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Sulfasalazine: Cautions
Generally, the incidence of severe sulfasalazine-induced adverse effects is low, but minor adverse effects occur frequently. Onset of adverse effects generally occurs within a few days to 12 weeks following initiation of sulfasalazine therapy, especially when dosage exceeds 4 g daily. Clinical experience to date indicates that the incidence of sulfasalazine-induced adverse effects in patients with ulcerative colitis generally is similar to that reported in patients with rheumatoid arthritis, although there is a greater incidence of some reactions. The most frequent adverse effects associated with sulfasalazine therapy in patients with ulcerative colitis are anorexia, headache, nausea, vomiting, gastric distress, and reversible oligospermia.
Sulfasalazine: Dosage and Administration
Sulfasalazine conventional and delayed-release tablets are administered orally. The total daily dosage should be divided into equally divided doses, and, if possible, doses should be administered after meals. The delayed-release tablets should be swallowed whole. For the treatment of ulcerative colitis, the interval between doses of sulfasalazine given as conventional or delayed-release tablets should not exceed 8 hours.
Sulfamethizole
Sulfamethizole shares the actions and uses of the other antibacterial sulfonamides. Sulfamethizole is used principally in the treatment of urinary tract infections caused by sulfonamide-susceptible organisms.
Sulfadiazine
Sulfadiazine is administered orally. Patients should be instructed to drink one full glass (250 mL) of water with each dose of the drug and at frequent intervals throughout the day while they are receiving sulfadiazine. The usual adult dosage of sulfadiazine is 2-4 g initially, followed by 2-4 g daily administered in 3-6 equally divided doses.
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The most frequent adverse effects of co-trimoxazole are adverse GI effects (nausea, vomiting, anorexia) and sensitivity skin reactions (e.g., rash, urticaria), each reportedly occurring in about 3.5% of patients. The incidence and severity of these adverse reactions are generally dose related, and adverse reactions may occasionally be obviated by a reduction in dosage. Hypersensitivity and hematologic reactions are the most serious adverse effects of co-trimoxazole, reportedly occurring in less than 0.5% of patients.
Order Bactrim (Co-trimoxazole) No Prescription 400/800mg
Co-trimoxazole (Bactrim 400+80mg, 800+160mg Tablets) is administered orally or by IV infusion. When oral therapy is not feasible or for severe infections, the drug may be administered IV. The drug should not be injected IM. Co-trimoxazole for injection concentrate must be diluted prior to IV infusion.
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Co-trimoxazole is used for the treatment of urinary tract infections (UTIs) caused by susceptible strains of E. coli, Proteus (indole-positive or -negative), Klebsiella, Morganella morganii, or Enterobacter. Co-trimoxazole, given in single doses, as 3-day therapy, or for 7-10 days, is effective in the treatment of acute uncomplicated UTIs. Some clinicians consider a 3-day regimen of co-trimoxazole the treatment of choice for the empiric treatment of acute uncomplicated UTIs. Co-trimoxazole also is used for the treatment of acute complicated UTIs (e.g., UTIs associated with abnormalities of the urinary tract or neurogenic bladder), but other anti-infectives are preferred by most clinicians.
Sulfonamides General Statement
Sulfonamides, synthetic derivatives of p-aminobenzenesulfonamide (sulfanilamide), are classified as anti-infectives if they possess antibacterial activity that is antagonized by p-aminobenzoic acid or p-aminobenzoyl glutamic acid.
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Norfloxacin is administered orally. The drug should be given with a glass of water at least 1 hour before or at least 2 hours after a meal or ingestion of milk or other dairy products.