Sulfacetamide - instructions for use, dose, side effects, contraindications

Structural analogue of PABA, necessary for microorganisms for the synthesis of dihydrofolic acid. Competitive blockade of dihydropteroate synthetase of bacteria: disruption of the synthesis of dihydropteroic acid (precursor of tetrahydrofolic acid - cofactor of purine synthesis).Only those microorganisms that are forced to synthesize folic acid themselves are sensitive.

Pharmacokinetics:

Absorption into the systemic bloodstream through an inflamed conjunctiva. Reducing the concentration of the drug in a tear depending on the dosage form and concentration: 15% solution - after 30 minutes, 30% solution - after 2 hours, ointment - after 5.5 hours.

Indications:

Purulent corneal ulcers, conjunctivitis, blepharitis, gonorrheal diseases of the eyes in newborns and adults, prevention of blenarea in newborns.

ICD-10

I.A50-A64.A54.3 Gonococcal infection of the eye

VII.H00-H06.H01.0 Blepharitis

VII.H10-H13.H10.2 Other acute conjunctivitis

VII.H10-H13.H10.4 Chronic conjunctivitis

VII.H15-H22.H16.0 Corneal ulcer

Contraindications:

Hypersensitivity, oppression of bone marrow hematopoiesis, uremia.

Carefully:

Allergy to other medicines containing a sulfonamide moiety; CRF, hepatic insufficiency, bronchial asthma, SLE, G-6-FD deficiency, pregnancy, age up to 2 months, HIV infection, AIDS (systemic use).

Pregnancy and lactation:

Do not use during pregnancy and lactation.

The FDA category is not defined.

Dosing and Administration:

Apply 2-3 drops in the lower conjunctival sac of each eye 5-6 times / day.

For the prevention of blennery, newborn drops are injected with 2 drops of solution immediately after birth and 2 drops every 2 hours.

Side effects:

Burning, lacrimation, stinging, itching in the eyes, allergic reactions (topical application).

Leukopenia, agranulocytosis, allergic reactions, crystalluria, nausea, vomiting (systemic application).

Overdose:

Oppression of bone marrow hematopoiesis: leukopenia, agranulocytosis, infection.

Treatment: symptomatic.

Interaction:

With topical application.

Preparations of silver - incompatibility.

With systemic application.

Antacids - reduced absorption of sulfadimidine in the intestine.

Ascorbic acid, methenamine - increased risk of developing crystalluria.

Bactericidal antibacterial drugs (including penicillins and cephalosporins) reduce their effectiveness.

Local anesthetics (procaine) - decrease in antimicrobial activity (in the hydrolysis release PABC).

Non-steroidal anti-inflammatory drugs, hypoglycemic agents (sulfonylureas derivatives), phenytoin and anticoagulants coumarinovogo number - increased severity of side effects.

Means having a sulfonamide group (diuretics, oral hypoglycemic agents - sulfanylurea derivatives, inhibitors of carbonic anhydrase) - the risk of cross-sensitivity.

Chloramphenicol, thiamazole - Increased hematotoxicity.

Special instructions:

Most meningococcal serogroups A, B and C, Shigella spp., Escherichia coli resistant to sulfonamides.

Due to the bacteriostatic effect, intense immunity is required to kill the pathogen.

The most active preparations with heterocyclic aromatic substituents (sulfamethoxazole, sulfadiazine, sulfafurazole).

Due to widespread resistance, severe side effects and the development of new, more effective antimicrobial agents, sulfonamides in monotherapy are practically not applied (except - sulfacetamide for topical use).

Monitoring: ophthalmologic status (with topical application), general blood test, blood pH, kidney ultrasound (with systemic application).

Distinctive characteristics.

Activity in relation to Haemophilus influenzae and Streptococcus pneumoniae is comparable with gentamicin, trimethoprim and polymyxin. Local instillation with chlamydial infection (C. trachomatis) in newborns can lead to a chronic infection of the conjunctiva and the nasopharynx.

Instructions

Sulfacetamide (Sulfacetamidum)