Sulfanimida - These are synthetic chemotherapeutic agents that are derived sulfanyl acid. Were the first highly efficient antibacterial agents.

Mechanism of action:

Sulfanimamides have a structural similarity with para-aminobenzoic acid (PABK), are its competitive antagonists.

As a result, the synthesis is oppressed. nucleic acidsAs a consequence, the growth and reproduction of microorganisms is suppressed (bacteriostatic effect). With prolonged use of CA, the stability of microorganisms is developing. Stability Cross.

The antibacterial effect of sulfanimamides is reduced or disappears in the presence of blood, pus, the products of the decay of tissues, where there are noticeable amounts of PABK.

Antimicrobial spectrum:

Real spectrum (As a result of the resistance of microorganisms) of the antimicrobial effect of sulfonamides: Many strains of pneumococci (not all!), Dysentery pathogens, paratif, chlamydia, pneumocists.

They are practical do not work On infections caused by staphylococci, most strains of streptococci, gonococcal, meningococci, hemophilic stick, a blue rod, protemat, enterococci, klebseyella, an intestinal wand.

Sulfanimamide classification:

Depending on the pharmacokinetics, sulfonamides are divided into four groups.

1. Sulfanimamides that are well absorbed from the gastrointestinal tract (resorbing):

1.1. Preparations of short action (t 0.5 less than 10 hours):

Sulfadimesin

Sulfacyl

Norsulfazol.

Streptocid

1.2. Medium duration preparations (10 - 24 hours):

Sulfazine

Sulfamethoxazole.

1.3. Durable preparations (more than 24 hours):

Sulfadimetoxin

Sulfapyridazin

1.4. Prescription preparations (60 - 120 hours):

Sulfalen

2. Sulfanimamides, slowly and not completely absorbed in the gastrointestinal tract (non-rigging):

Phthalazol

Sulgin

3. Sulfonamides for local application:

Sulfacyl - sodium (sulfacetamide, albucid)

Sulfapyridazin - sodium

Sulfargin (sulfadiazine, dermazin)

4. Combined sulfoniamides

A) Salazosulfanimamides

Salazopyridazin (Salazodine)

Salazosulfapyridin

Salazodimetoxin

Mesalazin (Salofalc)

B) Combined preparations with trimetaprim:

Ko-trimoxazole (Biseptol, Septrine, Bactrim, etc.)

FANCER

Pharmacokinetics:

All sulfonamides are partially absorbed in the stomach, most - in thin intestines. In the blood, peak concentrations are usually created after 2-6 hours.

In high concentrations of sulfanimamides are found in the kidneys, lungs, liver, skin; They are not detected in the bones. Sulfanimonds penetrate well through the BC. In sufficiently high concentrations (50-80% of blood content), they are present in liquid media, as well as the tissues of the fetus (the teratogenic effect is possible). Sulfanimonds are poorly soluble in conventional acidic urine reaction. In the kidney channels, they can be precipitated in the form of crystals and block lumen. This complication can be prevented and significantly accelerated the removal of drugs, artificially raising the pH of the urine by intake of soda, alkaline mineral waters.

Indications for use:

1) eye infection, respiratory tract, sex tract caused by chlamydia (erythromycin and tetracyclines) remain;

2) primary (previously not treated) Acute urinary tract infections, especially in non-remote women (uroantics and antibiotics with bactericidal effects are still considered to be selected);

3) nonspecific ulcerative colitis, enteritis and other inflammatory bowel diseases, most of the strains of causative agents of dysentery have developed stability, and preference is given to antibiotics;

4) Shallow burns, wounds - only in linomies and ointments (Mafenide or Sulfadiazine of Silver).

In the treatment of pneumococcal and other pneumonia, meningitis - only after confirming the sensitivity of the flora and in combination with other chemotherapeutic agents.

Complications:

1. Overdose of the drug is more often manifested in children and older people, especially after 10 - 14 days of treatment.

Symptoms of intoxication of CNS - dizziness, headaches, oppressed state, nausea, vomiting (outpatient reception is contraindicated in transport drivers);

Kidney damage - pain in the lumbar region, oliguria, protein and red blood cells in the urine, microcrystals of drugs and their metabolites

Bloodside: hemolytic or aplastic anemia, granulocyptopenia, thrombocytopenia.

2. Hypersensitivity occurs on average in 5% of patients. Preparations can cause allergic reactions at any route of administration, but faster and brighter - after receiving well absorbing drugs. The most frequent skin manifestations of allergies (various rashes, limited dermatitis, generalized dermatitis, exudative erythema, necrotic lesions, etc.). Other manifestations include fever, vascular lesions and anaphylactic shock.

Characteristics of groups:

1. Ca, well absorbed from the GTS - are prescribed for systemic treatment of infections caused by sensitive microorganisms.

2. Sulfanimamides, slowly and not completely absorbed in the gastrointestinal tract and creating a high concentration in a thin and thick intestine - are prescribed only inside. Apply for the treatment of acute enteritis, bacterial dysentery, colitis and enterocolites caused by sensitive aerobic flora. We are prescribed according to the schemes, the course of treatment on average 5 - 7 days.

3. Sulfonamides for local applications - they are most successful in eye practice. Albucid is used in the form of 30% eye drops, eye ointment. The drug is prescribed inflammatory diseases Conjunctivations, blufarites, purulent corneal ulcers, with trachoma caused by chlamydia.

For local application, a large number of soluble sodium salts of sulfonamide sodium salts is produced: streptocide, norsulfazole, ethasol, sulphapyridazine, etc. in the form of solutions, in aerosols, in lines, ointments, powders are used for the treatment of purulent wounds, long-lasting ulcers, burns, fruit diseases , breakingles, etc. Pre-wounds and the affected surface must be washed from pus and processed by an antiseptic. Most sulfanimamide solutions have a strongly alkaline reaction and, when applied to damaged tissues, they cause sharp and long-term (for 1-3 h) pain. Better than others are transferred and more efficient 10% mafenida ointmentand 1% sulfargin ointment (silver sulfadiazine, dermatain).Contraindication: Allergic reactions to sulfonamides in history. The duration of treatment is from 1 to 3 weeks.

Swipping wounds and burns with powders of sulfanimamides not only ineffectively, but also undesirable, since the pus is accumulated under the resulting crust, and the process develops deep into.

4. Salazosulfanimide - compounds of a number of preparations with salicylic acid. Most widely used salazopyridazin (Salazodine)in the form of tablets, candles, suspensions. Used to treat polyimicrobial (nonspecific) colitis, including peptic.

5. Combined CA with trimetaprim. As a result of combining, not only the mutual potentiation of antimicrobial action occurs, but also the spectrum is expanding; In high therapeutic doses, the combined drugs exhibit a bactericidal effect on a number of microbes. The stability of microorganisms to combined drugs is developing slowly.

Its optimal ratio in combination with sulfamethoxazole (bispetol preparation) is 1: 5. At the same time, peak concentrations of drugs in the blood are achieved after 1 to 4 h.

Indications for the use of bispetol and its analogues:

1) Bacterial infections of the respiratory tract - pneumonia, acute bronchitis and aggravation of chronic; used for the treatment and prevention of secondary infections;

2) pneumonia caused by pneumocists - Biseptol is considered to be a drug selection; In severe flow, an intravenous infusion of the solution is shown;

3) infections of the lower and upper urinary tract (in the absence of bacteriuria);

4) enteritis and enterocolites caused by a dysenteric stick, bacteria of a typhoratyphound group, cholera vibriums and another microflora, including those gained resistance to ampicillin and leftomycetin;

5) inflammation of the middle ear, meningitis (in combination with other chemotherapeutic agents), sepsis (in / c);

Side effects.

- allergic reactions.

HEMOPOOEZ VIOLATIONS.

Principles of sulfonamide therapy:

1. Begin treatment as early as possible from the use of a shock dose.

2. Assign confirmation doses to the track behind the shock according to the scheme, based on the pharmacokinetics of the drug.

3. Conduct course treatment with a duration of at least 5 - 10 days, without interrupting and without reducing the course of treatment.

Sulfanimide and other means considered in this part of the section are subject to the number of synthetic antimicrobial drugsWith mainly bacteriostatic effects and used to treat many infectious diseases.

• Sulfanimide products

All sulfonamide remedies are similar to among themselves by chemical structure and antimicrobial mechanism.

They differ from each other by pharmacokinetic parameters: Some are easily absorbed from the gastrointestinal tract, quickly accumulate in the blood, organs and tissues; Others - delay in the intestines for a long time and create a high concentration of drugs sufficient to treat the diseases of the stomach and intestines; Third - in significant quantities accumulate in the kidneys and urinary tract, standing out from the body unchanged. On microorganisms, sulfonamide remedies have a bacteriostatic action. They suppress the livelihood of a large group of cockkops, dysenteric and intestinal sticks, pathogens of the Siberian ulcers, cholera vibrium, brucella and other causative agents of diseases.

The mechanism of the action of sulfonamide agents is based on the principle of antimetabolism, when the required microorganism of the substance is replaced on a substance close by the chemical structure, but the opposite in action. Such action is called competitive antagonism. In this case, competitive antagonism is carried out on the structural similarity of parasopensoic acid molecules (PABK) and sulfonamide (Fig. 4).

