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

Clinical and pharmacological group: & nbsp

Antidiarrhoeic agents

Antibiotics

Included in the formulation

Sugene Avexima

pills inwards

IRBITSK HFZ, OJSC Russia

АТХ:

A.07.A.B Sulfonamides

Pharmacodynamics:

Antagonism with PABA and competitive inhibition of dihydropteroate synthetase, a violation of the synthesis of tetrahydrofolic acid, necessary for the synthesis of purines and pyrimidines.

Pharmacokinetics:

Absorption is insignificant. A high bacteriostatic concentration is created in the intestine. The main amount of the drug taken inside, remains in the intestines and is excreted with feces.

Indications:

Bacterial dysentery. Colitis and enterocolitis with diarrhea. Carrying of dysentery rods, sticks of typhoid fever. Preparation for operations on the small and large intestine.

ICD-10

I.A00-A09.A01 Typhus and paratyphoid

I.A00-A09.A03.9 Shigellosis, unspecified

I.A00-A09.A04 Other bacterial intestinal infections

I.A00-A09.A09 Diarrhea and gastroenteritis of allegedly infectious origin

XXI.Z40-Z54.Z51.4 Preparatory procedures for subsequent treatment, not elsewhere classified

Contraindications:

Hypersensitivity to sulfaguanidine and other sulfonamides, hyperbilirubinemia (in children), G-6-FD deficiency (risk of hemolysis), nephrolithiasis, porphyria, vitamin-B12-deficiency anemia, pregnancy, breast-feeding, neonatal period, infancy; severe violations of the kidney and liver, blood disorders, systemic lupus erythematosus.

Carefully:

Renal insufficiency (dose adjustment may be required), hepatic insufficiency, elderly age, bronchial asthma and other allergic reactions in the anamnesis, AIDS (tendency to adverse reactions).

Pregnancy and lactation:

Some sulfonamides can cause embryonic abnormalities, including cleft palate in animals, but concerns about teratogenic effects in children seem unfounded. Sulfonamides are probably safe in the first trimester of pregnancy; During pregnancy, they should be used only if there is no suitable alternative treatment. Because of the possible replacement of indirect bilirubin and the risk of nuclear jaundice in newborns, sulfonamides should be avoided in the last trimester of pregnancy. Sulfonamides penetrate into breast milk in low concentrations, for healthy children, the risk is insignificant. The risk of nuclear jaundice is higher for premature infants, children with various diseases and pathological conditions, children with hyperbilirubinemia, deficiency of G-6-FD3.

The category of FDA recommendations is not defined.

Dosing and Administration:

In acute intestinal infections, a single dose for adults is 1-2 g; multiplicity of application: 1st day - 6 times, 2-3 day - 5 times, 4th day - 4 times, 5th day - 3 times / day. The course of treatment is 5-7 days. Children under 3 years of age - 200 mg / kg / day in 3 divided doses for 7 days; children over 3 years - 400-750 mg (depending on age) 4 times / day. For prophylaxis of postoperative complications: 50 mg / kg every 8 hours for 5 preoperative days and at the same dose for 7 days after the operation.

Side effects:

Crystalluria, dyspepsia, nausea, vomiting, deficiency of B vitamins, leukopenia, neuritis, allergic reactions (urticaria, exfoliative dermatitis, etc.).

Overdose:

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

Treatment is symptomatic.

Interaction:

Not described.

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, etc.).

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

In order to prevent crystalluria during the treatment period, an abundant drink (2-3 liters per day) is necessary, the risk of crystalluria can be reduced by basifying urine.

When rashes appear, treatment should be discontinued because of the danger of developing serious allergic reactions like Stevens-Johnson syndrome.

It may be necessary to monitor blood and urine tests, especially with prolonged treatment.

All sulfonamides have a high degree of binding to proteins, each of them has a different ability to displace indirect bilirubin.

All sulfonamides have a wide spectrum of action, but due to the wide spread of resistance their use is limited, sensitivity to them varies widely, even in potentially sensitive pathogens. Acquired resistance to sulfonamides is widespread among previously sensitive microorganisms - Neisseria spp., Shigella spp. and other enterobacteria, as well as staphylococci and streptococci. High-level stability is usually constant and irreversible. There is complete mutual stability between all sulfonamides.

Instructions

Sulfaguanidine (Sulfaguanidinum)

Bacterial dysentery. Colitis and enterocolitis with diarrhea. Carrying of dysentery rods, sticks of typhoid fever. Preparation for operations on the small and large intestine.