredient is combined with trimethoprim. Here is a table of these sulfo drugs:
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"Bactrim" - the main active substance: sulfamethoxazole, trimethoprim. Infectious diseases of the lower and upper respiratory tract, urinary tract, kidneys, gastrointestinal tract, soft tissues, skin and other bacterial infections.
sulfonamide treatment - "Berlocid" - the main active substance: sulfamethoxazole, trimethoprim. Infectious diseases of the respiratory tract, throat, nose, ear, genitourinary tract, kidneys, nocardiosis, brucellosis, South American blastocycosis, etc.
- "Duo-Septol" - the main active substance: sulfamethoxazole, trimethoprim. Infections of the gastrointestinal tract, respiratory tract, soft tissues and skin, urogenital infections, septicemia, brucellosis, meningomyelitis.
- "Ciplin" - the main active substance: sulfamethoxazole, trimethoprim. Infectious diseases of the respiratory tract, urinary tract, gastrointestinal tract, soft tissues and skin, ENT organs, urogenital infections.
Recommendations for use
How to treat with sulfonamides? These antibacterial agents can be administered both topically and orally. The instructions for the use of sulfanilamide preparations state that children under the age of one year should use the drug at 0.05 g, between the ages of two and five years - at 0.3 g, between the ages of six and twelve years - at 0.6 g. Adults are shown to take 0.5-1.3 g about five times a day. The general course of therapy is prescribed by a doctor and depends on the severity of the disease. Most often, the duration of the drug is a week. Each sulfanilamide drug should be washed down with alkaline water. Also, the patient's diet should include foods containing sulfur to prevent crystallization and maintain the overall reaction of the urine.
The action of sulfonamides is not always positive. There may be negative reactions from the body.
Side effects
During prolonged and uncontrolled use of sulfa drugs, side effects may occur. These include various allergic reactions of the body, headaches, dizziness, nausea, vomiting. With systemic absorption into the blood, sulfanilamide drugs are able to pass through the placenta, and then penetrate into the blood of the child to be born, while exerting a toxic effect. It is because of this that pregnant women are advised to be very carefultreat the application and strictly follow the treatment regimen prescribed by the specialist.
Contraindications to the use of sulfa drugs are:
- individual hypersensitivity to the main active ingredient of the drug;
- low hemoglobin content;
- impaired hemoglobin synthesis;
- liver or kidney dysfunction;
- diseases of hematopoietic organs and blood;
- azotemia.
The mechanism of sulfonamides we discussed above.
Cost of sulfa drugs
Sulfanilamide preparations can be purchased at a pharmacy or ordered through an online store. The advantage of the latter method of purchase is that when ordering several drugs at the same time, the difference in price will be noticeable, because you will have to pay extra for shipping to buy one drug. Sulfanilamide preparations of domestic production are much cheaper. Here is a sample price:
- "Sulfanilamide" (white streptocide) with a volume of 250 g of Swiss production will cost about 1900 rubles.
- Biseptol (pack of 20 tablets of 120 mg) of Polish production will cost about 30 rubles.
- "Sinersul" with a volume of 100 ml of Croatian production will cost 300 rubles.
- Sumetrolim (pack of 20 tablets of 400 mg) of Hungarian production will cost 115 rubles.
Now we know thatthese are sulfonamides.