A vapor-aminobenzoic acid is directly involved in biotransformation of folic acid, which, transforming into folineic acid, is involved in the synthesis of nucleic acids (protein), which underlies the growth, development and reproduction of microorganism. Replacing the PABK on sulfonamide disrupts protein synthesis, leads to a delay in the growth and reproduction of causative agents of diseases. But to obtain such an effect of the concentration of sulfonamide funds, there must be many times the concentration of PABK (the second principle of chemotherapy). That is why treatment with sulfonilamine means begin with large (shock) doses of drugs, in order to create a high concentration of competitive drug in the body as soon as possible.

By the time of action, sulfonamide products are divided into short, medium, long-term and extreme-duty drugs.

A short-acting sulfonylamide includes streptocid, norsulfazole, sulfadimezin, ethazol, etc.

Streptocid (Streptocidum) is one of the first sulfonamide preparations used in medical practice. It is used to treat angina, pyelitis, cystitis, colitis, grinding inflammation, wound infections, etc.

Treatment with streptocide is beginning with a shock dose of 2 g, and then inside 0.5-1 g to 5 times a day, gradually reducing the number of techniques towards the end of treatment. The externally streptocid is injected into the wound in the form of a sterile powder or use its 5% liniment and 10% ointment.

Among the side effects are allergic reactions, leukopenia, agranulocytosis, tachycardia, etc. streptocide is contraindicated in diseases of the blood formation system, impaired kidney functions, thyrotoxicosis and increased body sensitivity to sulfanimide products.

Release streptocid in powder, tablets of 0.3 and 0.5 g, in the form of 5% of the line and 10% ointment in the package of 25-30 g.

Norsulfazol (NORSULFAZOLUM) is active in terms of gram-negative bacteria, is easily absorbed from the gastrointestinal tract and quickly allocated from the body with urine.

Apply Nurfases for the treatment of pneumonia, cerebral meningitis, with streptococcal and staphylococcal sepsis, gonor, and other diseases. Treatment is beginning with the appointment of a shock dose 2 g, and then taken 1 g every 4-6 hours, and then after 6-8 hours. In total, the course of treatment is necessary from 20 to 30 g of the drug.

In the treatment of norsulfazole, it is recommended to increase fluid consumption to 2-3 liters per day in order to prevent possible crystaluria. Also advised after each reception of the drug to drink it with a glass of water with the addition of a small amount of drinking soda.

Among the side effects with the use of Nisulfazole are allergic reactions, leukopenia, neuritis and intestinal disorder.

Produce a drug in powder, tablets of 0.25 and 0.5 g. List B.

Ethazol (Aethazolum) has antibacterial activity that applies to all types of coccquits, intestinal wand, diphetteria causative agents and urinary tract infections. Apply ethasol for the treatment of pneumonia, corrosive inflammation, angina, purulent infections of urinary tract, wound infections and peritonitis.

Prescribed the drug inside 1 g 4-6 times a day, depending on the nature of the disease. Ethasol is small, not cumulating and almost does not cause crystalluria. The side effects of it are the same as the remaining sulfanimide products.

Produce a drug in powder and tablets of 0.25 and 0.5 g.

Sodium salts of the above preparations are well soluble in water and are more often used for injection in cases where oral administration is impossible. It should be noted that with the advent of more efficient chemotherapeutic agents, the use of sulfonamide drugs has decreased significantly.

Sulfanimide means of medium duration of action are represented by the preparation of sulfazine and its silver salt.

Sulfazine (Sulfazinum) differs from other drugs by a longer action (up to 8 hours). Indications for use are the same as Nisulfazole.

Prescribe sulfazine inside, the first reception is 2 g, then during

• 2 days 1 g after 4 hours and then 1 g every 6-8 hours.

It rarely causes side effects, and to prevent complications from the kidney side, it is recommended to use alkaline drink.

Produce sulfazine in powder and tablets of 0.5 g.

Widespread use in the treatment of infectious diseases, long-term drugs were found, applied in smaller doses to the course of treatment, almost do not cause crystalluria and designated 1-2 times a day after receiving the impact dose.

Sulfadimetoxin (Sulfadimethoxinum) - a preparation of prolonged action, is slowly absorbed from the gastrointestinal tract, reaching the maximum concentration after 8-12 hours.

The antibacterial effect of the drug applies to all types of coccquits, pathogens of dysentery, trachomas and some simplest. It is used to treat sharp respiratory diseases, pneumonia, bronchitis, sinusitis, otitis, inflammatory diseases of bile and urinary tract, wound infections, etc.

Prescribed the drug inside from 1-2 g on the first day and 0.5-1 g in the following days.

When using sulfadimetoxin, skin rashes, leukopenia and rarely - intestinal disorder is possible. The drug is contraindicated in its individual intolerance.

Support sulfadimimetoxin in tablets of 0.5 g per pack of 10 pieces.

Sulfapyridazin (sulfapyridazinum) in the intestines is absorbed faster than sulfadimetoxin, but it is highlighted from the body slower than and its long-term action is explained.

Indications and contraindications to the use of sulfapyridazine are similar to sulfadimetoxin and other sulfanilamide products. With caution, it is used for diseases of the hematopoietic system, with a violation of kidney functions and decompensation of cardiac activity.

Produced sulfapyridazin in tablets of 0.5 g. List B.

Well soluble sodium salt sulfapyridazine (sulfapyridazinumnatrium) is often used for local treatment of purulent infection, in the form of eye drops With trachus and inhalations in chronic purulent processes in bronchops and lungs.

They produce a drug in powder for the preparation of solutions and in the form of eye films in a package of 30 pieces.

Sulfamonometoxin (Sulfamonomethoxinum) according to the testimony and contraindications to use is close to long-acting drugs. It is easily soluble in water, quickly absorbed, penetrates through the hematorecephalic barrier, relatively low toxic.

Assign it inside in tablets on the first day of 1 g, and in the following days 0.5 g per day. Daily dose give 1 time per day.

Release the drug in tablets of 0.5 g. Sulfonimetoxin is part of the preparation of Sulfaton.

A group of extreme action preparations represents sulfalen and its methylglyukovy salt.

Sulfalen (Sulfalenum) on antibacterial action is close to sulfapyridazin and other long-acting sulfanimides, but has an overnight effect, as it is very slowly distinguished from the body through the kidneys (up to 72 hours).

When taking inside it is well absorbed, easily penetrates in liquid and fabric, in large concentrations is found in the liver, etc. Unlike other sulfonamide products, it is almost not associated with proteins and is in the blood in free state, which ensures its long therapeutic effect.

Sulfalen is used for infectious diseases Respiratory organs, bile and urinary tract, purulent infections of various localization (abscesses, mastitis), with osteomyelitis, otitis, etc.

Sulfal is prescribed inside in tablets: on the first day 1 g of the drug and in the next - 0.2 g per day 30 minutes before meals. The duration of treatment depends on the nature of the disease and is approximately 7-10 days.

Sulfalin is usually well tolerated, but sometimes allergic reactions, nausea, headache and leukopenia are developing.

We produce sulfalin in tablets of 0.2 g per pack of 10 pieces.

Sulfalen soluble salt (Sulfalenum-Megluminum) is used for parenteral administration with severe forms of purulent infections in surgery, therapy, urology, with pneumonia and meningitis. Enter the drug in Vienna or intramuscularly. List B.

Combined sulfonamide preparations Sulfaton and Bisptol (Biseptol) were widely used in medical practice.

Bactrim (BACTRIM), Synonym: Biseptol, - Antibacterial preparation of a wide range of action. It consists of sulphate-coxazole and trimethopris. The bactericidal effect is explained by the double blocking effect on the metabolism of bacteria, which is associated with the synthesis of folic acid synthesis.

Bactrim use with infectious and inflammatory diseases of respiratory organs, urinary tract, gastrointestinal diseases, diseases of the skin and soft tissues.

When taking inside the drug is quickly absorbed, reaches the maximum concentration in the blood in 1-4 hours and is saved to 7-8 hours. Assign Bactrim inside 2 tablets in the morning and in the evening after eating. The course of treatment takes from 5 to 14 days depending on the nature of the disease. Treatment is desirable to conduct blood picture control.

Among the side effects at the reception of Bactrim are allergic reactions, nephropathy, some changes from blood, nausea, vomiting, etc.

Release Bactrim (Biseptol) in 480 mg tablets for adults and 120 mg for children. In children's practice, starting from 1.5 months, a preparation is used in the form of a suspension, which is produced in 100 ml bottles.

Sulfaton (Sulfatonum) contains two active substances: sulfamimetoxin and trimethopris, and on the action close to the Bactrim.

Indications for the use of the drug are the infections of the respiratory tract, the urine and biliary tract, the corrosive inflammation, sepsis, meningitis, purulent surgical infection, etc.

Sulfaton is prescribed inside on the first day 2 g in the morning and in the evening (shock dose), and in the following days 1 tablet 2 times a day (supporting dose). The course of treatment is 7-10 days.

Produced sulfaton in tablets at 0.35 g

For local use, sulfonamide products are used as part of Sunoref and Dermazine ointments, a complex drug inhalipte and in the form of eye drops of sulfacyl sodium.

Sulfacyl sodium (Sulfaciylum-Natrium) - a wide antimicrobial effect, effective in coccol and colibacillary infections, purulent eye lesions, conjunctivitis, corneal ulcers and in the treatment of infected wounds. It is well soluble in water, which allows it not only in the form of eye drops, but also for injections.

The widest use of sodium sodium solution has found in ophthalmology, where it is used in 20 and 30% concentration or in the form of 10, 20 and 30% eye ointment. For the prevention of Blennoriya, the newborns are drunk in front of 2 drops of 30% of the solution directly after birth and 2 drops after 2 hours. With purulent eye lesions, sodium sodium solution burst 2 drops to 6 times a day. Inside with diseases of the respiratory organs, the genitourinary system, the drug is prescribed 0.5-1 g at the reception 3-5 times a day. In severe cases, a 30% solution of the drug is introduced into a vein.

Sulphazyl sodium produced in powder, in the form of 20 and 30% solutions in tubes - droppers of 1.5 ml per pack of 2 pieces, 30% solution in bottles of 5 ml and 30% solution in 5 ml ampoules per pack per pack 10 pieces List B.

For the treatment of infectious diseases of the gastrointestinal tract, sulfanyamide products are used, which are poorly absorbed from it, creating a high antimicrobial concentration, leading to the death of causative agents of diseases. These include Sulgin, phthalazole, phthazine, etc.

Sulginum (Sulginum), synonym: Sulfaguanidine, - a short action preparation, after taking inside the main amount is delayed in the intestine, where its effect is manifested.

Sulgin for adults and children are used for all types of bacterial dysentery, colitis, enterocolites and preparation of patients with a fine and thick intestine. With acute intestinal infections, the drug is used according to the scheme: on the first day of 1 -2 g 6 times a day, in the second and third - 5 times, the fourth - 4 times and fifth day 3 times a day. The course of treatment is 5-7 days, and after a short break, if necessary, it can be repeated.

In order to avoid side effects on the side of the kidney during treatment, it is recommended to maintain reinforced diuresis by receiving

• 3 liters of fluid per day, and for the prevention of avitaminosis advise the vitamins of group V.

We produce sulgin in powder and tablets of 0.5 g per pack of 10 pieces.

Familiar people of Sulfanimamides have long established themselves, as they appeared before the history of Penicillin opening. To date, these drugs in pharmacology partially lost their significance, because in efficiency is inferior to modern medicines. However, in the treatment of some pathologies, they are indispensable.

What is sulfonamide drugs

Sulfanilamide (sulfonamidam) includes synthetic antimicrobial drugs that are derivatives of sulfanyl acid (aminobenzenesulfamide). Sulfanimide sodium suppresses the life of the cockfields and sticks, affects knockaddia, malaria, plasmodia, protea, chlamydia, toxoplasm, has a bacteriostatic effect. Sulfanimide drugs are medicines that are prescribed for diseases caused by pathogens, resistant to antibiotics.

Classification of sulfanimide drugs

According to its activity, sulfonamide agents are inferior to antibiotics (not to be confused with sulfonanildes). These drugs have high toxicity, so they have a limited spectrum of indications. The classification of sulfonamide drugs is divided into 4 groups, depending on pharmacokinetics and properties:

1. Sulfanimamides, quickly absorbed from the gastrointestinal tract. They are prescribed in systemic therapy of infections that are caused by sensitive microorganisms: ethasol, sulfadimetoxin, sulfamethisol, sulfadimidine (sulfadimesin), sulfarbamide.
2. Sulfanimamides, not completely or slowly suction. They are created in a thick and small intestine a high concentration: sulgin, phthalazole, phtrugen. Ethazol sodium
3. Local sulfonamides. Well established itself in eye therapy: sulfacyl sodium (albucid, sulfacetamide), silver sulfadiazine (dermazine), acetate mafenide ointment 10%, ointment in strepticide 10%.
4. Salazosulfanimamides. This classification of sulfonamide compounds with salicylic acid: sulfasalazine, saladoxin.

The mechanism of action of sulfonamide drugs

The choice of medication for the treatment of the patient depends on the properties of the pathogen, because the mechanism of action of sulfanimamides is reduced to blocking sensitive microorganisms in folic acid synthesis cells. For this reason, some medicines, for example, novocaine or methomolsin are incompatible with them, as they weaken their action. The key principle of sulfonamide is a violation of the metabolism of microorganisms, the suppression of their reproduction and growth.

Indications for the use of sulfonamide

Depending on the structure, sulfide preparations have a general formula, but unequal pharmacokinetics. There are dosage forms for intravenous administration: Sulfacetamide sodium, streptocid. Some drugs are injected intramuscularly: sulfalen, sulfadoxin. Combined drugs are used by both paths. For children, sulfonamides are used locally or in tablets: co-trimoxazole-rivofarm, Kotrifarm. Indications for the use of sulfonamide:

• folliculitis, vulgar acne, corrosive inflammation;
• impetigo;
• burns 1 and 2 degrees;
• pyodermia, carbuncules, furuncula;
• purulent inflammatory processes on the skin;
• infected wounds of different origin;
• tonsillitis;
• bronchitis;
• eye diseases.

List of sulfonamide drugs

Upon period of circulation, sulfonamide antibiotics are divided into: short, medium, long and superconductance. It is impossible to compile a list of all drugs, therefore, the long-term sulfonamides used to treat many bacteria are presented in this table.

Combined sulfanimide drug

The time in place is not worth it, and many strains of microbes mutated and adapted. Doctors have found a new way to combat bacteria - created a combined sulfonilamide drug, in which antibiotics are combined with trimethoprim. List of such sulfocreparations:

Sulfanimide drugs for children

Since these drugs are medicines of a wide range of action, they are used in pediatrics. Sulfanimide drugs for children are produced in tablets, granules, ointments and injection solutions. Medicine list:

Instructions for the use of sulfonamide

Antibacterial agents are prescribed, both inside and locally. The instructions for the use of sulfanimamides say that children will apply the drug: up to a year of 0.05 g, from 2 to 5 years - 0.3 g, from 6 to 12 years - 0.6 g for the entire reception. Adults take 5-6 times / day at 0.6 -1.2. The duration of treatment depends on the severity of pathology and is appointed by the doctor. According to annotations, the course is not more than 7 days. Any sulfonamide drug should be formed with alkaline fluid and use products that contain sulfur to maintain urine reactions and prevent crystallization.

Side effects of sulfonamide drugs

With long or uncontrolled application, side effects of sulfonamides can be manifested. These are allergic reactions, nausea, dizziness, headaches, vomiting. With systemic absorption, sulfopreparations can pass through the placenta, and then detected in the blood of the fetus, causing toxic effects. For this reason, during pregnancy, the safety of drug use in question. The doctor should take such a chemotherapeutic effect when appointing them to pregnant women and during lactation. Contraindication to the use of sulfanimamides is:

• hypersensitivity to the main component;
• anemia;
• porphyry;
• liver or renal failure;
• pathology of the hematopoietic system;
• azotemia.

Price for sulfonamide preparations

Drugs of this group is not a problem to buy in the online store or in a pharmacy. The difference in the cost will be tangible if you order in the catalog on the Internet several drugs at once. If you buy a medicine in a single version, you will have to additionally pay for delivery. Inexpensive will cost sulfonamides of domestic production, while imported medicines are an order of magnitude more expensive. Approximate price for sulfonamide preparations:

Video: What is sulfonamides

The information presented in the article is familiarized. Article materials do not call for independent treatment. Only a qualified doctor may diagnose and give recommendations on treatment based on the individual characteristics of a particular patient.

Sulfanimiam children instructions

pharmachologic effect Sulfanimamides:

Depending on the chemical structure of sulfonamides, it is characterized by unequal pharmacokinetics. All drugs can be prescribed inside. Sulfonamide preparations used in the infections of the gastrointestinal tract are practically not absorbed, so their kinetic parameters are not considered. By the way, according to the instructions, they prescribe them with multiplicity 4 - 6 times a day.

There are dosage forms of sulfanimamides for intravenous (streptocide, sulfacyl, norsulfazole, ethazol, sulfalent) and intramuscular (streptocid, sulfalen) administration. Preparations combined with trimethoprim can be administered by both paths. Sometimes sulfonamides for children are used locally (eye practice, burns, etc.).

Indications for the use of sulfonamide:

Suction sulfonamide comes from the small intestine, they have a high bioquality (70-90%). The time of the maximum concentration in the blood plasma is 2-4 hours. At the same time, they are 50-90% associated with blood plasma proteins (an exception is streptocid - 12% and sulphacyl - 22%). Moreover, sulfonamide products have a very high affinity for blood proteins, so they can oust other drugs by increasing their free, "working" fraction.

These drugs (especially long-term and superconducting drugs) are well penetrated into the lungs, adenoids and almonds, tissues and liquids of the middle and internal ear, pleural, synovial and ascitic fluid, through a placental barrier and a mother's milk. The cerebrospinal fluid is better than all of sulfanimamides, sulfapyridazine falls, and the sulfadimetoxin is worse. In purulent and necrotic foci, the effectiveness of sulfonamide is significantly lower, as they have a lot of PABK.

Biotransformation of sulfanimamides is carried out at all stages: the epithelium of the gastrointestinal tract, the liver, kidneys. It should be noted that the resulting metabolites do not have antimicrobial activity, but can provoke side effects.

Classification of drug duration

Sulfonamide preparations of short and medium duration of action are subjected to the process of acetylation in the mucous membrane of the gastrointestinal tract, liver and kidneys. At the same time, metabolites are formed, which in an acidic medium crystallized and fall into the sediment, irritating the intestinal mucosa and damaging the epithelium of the kidney channel. To reduce the crystallization of metabolites, these drugs need to be littered with an alkaline drink (5-10 g of sodium bicarbonate per day).

Sulfanimides of long-term and extreme action are exposed to the process of glucuronidation in the liver. These metabolites in the acidic environment are precipitate not falling out, but the distraction of liver enzymes on their formation can disrupt the glucuronidation of other drugs and endogenous substances (for example, bilirubin).

Sulfonamide excretion

The excretion of sulfonilaminamides by a short and medium duration of action in unchanged and in acetylated form is carried out mainly to be renal by glomerular filtration. When the endogenous creatinine clearance is less than 20 ml / min, these drugs cannot be applied.

Preparations of long and superlifting duration in the kidneys are almost completely rebupping. This is the main reason explaining their long-term foundation in the blood plasma. Thus, the period of their semi-elimination from the blood is an average of 36 and 48 hours, while the preparations of the short and medium duration of action on average 8 and 16 h, respectively.

The excretion of long-term and super-valve sulfonamides in the modified and unchanged form is carried out by the liver. Moreover, sulfalen, sulfapyridazine and sulfadimetoxin in a sufficiently large quantity are in bile in active condition. Multiplicity of destination:

• short-acting preparations - 4-6 times a day;
• average action - 3-4 times a day;
• long action - 2 (sometimes 1) times a day;
• experminal action - 1 time per day.

Side effects sulfanimid

Sulfanimide drugs can not be prescribed together with nephrotoxic and hematotoxic drugs, as well as they are not recommended to be introduced together with Novocaine and Novocainamide, since the latter in the body turn into a PABK that comes with them into competitive relations.

Very carefully, it is necessary to use sulfonamides together with the preparations that they displace due to blood plasma proteins.

Side effects of sulfonamide in this case can be quite serious. For example, with indirect anticoagulants (phenylin, neodymary) - danger of bleeding; with methotrexate - the danger of agranulocytosis; With synthetic antidiabetic agents (butamide, glibenklamide, buccarban) - the risk of the occurrence of hypoglycemic coma, etc.

In order to increase the spectrum of action and increase the efficiency of sulfanimamides, it is possible to combine with other bacteriostatic means, and the free fraction of the latter in the blood, as a rule, increases, which in this case should be regarded as a positive phenomenon.

Sulfanimamides in their chemical structure are similar to furosemid, butamide, diakarb, therefore, if the patient reacts poorly to the above-mentioned drugs, then intolerance and sulfonamide means can be expected.

Unwanted effects of sulfonamide for children:

Nephrotoxicity. It can manifest themselves when using short-acting sulfanimides (except Wrosulfan, as it is not exposed to acetylation).

Methemoglobinemia. It occurs more often in newborns and children of the first year of life, since they have special, fetal, hemoglobin and low activity of reducing enzymes (methemoglobinreductase, glutathionereductase, etc.). In this case, the complication decreases the oxygen capacity of the blood (hypoxia, metabolic acidosis occurs). To convert the methemoglobin (ion of trivalent iron) into oxymemoglobin (ion of bivalent iron), reducing substances are prescribed (methylene blue, ascorbic acid and etc.).

Methemoglobinemia and hemolytic anemia can occur in patients with congenital forms of enzymopathy (deficiency of glucose-6-phosphate dehydrogenase), especially with simultaneous reception of sulfanimamides with other drug-oxidant drugs (paracetamol, fenacetin, acetylsalicylic acid, furadonin, fuzolidone, vikasol, butamide, quinidine, and t .P.).

Hyperbilirubinemia. It is observed when using long and superconducting sulfonamides, more often:

• in children of younger age;
• patients suffering from liver diseases;
• patients with insufficiency of uridindiffosphoglucuronic transferase;
• patients receiving other preparations at the same time with sulfanimamides subjected to glucuronidation reactions (for example, Vikasol, a nicotinic acid, Levomycetin, paracetamol, glucocorticoids, estrogens, androgens, triiodothyronine, adrenaline, etc.).

At the same time, the complication arises the danger of the development of bilirubin encephalopathy (convulsions, hypercines, paralysis, a fatal outcome is possible).

"Red Volchanka Syndrome may appear in people with a genetically determined deficiency of acetyltransferase. Clinical manifestations The syndrome is as follows: Headache, nausea, vomiting, tachycardia, rash, fever, flushed cavity, anti-nuclear antibodies are found in the blood. This complication occurs when using sulfonamides exposed to the acetylation process, especially often when using sulfadimezin.

Allergic reactions: urticaria, itching, photosensitization of the skin, rarely - Stevens-Johnson syndrome, Lailel and Lefler.

Neuritis (muscle weakness may occur without loss of sensitivity).

Folic acid deficiency syndrome:

• neutropenia, leukopenia, thrombocytopenia;
• disorders of the gastrointestinal tract (nausea, vomiting, anorexia, diarrhea, stomatitis, etc.);
• hypotrophy;
• violation of spermatogenesis.

This complication group more often cause combined sulfonamide preparations with trimethoprim. These effects of sulfanimamides can be prevented by taking folinium acid (calcium folinate, leivoorin), which is the active form of vitamin V.

Teratogenicity, especially when using preparations with trimethoprim.

Provocation of porphyria - an atypical reaction arising in hereditary metabolic disorders. In patients, the formation of aminolevulene acid and porpobilogen in the liver increases, their concentration in the urine of patients increases. The disease is manifested by the attacks of intestinal colic, polyneuritis, muscle paralims, mental disorders, epileptiform seizures, etc. Sulfanimonds in this case must be canceled.

Sulfanimide drugs list

There are 2 groups of sulfonamide:

I. Sulfanimide drugs used in system infections

By time, they are divided into:

Preparations of short duration of action:

• streptocid;
• sulfacyl (albucid);
• norsulfazol;
• etazol;
• urosulfan;
• sulfadimezin;
• sulfazoxazole;
• sulfanezin (independently not applied, is part of the combined means).

Medium duration of action:

• sulfazine;
• sulfamethoxazole;
• sulfamoksal.

Sulfanimide preparations for children of long-term action:

• sulfapyridazine;
• sulfamimetoxin;
• sulfadimetoxin.

Very-grade preparations:

• sulfalen (Kelfizin, Meglumin);
• sulfadoxin.

Preparations of different duration of action combined with trimethoprim:

• sweating (sulfadimezin + trimethoprim);
• grosptol (sulfiamezine + trimethoprim);
• kotrimoxazole (synonym: Bactrim, Biseptol; consists of sulfamethoxazole + trimethopris);
• lidaprim (sulfamethelol + trimethoprim);
• sulfaton (sulfonimetoxin + trimethoprium).

II. Preparations used in the infections of the gastrointestinal tract:

• sulgin;
• phthalazole;
• phthazin;
• disoulomba;
• preparations Combined with 5-aminosalcyl acid (Salazosulfapyridine, Salazopyridazine, Salazodimetoxin).

Pharmacodynamics sulfanimide

Sulfanimamides in their chemical structure are similar to para-aminobenzoic acid (PABK), which, together with glutamic acid and PERDIDIN, is part of folic acid (vitamin Sun), the role of which is to transfer single-carbon residues going on the formation of nucleic acids and proteins. Some microorganisms for their livelihoods can only use their own, independently synthesized (endogenous) folic acid, such microorganisms are mistaken, including in the structure of folic acid instead of the PABK sulfonylaminide drug, so they are synthesized by defective vitamin B6.

Thus, suulfanimamides are competitive with the PABK mechanism of action. It is necessary to emphasize that folic acid itself works, and its reduced form is a tetrahydrofolya (pholein, folinium) acid; The transformation into an active form occurs under the influence of the enzyme - dihydrofolatreductase. Timetoprix, which is part of some combined drugs, inhibits called enzyme. Therefore, the spectrum of the action of such drugs is greater, as they can affect microorganisms that can use exogenous folic acid for its livelihoods.

Pharmacological effect - bacteriostatic. In preparations combined with trimethoprim, the pharmacological effect is bactericidal. The spectrum of action is wide. Most sulfanimamides affect c. "-" Enterobacteria (Escherichia, some strains of Salmonella, Shigella, Irani, Klebsiella), c. "+" Cockki (except Enterococci and Green Streptococcus) and Nassery.

Sulfapyridazine and sulfonimetoxine additionally has an action on chlamydia, toxoplasm, protea, knockaddia and malaria plasody. Sulfonamide preparations combined with trimethoprim affect the above-mentioned microorganisms, hemophilic chopsticks, aeromonads, legionells, actinomycetes and pneumocists (the latest special microorganisms, for a long time they relate to the simplest, currently talking about their accessories to yeast-like fungi).

Antrima (Antrima)

Pharmachologic effect. Combined sulfonamide drug. Sulfadiazine and trimethopris are rendered bacteriostatic (preventing the reproduction of bacteria) and bactericidal (destroying bacteria) action, in combination their antimicrobial effect is enhanced. The drug is highly sensitive: E.Coli, Klebsiella, Enterobacter, Proteus, Citrobacter, Salmonella, Shigella, Haemophilus, Vibiocholerae, Listeria, Pneu-Mocystiscarinii.

Indications for use. Bacterial infections caused by microorganisms sensitive to the drug, including respiratory infections, urinary tract infections, gastrointestinal infections (especially abdominal typhoid).

Method of use and dose. Before appointing the patient of the drug, it is desirable to determine the sensitivity to it from microflora, which caused the disease in this patient. Adults are prescribed 1 tablet 2 times a day during meals. Children are usually prescribed in the form of a suspension (suspension of solid particles of the drug in liquid) - 1 attached measuring spoon (2.5 ml) per 5 kg of body weight 2 times a day during meals. Maximum daily dose -8 dimensional spoons. Patients with creatinine clearance (the rate of blood purification from the final product of nitrogen exchange - creatinine) from 30 to 15 ml / min The preparation is prescribed only in the case of hemodialysis (blood purification method), 1 time per day.

In case of continuing treatment, the drug requires systematic control of the pattern of peripheral blood, kidney and liver function. In the case of the use of the drug in patients with diabetes It should be borne in mind that 2.5 ml of the preparation contains 1 g of sucrose.

Side effect. Nausea, abdominal pain, thrombotic cytopenia (decrease in blood platelets),

neutropenia (reducing the number of neutrophils in the blood), allergic reactions.

Contraindications. Glucose-6-phosphate dehydrogenase enzyme deficiency in red blood cells (risk of increased hemolysis / destruction of erythrocytes /); Pregnancy, breastfeeding; Increased sensitivity to the components of the drug. The drug is not prescribed to premature and newborn children.

Release form. Tablets containing 0.4 g of Sul-Fadiazine and 0.08 g Trimethopris; Suspension for intake for children (2.5 ml - 0.1 g of sulfadiazine and 0.02 g of trimethopris) in 50 ml bottles.

Storage conditions. List B. in the dry, cool, protected from the light place.

Bispetol (Biseptol)

Synonyms: Bactrim, Septrine, Abacin, Abaktrim, Andoprine, Bacterial, Baktal, Baktifer, Bactrine, Bactraine, Bactrinisol, Berlocide, Hemitrine, Doctonil, Ectapprise, Expenette, Falprin, Gantrin, Infectrim, Metomide, Microcetim, Nolat, PS, Oradin, Oribact, Pleavept, Primazole, Resinm, Septocid, SMETROLIM, TRIMEXAZOL, TRIXZAZOL, ORKSEN, VANADIL, APOSULFATRIN, BACTECOD, BACTROGREDUCH, BACKLEKON, Grosptol, Kotriben, Kotrimol, Eriprim, Wrong, Rancotrim, Sulfatrim, Trimezzol, Expasal, Novotried, Orifim, Synesul, Kotrimaksol, Kotrimaxazol, Sulletrim, Trimosul, etc.

Combined preparation containing two active substances: sulfonamide preparation sulfamethoxazole and DIInopyrimidine derivative - trinometh.

Pharmachologic effect. The combination of these two drugs, each of which has a bacteriostatic (preventing reproduction of bacteria) action provides high bactericidal (destroying

bacteria) Activity with respect to gram-positive and gram-negative microorganisms, including bacteria resistant to sulfanillary drugs.

The bactericidal effect is associated with the double blocking effect of Bactrim on metabolism (metabolism) bacteria. Sulfamethoxazole disrupts the biosynthesis of dihydrofoliic acid, and the trimethoprium blocks the following stage of metabolism - the reduction of the dihydrofolytic acid into the tetrahydrofoliic acid necessary for the development of microorganisms. The selection of sulfamethoxazole as a bundle component is caused by the fact that it has the same elimination rate (elimination rate) with trimethoprim.

The drug is effective in relation to streptococci, staphylococci, pneumococci, chopsticks of dysentery, abdominal typhoid, intestinal sticks, ace; It is ineffective with respect to mycobacterium tuberculosis, spirochete, and cinema stick.

The drug is quickly absorbed when taking inside. The maximum concentration in the blood is observed in 1-3 hours after the reception and is preserved for 7 hours. High concentrations are created in lungs and kidneys. It is distinguished in significant amounts with urine (40-50% of trimethopril and about 60% sulfamethoxazole are released for 24 hours, mainly in acetylated form).

Indications for use. Bispetol is used in respiratory tract infections: acute and chronic bronchitis (inflammation of bronchi), Empiasis of Plevura (Muka cluster between lung shells), bronchiectatic disease (bronchial disease associated with the expansion of their lumen), abscess (affection) of the lung, pneumonia (lung inflammation) ; Urinary tract: urethritis (inflammation ureyeing Canal), cystitis (inflammation bladder), pelitis (inflammation of the renal pelvis), chronic pyelonephritis (inflammation of kidney and renal flavors), prostatitis (inflammation of the prostate gland), gonococcal urethritis. It is also used in the infections of the gastrointestinal tract, surgical infection and other infectious diseases. The drug is also effective in septicemia (the form of blood infection by microorganisms) caused by the bacteria sensitive to the drug. The high efficiency of the drug is established with uncomplicated gonor.

Method of use and dose. Before appointing the patient of the drug, it is desirable to determine the sensitivity to it from microflora, which caused the disease in this patient. Adults and children over 12 years are usually prescribed in a daily dose of 4 tablets (or 2 Forte Tablets, or 8 dimensional spoons of syrup). Minimum daily dose for long-term therapy (more than 14 days) - 2 tablets (or 1 Tablet Forte, or 4 dimensional spoons of syrup). Maximum daily dose (for the treatment of particularly severe cases) -6 tablets (or 3 Forte Tablets, or 12 measuring spoons of syrup). The daily dose is divided into 2 receptions (in the morning and evening). The drug is accepted after eating with a sufficient liquid. For acute infections Treatment with the drug is carried out within 5 days or until the patient within 2 days there will be no symptoms of the infectious disease.

With gonorly, the drug is prescribed within one day in a daily dose of 10 tablets (5 tablets forte, or 20 dimensional sirop beds), divided into 2 receptions (in the morning and evening). With acute uncomplicated urinary tract infections, women are recommended to assign once 2-3 Tablets Forte. It is advisable to take tablets in the evening after eating or before going to bed.

With pneumocystosis (acute form of lung inflammation; there is more often in the weakened children of the first months of life) caused by Pneumocystiscarinii, prescribed in a daily dose of sulfamethoxazole to 0.1 g / kg of body weight and

trimethopril to 0.02 g / kg. Assign every 6 hours. Course treatment is 14 days.

For children under 12, the drug is prescribed in the form of a syrup in the daily dose of sulfamethoxazole 0.03 g and trimethopril 0,006. Syrup is taken 2 times a day (in the morning and evening). With severe infections, the daily dose can be increased by about 50%.

Patients with impaired kidney function dose are determined depending on the value of the clearance of creatinine (blood purification rate from the final product of nitrogen exchange - creatinine). When creatinine clearance, more than 30 ml / min, the dose correction is not required; At 15-30 ml / min, half of the usual dose is used; With creatinine clearance, less than 15 ml / min apply the drug is not recommended. Elderly patients may also require a dose correction.

The drug should be applied under careful medical supervision.

Side effect. Nausea, vomiting, diarrhea (diarrhea), allergic reactions, nephropathy (general name of some kidney diseases) are possible. Leukopenia can develop (decrease in blood leukocytes) and agranulocytosis (a sharp decrease in the number of granulocytes in the blood).

Contraindications. Increased sensitivity To sulfanimamides, diseases of the hematopoietic system, disorders of the liver and kidney function, pregnancy. The drug should not be prescribed to premature children and newborns. Caution should be used by Bactrim in young children. When treating the drug, it is necessary to carefully monitor the picture of the blood.

Release form. Packing pills for 20 pieces. The drug is available in tablets in two dosages: for adults with a content in one tablet 0.4 g (400 mg) of sulfamethoxazole and 0.08 g (80 mg) trimethopril; For children with content in one tablet 100 mg of sulfamethoxazole and 20 mg of trimethopril.

For adults also produced tablets "Bactrim Forte", containing 800 mg of sulfamethoxazole and 160 mg of trimethopril, and for children - syrup, in 1 ml of which contains 40 mg of sulfamethoxazole and 8 mg of trimethopril (white suspension with a yellowish colors in bottles of 100 ml ).

Storage conditions.

Bactrim Suspension (BACTRIM)

Synonyms: Biseptol, septrine, etc.

Pharmachologic effect. Combined drug. The combination of sulfamethoxazole and trimethopril provides high efficacy against gram-positive and gram-negative microorganisms, including those resistant to sulfanilaminamide drugs. Bactrim is quickly absorbed when taking inside. The maximum concentration in the blood is observed after 1-3 hours and is preserved for 7 hours.

Indications for use. Septicemia (form of blood infection by microorganisms), respiratory infections, urinary tract and gastrointestinal tract caused by microorganisms sensitive to the drug and others.

Method of use and dose. Before appointing the patient of the drug, it is desirable to determine the sensitivity to it from microflora, which caused the disease in this patient. Assign inside after meals (in the morning and evening). Doses are set depending on the age of the child: from 6 weeks. up to 5 months - on "/ 2 teaspoons 2 times a day; from 6 months to 5 years - 1 teaspoon 2 times a day; from 5 to 12 years old - 2 teaspoons 2 times a day.

Side effect. Nausea, vomiting, allergic reactions, leukopenia (decrease in blood leukocyte levels) and agranocytosis (a sharp decrease in the number of granulocytes in the blood). Treatment is carried out under blood pattern control.

Contraindications.

Release form. Suspension (syrup) in 100 ml bottles. The composition of the suspension (based on 5 ml) includes the following substances: sulfamethoxazole-3 (POINBENZOLSULFAMIDO) -5-methylisoxazole - 0.2 g; Timetoprix - 2,4-diamino-5- (3,4,5-trimethoxybenzyl) -pyrimidine - 0.04 g.

Storage conditions. List B. In a dry cool dark place.

Lidaprim (Lidaprim)

Pharmachologic effect. Combined preparation containing sulfametrol and trimethopris. The sulfameterol has high antibacterial activity, and in combination with trimethoprim (see Biseptol provides bactericidal (destroying bacteria) Action against gram-positive and gram-negative microorganisms, including bacteria resistant to conventional sulfanilaminamide drugs.

Indications for use. Indications for the use of lidaprim are mainly coincided with the testimony for the use of bispetol.

Lidaprim is effective in the infections of the respiratory tract, ear, throat and the silence of the kidneys and the urinary tract and the gastrointestinal tract, with prostate (inflammation of the prostate gland), gonorrhea, gynecological infectious diseases and other infections caused by the pathogens sensitive to the drug.

Method of use and dose. Before appointing the patient of the drug, it is desirable to determine the sensitivity to it from microflora, which caused the disease in this patient. Adults and children over 12 years old are prescribed the drug inside, starting usually with 2 pills of lidaprim or 1 tablets of Lidaprim Fort 2 times a day (in the morning and evening). Adopted before the disappearance of acute manifestations of infection (at least 5 days); Then 1 tablet or U2 Tablets Lidaprim Forte 2 times a day.

Patients with chronic pyelonephritis (inflammation of kidney and renal loching fabric) and in chronic salmonellacement, 2 tablets of lidaprim or 1 tablet lidaprim are prescribed 2 times a day (on average 3 months).

Gonorly usually appoint once 4 tablets Lidaprim Forte 1 time per day.

With acute infections, it is possible to start with intravenous infusion of the lidaprim solution; Enter slowly 250 ml (1 vial) 2 times a day.

Children under the age of 2 are prescribed by "/ 2 teaspoon of suspension 2 times a day, from 2 to 3 years - 1 teaspoon of suspension or 2 tablets for children 2 times a day; 3-6 years - 1" / 2 teaspoons or 3 tablets for children per day; 6-12 years old - 2 teaspoons or 4 tablets for children 2 times a day.

Side effects and contraindications are the same as Biseptol.

Release form. Lidaprim is available in different dosage forms: a) Lidaprim tablets containing 400 mg of sulfametheraol and 80 mg of trimethopril, in a package of 20 or 100 pieces; b) Lidaprim's Tablets, coated with a shell containing 800 mg of sulfametrolol and 160 mg of trimethopril, in the package of 10; 25 or 50 pieces; c) pills lidaprim for children containing 100 mg of sulfameter and 20 mg of trimethopril, in the package of 20 pieces; d) suspension of lidaprim (for children) containing in 5 ml (1 teaspoon) of 200 mg of sulfamemarol and 40 mg of trimethopril, in vials of 50 and 100 ml; e) a solution for injection (infusion) in 250 ml glass bottles, containing 800 mg of sulfametrol and 160 mg of trimethod.

Storage conditions.

Maphenidum

Synonyms: Ambamide, Bandsulfamidin, Homosulfamidin, Sulfamilon, Mafenide Acetate, etc.

Sulfanimide antibacterial drug for outdoor use. Produced in the form of acetate mafenide.

Pharmachologic effect. Mafenide Acetate has a wide range of action, effective in terms of gram-positive and gram-negative bacteria and pathogenic (pathogenic) anaerobes (microorganisms capable of exist in the absence of oxygen), gas goggle pathogens. Not inactivated by para-aminobenzoic acid and does not change activity in an acidic environment.

Indications for use. It is used for the treatment of infected burns, purulent wounds, bedding (samples of tissues caused by prolonged pressure on them due to lying), trophic ulcers (slowly healing skin defects).

Method of use and dose. Before appointing the patient of the drug, it is desirable to determine the sensitivity to it from microflora, which caused the disease in this patient. The ointment (10%) is applied directly to the affected surface, tampons impregnated with ointments are introduced into the cavity, napkins are also imposed on the wipes, lubricated with a layer of 2-3 mm. Usually, 30-70 g of ointment is consumed on one dressing. Before applying the bandage, the wound is purified from purulent-necrotic masses (inflamed necrotic / dead / tissues). The shift of the dressings produce daily or 2-3 times a week depending on the amount of purulent discharge. The duration of treatment from 1 to 4-5 weeks.

When burns, there is a single dressing bandage.

Side effect. When applying ointments on a burn or wound surface, there may be a burning, pain that are from "/ 2 to 1-3 h; strong pain Analgesics are prescribed (painkillers).

Contraindications. The use of ointments is contraindicated in the presence of a history of data on toxic-allergic reactions to sulfanilaminamide drugs.

Release form. 10% ointment in the cannons of light glass 50 g and 2 kg.

Storage conditions.

Algimaf (Algimafum)

Lyophilized gel (ferrous dosage form, dehydrated due to freezing in vacuo) sodium-calcium alginic acid salt with a content of mafenide and other substances.

Pharmachologic effect. Exhibits an adsorbing (absorbing) and antimicrobial activity, purifies wounds, promotes the regeneration (restoration) of tissues.

Indications for use. Applied with surface burns 2 and 3 degrees, do not spend heavy ulcers and wounds.

Method of use and dose. Apply to the affected surfaces (after processing) the plate of the appropriate size. Fixed with a gauze bandage or bandage. It can be left in the wound until the end of the epithelization (rehabilitation of the skin surface or mucous).

Side effect. The passage of burning sensation.

Release form. Sterile porous sheets ranging from 50x50 to 135x250 mm and a thickness of 10mm in packets,

Storage conditions. List B. In the dry, protected from light, not engaging bags and protect them from mechanical damage.

Norsulfazol (Norsulfazolum)

Synonyms: Sulfatiazole, amidothiazole, aseptosyl, azoseptal, tombazole, eleudron, poluspetyl, pirisulfon, thiazamide, etc.

Pharmachologic effect. Sulfanimide drug. Effective in infections caused by hemolytic streptococcus, pneumococcal, gonococcus, staphylococcus, as well as intestinal wand.

Indications for use. Pneumonia (inflammation of the lungs), cerebral meningitis (purulent inflammation of brain shells), gonorrhea, staphylococcal and streptococcal sepsis (blood infection by microbes / streptococci / focus of purulent inflammation), dysentery, etc.

Method of use and dose. Before appointing the patient of the drug, it is desirable to determine the sensitivity to it from microflora, which caused the disease in this patient. Take inside. With pneumonia and meningitis on the first reception 2 g, then 1 g every 4-6 g (term dose 20-30 g); In staphylococcal infections on the first reception 3-4 g, then 1 g 4 times a day for 3-6 days. In the treatment of dysentery of 6-4-3 g per day according to a special scheme.

Children Norsulfazole are prescribed every 4-6-8 hours in the following one-time doses: aged 4 months. up to 2 years - 0.1-0.25 g, from 2 to 5 years - 0.3-0.4 g, from 6 to 12 years - 0.4-0.5 g. Double dose.

Side effect. Disps (digestion dispersion), allergic reactions, leukopenia (decrease in blood leukocytes), neuritis (inflammation of the nerve), violation of the kidney function (crystalluria - the presence of salts crystals in the urine).

Contraindications. Increased sensitivity to sulfanilamide drugs.

Release form. Powder; Tablets in packs of 10 pieces of 0.25 g and 0.5 g with risk.

Storage conditions. List B. in a dry, light-protected place.

Norsulfazol is also part of the drugs inhalipt, Sunoref ointment.

Norsulfazolum-Natrium (Norsulfazolum-Natrium)

Synonyms: Soulphatiazole sodium, sodium sulfatiazole, Nisulfazol soluble.

Sodium salt of Nisulfazole.

Indications for use. The same as for Nurphazole. In addition, with infectious diseases of the eyes.

Method of use and dose. Before appointing the patient of the drug, it is desirable to determine the sensitivity to it from microflora, which caused the disease in this patient. Intravenously introduced in cases if the possibility of administering noselliphazole in the stomach (for example, after surgery on the gastrointestinal tract, during vomiting and the unconscious state of the patient) and if it is necessary to quickly create a high concentration of the drug in the blood. As soon as the patient's condition allows, transfers to the drug intake.

5% or 10% solution are introduced into the vein; Prescribed at the rate of 0.5-1.0-2.0 g per infusion (10-20 ml of 5% or 10% solution; pour slowly). It is advisable to additionally dissolve the solutions of the norsulfazol soluble in a 5% solution of glucose or in isotonic sodium chloride solution. When using concentrated solutions, it is necessary to take into account the possibility of the appearance of phlebitis (inflammation of veins) at the injection site. Subcutaneously and intramuscularly solutions are not prescribed, as they can cause tissue irritation up to necrosis (tissue homation).

It is also used in the form of eye drops (10% solution of 2 drops 3-4 times a day) in conjunctivitis (inflammation of the outer shell of the eye), blefarites (inflammation of the edges of the age) and other infectious diseases of the eyes. You can take inside.

Higher doses for adults inside: one-time - 2 g, daily - 7g.

Side effects and contraindications. The same as for Nisulfazole.

Release form. Powder.

Storage conditions. List B. in a dry, light-protected place.

Salazodimethoxin (Salazodimethoxintun)

Pharmachologic effect. Sulfanimide prolonged (long) action. -Like salausopyridazine drug decomposes in the intestine, with 5-aminoalcyl acid and sulfadimetoxin, which have anti-inflammatory and antibacterial action. The drug is small toxic.

Indications for use. Non-specific ulcerative colitis (chronic inflammation of the colon with the formation of ulcers caused by obscure causes) in the active stage mainly with light and medium-free forms of the disease, poor tolerability or inefficiency of salasopyridazine.

Method of use and dose. Prescribed inside (after meals) in about the same doses and for the same period as Salazopyridazine. Usually give adults 0.5 g 4 times a day (1 g 2 times a day) for 3-4 weeks, and then (if during this period the therapeutic effect occurs) 0.5 g 2-3 times in Day for the next 2-3 weeks. In severe forms of the disease, the daily dose increases in the first days to 4 g, and after reducing the frequency of the chair, the dose is reduced. With light shapes of the disease, it is possible to start with a dose of 1.5 g per day, and in the absence of the effect, go to 2 g per day.

Children aged 3 to 5 years old in the first 7-14 days are prescribed 0.5 g per day, in the next 2 weeks. -Inu 0.25 g per day, on the other days (until the 40th - 50th day from the beginning of treatment) - at 0.125 g per day; Children from 5 to 7 years - respectively, 0.8-1.0 g; 0.4-0.5 g and 0.2-0.25 g; from 7 to 15 years - 1.0-1.5 g; 0.5-0.75 g and 0.25-0,375. Daily doses are given in 2-3 receptions.

If during the first 14 days from the start of treatment, it is not possible to obtain the therapeutic effect, the salazodimetoxin is canceled; You can go to the use of salazopyridazine or salazosulfapyridine.

To prevent recurrences (re-appearance of signs of the disease) of non-specific ulcerative colitis and disease Crown (diseases of the unclear cause characterized by inflammation and narrowing of the lumen of individual intestinal departments) Salazodimetoxin is prescribed for a long time in gradually decreasing doses: adults 0.5 g 1-2 times a day daily For 2-6 months, then 0.25-0.5 g daily or every other day for 6-12 months. Children are prescribed to smaller

doses, taking into account age and doses used in the acute period of the disease. In case of deterioration of well-being, the dose of salazodimetoxin increases,

Side effect. Allergic reactions, leukopenia (decrease in blood leukocytes), dyspeptic disorders (digestion disorders).

Contraindications. Increased sensitivity to sulfanimamides.

Release form.

Storage conditions. List B. in light-protected place.

Salazopyridazin (Salazopyridazinum)

Synonyms: Salazodine.

Pharmachologic effect. Sulfanillary drug. It has anti-inflammatory and immunosuppressive (overwhelming protective forces of the body) action.

Indications for use. Nonspecific ulcerative colitis (chronic inflammation of the colon with the formation of an ulcers caused by obscure causes), as well as in diseases occurring with autoimmune disorders (violations, based on allergic reactions to their own tissues or the products of the body's livelihoods), including as a basic Tools in therapy rheumatoid arthritis (infectious allergic disease from a group of collagenosis, characterized by chronic progressive inflammation of the joints).

Method of use and dose. In nonspecific ulcerative colitis, a salazopyridazine is prescribed inside (after meals) in tablets of 0.5 g 4 times a day for 3-4 weeks. If during this period the therapeutic effect is manifested, the daily dose is reduced to 1.0-1.5 g (0.5 g 2-3 times a day) and the treatment continues for another 2-3 weeks. In the absence of the effect, the drug is stopped. Patient S. light shapes Diseases prescribe the drug first in a daily dose of 1.5 g, and in the absence of effect, the dose is increased to 2 g per day.

Children aged from 3 to 5 years old, salazopyridazine is prescribed, starting with a dose of 0.5 g per day (2-3 receptions). In the absence of effect for 2 weeks. The drug is canceled, and at. The presence of the therapeutic effect continues treatment in this dose for 5-7 dere, then the dose is reduced by 2 times and continue treatment for another 2 weeks. In the case of clinical remission (temporary weakening or disappearance of manifestations of the disease), the daily dose is again reduced by half and assign it to the 40-50th day, counting from the beginning of treatment.

Children aged 5 to 7 years old are prescribed, starting from 0.75-1.0 g per day; From 7 to 15 years old - with a dose of 1.0-1.2-1.5 g per day. Treatment and reduction of doses are carried out by the same scheme as in children from 3 to 5 years.

The use of salazopyridazine is combined with general treatment methods and a diet recommended for non-specific ulcerative colitis.

Salazopyridazine can also be used in non-specific ulcerative colitis and crown disease (diseases of the unclear cause characterized by inflammation and narrowing of the lumen of certain intestinal departments) rectally (in the rectum) in the form of suspensions (suspension of solid particles in liquid) and candles.

Salazopyridazine suspension is used for rectal administration during the damage to the straight and sieve, in the preoperative period and after the subtogonic colostomy (after removal of a part of the colon), with poor tolerability of the drug in the form of tablets. Suspension is slightly heated and administered in the form of an enema in the rectum or in the culture of the intestine of 20-40 ml

1-2 times a day. Children introduce 10-20 ml (depending on age). Rectal administration can be combined with the drug intake.

Candles apply rectally. IN acute stage Diseases are prescribed 1 candle 2-4 times a day for 2 weeks. up to 3 months The duration of the course depends on the effectiveness of the treatment and tolerance of the drug. Maximum daily dose - 4 candles (2 g). At the same time, salazopyridazine can be taken in tablets (not exceeding the total daily dose of 3 g) and other means for the treatment of non-specific ulcerative colitis.

In order to prevent relapses (re-appearing of the symptoms of the disease), 1-2 candles per day are prescribed for 2-3 months.

Doses and preparation scheme with other forms of colitis with ulceal lesions are the same as in non-specific ulcerative colitis.

Side effect. When taking salazopyridazine tablets, the same adverse reactions are possible inside that when using sulfonamides and salicylates: allergic phenomena, leukopenia (decrease in blood leukocytes), dyspeptic disorders (digestive disorders), sometimes a minor reduction in hemoglobin levels (the functional structure of the erythrocyte providing its interaction with oxygen). In such cases, a dose or cancel the drug should be reduced. After the introduction of the suspension, a feeling of burning in the rectum and the cisup of defecation (intestinal emptying) may appear, especially with rapid administration. When using salazopyridazine in candles, there is a feeling of burning and pain in the rectum, sometimes the participation of the chair. In the case of pronounced pain in the rectal administration of salazopyridazine in Candle, it is recommended to prescribe a drug rectally in the form of a 5% suspension and inside in tablets.

Contraindications. The drug is contraindicated in the presence (history of the disease) of data on toxic-allergic reactions in the treatment of sulfanimide and salicylate.

Forms of release. Tablets of 0.5 g per pack of 50 pieces; 5% suspension in 250 ml bottles, containing salasopyridazine, twin-80, alcohol, benzyl and alcohol, polyvinyl (preparation after stigma is a suspension of orange color, which then settles); Candles (brown) 0.5 g per pack of 10 pieces.

Storage conditions. List of B. in the light-protected place at room temperature.

Salazosulfapyridin (Salazosulfapyridinum)

Synonyms: Sulfasalazine, Azropin, Azufidine, Salazopyridine, Salazopyrin, Salicylazosulfapyridine, Salisulf.

Pharmachologic effect. The drug has an antibacterial effect against diplococci, streptococcal, gonococcal, intestinal sticks. The feature of the drug is that it has a pronounced therapeutic effect In patients with nonspecific ulcerative colitis (chronic inflammation of the colon with the formation of ulcers caused by obscure causes). The mechanism of this action is not fully studied. A certain role plays the ability of the drug to accumulate in the connective tissue (including in the bowel tissue) and gradually separate 5-aminosalcyl acid and sulfapyridine with anti-inflammatory and antibacterial properties.

Indications for use. Nonspecific ulcerative colitis, rheumatoid arthritis (infectious-allergic disease from a group of collagenosis, characterized by chronic progressive inflammation of the joints).

Method of use and dose. Before appointing the patient of the drug, it is desirable to determine the sensitivity to it from microflora, which caused the disease in this patient. Prescribed inside. It is recommended in the 1st day with adults 1 tablet (0.5 g) phrase per day (with equal intervals), on the 2nd day - 2 tablets 4 times and in the following days in the case of good tolerability of the drug - 3-4 Tablets 4 times a day. After the element of clinical symptoms of the disease, supporting doses are prescribed (1.5-2.0 g per day) for several months.

Salazosulfapyridine children are prescribed in smaller doses: at the age of 5-7 years - by! / 2-1 tablets (0.25-0.5 g) 3-6 times a day, over 7 years old - 1 tablet (0.5 g ) 3-6 times a day.

Salazosulfapyridine is also effective in the light and moderate forms of crown disease (diseases of the unclear cause characterized by inflammation and narrowing of the lumen of individual intestinal departments)

Salazosulfapyridine is also used as a base agent in the treatment of rheumatoid arthritis due to the presence of immunocorrorizing properties (restoring immunity / protective forces of the body /). Assign 2-3 g per day (40 mg / kg per day) for 2-6 months.

Treatment is carried out under careful medical supervision; It is necessary to systematically control the picture of the blood.

Side effect. Nausea may occur, vomiting, headache, dizziness. In such cases, the drug is canceled, and after 2 days gradually, within 3 days, again increase the dose. Allergic reactions in the form skin rashes, medicinal fever (sharp rise in body temperature in response to the reception of the drug); leukopenia (decrease in blood leukocytes). In these cases, the use of the drug should be discontinued. The drug is distinguished with urine and with an alkaline reaction stains it in yellow-orange color.

Contraindications. Pronounced toxic-allergic reactions in history (formerly earlier) on sulfanimamides.

Release form. Tablets of 0.5 g per pack of 50 pieces.

Storage conditions. List B. in a dry, light-protected place.

Streptocidum (Streptocidum)

Synonyms: Sulfanimide, streptocid white, ambeseid, deptutal, dipon, pronalin, nortaline, Pratnoin, ripped white, streptamine, streptozol, sulfamidyl, etc.

Pharmachologic effect. Sulfanil. Amid drug. It has antimicrobial effect in relation to streptococci, meningococci., Gonocons, pneumococci, intestinal sticks and some other bacteria.

Indications for use. Rigorous inflammation, angina, epidemic cerebripnyal me Ningitis (purulent inflammation of brain shells), cystitis (bladder inflammation), pelitis (inflammation of the kidney pellets), colitis (colon inflammation :), wound infection.

Method of use and dose. Before the interconnection of the drug, it is desirable to determine the accuracy of microflora to him, which caused the diseased patients. Inside 0.5-1 g 5-6 times a day. Children dose

reduce age respectively. Higher doses for adults inside: one-time - 2 g, daily - 7g.

Locally injected into a wound 5-15 g of sterile powder; externally in the form of a 5% liniment or 10% ointment.

Side effect. Headache, dizziness, nausea, vomiting, cyanosis (skinning of the skin and mucous membranes), allergic reactions, leukopenia (decrease in blood leukocytes), agranulocytosis (sharp decrease in the number of granulocytes in the blood), paresthesia (sense of numbness in the limbs), tachycardia (rapid heartbeat ).

Contraindications. Diseasement of the hematopoietic system, kidneys, Basnedov disease (thyroid disease), increased sensitivity to sulfonamide.

Release form. Powder; Tablets in the package of 10 pieces of 0.3 g and 0.5 g; 5% liniment in packing 50 g; 10% ointment in package for 30 g

Storage conditions. List B. in a dry, light-protected place.

Strepsid Liniment 5% (LinimentUstreptocidi5%)

Indications for use. To accelerate the healing of infected wounds, burns II sighuping, boils (purulent inflammation of the leather hair bag, spreading to the surrounding tissues), carbuncles (acute spilled purulent-necrotic inflammation of several silent glands and hair luckers), with surface piderms (purulent skin inflammation) , vulgar acne, impetigo (surface inflammation of the skin, characterized by the occurrence of ulcers drying with the formation of crusts) and other purulent-inflammatory skin diseases.

Method of use and dose. Before appointing a patient of the drug, it is desirable to determine the sensitivity to it by microflora, which caused the disease in this patient, the line is applied to the lesion focus (under the gauze bandage) 1-2 times a day.

Side effects and contraindications are the same as for strepticide.

Release form. In tubes or glass jars for 30 g

Storage conditions. In a dry, cooler place; Banks - in the place protected from light.

"Sunoref" ointment (Unguentum "sunoreph")

Indications for use. Acute and chronic rhinitis (inflammation of the nasal mucosa).

Method of use and dose. Locally (lubricated the mucous membranes of the nose).

Side effect. Allergic reactions are possible.

Contraindications. Increased sensitivity to sulfanilamide drugs.

Release form. Ointment composition: streptocide - 5 g, Nisulfazole - 5 g, sulfadimezine - 5 g, Ephedrine of hydrochloride - 1 g, camphor - 3 g, eucalyptus oil - 5 drops, ointment base - 100 g, in the package for 15 g.

Storage conditions. In a cool place.

Streptocid is also part of the drug Oskarcid.

Streptocid soluble (StreptocidumSolubile)

Pharmachologic effect. Sulfanimide drug. (See streptocid).

Indications for use. Epidemic, cerebrospinal Menin Git (purulent inflammation of brain shells), corrosive inflammation, angina, cystitis (bladder inflammation), pelitis (inflammation of the renal loch), colitis (colon inflammation), wound infection. The purpose of the drug is especially shown in vomiting or unconscious of the patient.

Method of use and dose. Before appointing the patient of the drug, it is desirable to determine the sensitivity to it from microflora, which caused the disease in this patient. Subcutaneously, intramuscularly up to 100 ml of 1-1.5% solution 2-3 times a day; intravenously up to 20-30 ml of 2%, 5% or 10% solution.

Side effects and contraindications are the same,. This is for strepticide.

Release form. Powder.

Storage conditions. List B. in a dry, light-protected place.

Streptocid soluble is also part of the drug inhalipt.

Sulginum (Sulginum)

Synonyms: Sulfaguanidine, Abiguanil, Aseptiguamidin, Ganidan, Guamid, Guaitille, Guausept, Neosulfonamide, Resulfon, Sulfaguanisan, etc.

Pharmachologic effect. Sulfanimide drug. Sulgin is very slowly absorbed. The main amount of the drug is taken inside, is delayed in the intestine and stands out with the feces. Is an effective tool For treatment intestinal infections. According to the action, it is similar to phthalazol.

Indications for use. Bacterial dysentery, colitis (colon inflammation) and enterocolitis (inflammation of thin and colon) with diarrhea, Schigell carriage and abdominal chopsticks, preparation for the intestine operation.

Method of use and dose. Inside 1-2 g 6-5-4-3 times a day (on the first day - 6 times; in 2 and 3 - 5; at 4 - 4, and at 5 - 3 times a day).

Children up to 3 years old - 0.2 g / kg per day in 3 receptions within 7 days; Children over 3 years old - 0.4-0.75 g (depending on age) 4 times a day.

For the prevention of postoperative complications on the intestines of 0.05 g / kg every 8 hours within 5 days before the operation and 7 days after the operation.

Higher doses for adults inside: one-time 2 g, daily 7 g

Side effect. Nausea, vomiting, crystalluria (the presence of crystals of salts in the urine) is possible.

Contraindications. Increased sensitivity to sulfanimamides, impaired kidney function.

Release form.

Storage conditions. List B. In the dry, stitching place.

Sulfadimezinum (Sulfadimezinum)

Synonyms: Sulfadimidine, diazyl, diazole, dimethazyl, dimethyl deceived, dimethyl sulfadiazine, dimethyl sulfapyrimidine, primazine, sulpha phasezine, sulfamethazine, sulfamezath, sulfamezatin, sulmet, sulfadimethyl-pyrimidine, supersptil.

Pharmachologic effect. Sulfanimide drug. Active in relation to pneumococci, meningococci, streptococci, gonococcal, intestinal sticks and some other microorganisms.

Method of use and dose. Before appointing a patient of the drug it is desirable to determine sensitivity

it has microflora, which caused the disease in this patient. Inside 1 g 4-6 times a day. With pneumonia and meningitis, 2 g are prescribed on the first reception; Children at the rate of 0.1 g / kg per first reception, then 0.25 g / kg every 4, 6, 8 hours. Higher doses for adults inside: one-time 2 g, daily 7 g.

For the treatment of dysentery adults in the 1st day - 1 g 6 times; in the 3-4th day - 1 g 4 times; In the 5-6th day - 1 g 3 times a day. Course dose -25-30 g. After 5-6 days of the break to repeat the course of treatment within 5 days, a term dose of 21 g of the drug. With dysentery for children up to 3 years old - 0.2 g / kg per day in 4 receptions within 7 days; Children over 3 years old - 0.4-0.75 g (depending on age) 4 times a day.

Side effect. Nausea, vomiting, allergic reactions, leukopenia (decrease in blood leukocyte levels), agranulocytosis (sharp decrease in the number of granulocytes in the blood), crystalluria (the presence of salt crystals in the urine).

Contraindications. Increased sensitivity to sulfanimamides, diseases of the hematopoietic system, violation of the kidney function.

Release form. Powder; Tablets of 0.5 g per pack of 10 pieces.

Storage conditions. List B. In the place stacked from light.