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    Trimethoprim Sulfamethoxazole (TMP SMZ) Co Trimoxazole

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    Renmico Aquino
    Trimethoprim-sulfamethoxazole (TMP-SMZ) is a fixed combination of sulfamethoxazole and trimethoprim, which are synthetic folate antagonist antiinfectives that work by inhibiting bacterial synthesis of essential nucleic acids and proteins. It is indicated for systemic infections, pneumocystis carinii pneumonitis, shigellosis enteritis, UTIs, acute otitis media, and acute episodes of chronic bronchitis. Potential adverse effects include skin rashes, gastrointestinal issues, hematologic effects like agranulocytosis, and renal impairment.

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    Trimethoprim Sulfamethoxazole (TMP SMZ) Co Trimoxazole

    Uploaded by

    Renmico Aquino
    2K views1 page
    Trimethoprim-sulfamethoxazole (TMP-SMZ) is a fixed combination of sulfamethoxazole and trimethoprim, which are synthetic folate antagonist antiinfectives that work by inhibiting bacterial synthesis of essential nucleic acids and proteins. It is indicated for systemic infections, pneumocystis carinii pneumonitis, shigellosis enteritis, UTIs, acute otitis media, and acute episodes of chronic bronchitis. Potential adverse effects include skin rashes, gastrointestinal issues, hematologic effects like agranulocytosis, and renal impairment.

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    Trimethoprim Sulfamethoxazole (Tmp Smz) Co Trimoxazole

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    Trimethoprim-sulfamethoxazole (TMP-SMZ) is a fixed combination of sulfamethoxazole and trimethoprim, which are synthetic folate antagonist antiinfectives that work by inhibiting bacterial synthesis of essential nucleic acids and proteins. It is indicated for systemic infections, pneumocystis carinii pneumonitis, shigellosis enteritis, UTIs, acute otitis media, and acute episodes of chronic bronchitis. Potential adverse effects include skin rashes, gastrointestinal issues, hematologic effects like agranulocytosis, and renal impairment.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as DOC, PDF, TXT or read online from Scribd
    Download as doc, pdf, or txt
    2K views1 page

    Trimethoprim Sulfamethoxazole (TMP SMZ) Co Trimoxazole

    Uploaded by

    Renmico Aquino
    Trimethoprim-sulfamethoxazole (TMP-SMZ) is a fixed combination of sulfamethoxazole and trimethoprim, which are synthetic folate antagonist antiinfectives that work by inhibiting bacterial synthesis of essential nucleic acids and proteins. It is indicated for systemic infections, pneumocystis carinii pneumonitis, shigellosis enteritis, UTIs, acute otitis media, and acute episodes of chronic bronchitis. Potential adverse effects include skin rashes, gastrointestinal issues, hematologic effects like agranulocytosis, and renal impairment.

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    Drug Name

    Dosage & Route

    Action Fixed combination of sulfamethoxazole (SMZ), an intermediate acting antiinfective sulfonamide, and trimethoprim (TMP), a synthetic antiinfective. Both components of the combination are synthetic folate antagonist antiinfectives. Mechanism of action is principally enzyme inhibition, which prevents bacterial synthesis of essential nucleic acids and proteins.

    Indication

    Adverse Effects

    Contraindication

    Nursing Responsibility

    TRIMETHOPRIMSULFAMETHOXAZOLE (TMP-SMZ) (tri-meth'o-prim-sul-fameth'ox-a-zole) Bactrim, Co-Trimoxazole, Septra Classifications: antiinfective; urinary tract agent; sulfonamide

    Systemic Infections Adult: PO 160 mg TMP/800 mg SMZ (1 double strength [DS] tablet) q12h IV 810 mg/kg/d TMP divided q612h infused over 6090 min Child: PO >2 mo & <40 kg, 4 mg/kg/d TMP q12h; >40 kg, 160 mg TMP/800 mg SMZ (1 DS tablet) q12h IV >2 mo, 810 mg/kg/d TMP divided q612h infused over 6090 min Pneumocystis carinii Pneumonia Adult: IV 20 mg/kg/d TMP divided q6h infused over 6090 min Prophylaxis for Pneumocystis carinii Pneumonia Adult: PO 160 mg TMP/800 mg SMZ q24h Child: PO 150 mg/m2 TMP/750 mg/m2 SMZ b.i.d. 3 consecutive d/wk (max: 320 mg TMP/d) Renal Impairment Clcr 1030 mL/min: reduce dose by 50%; <10 mL/min: reduce dose by 75%

    Pneumocystis carinii pneumonitis, Shigellosis enteritis, and severe complicated UTIs due to most strains of the Enterobacteriaceae. Also children with acute otitis media due to susceptible strains of Haemophilus influenzae, and acute episodes of chronic bronchitis in adults.

    Skin: Mild to moderate rashes (including fixed drug eruptions), toxic epidermal necrolysis. GI: Nausea, vomiting, diarrhea, anorexia, hepatitis, pseudomembranous enterocolitis, stomatitis, glossitis, abdominal pain. Urogenital: Kidney failure, oliguria, anuria, crystalluria. Hematologic: Agranulocytosis (rare), aplastic anemia (rare), megaloblastic anemia, hypoprothrombinemia, thrombocytopenia (rare). Body as a Whole: Weakness, arthralgia, myalgia, photosensitivity, allergic myocarditis.

    Hypersensitivity to TMP, SMZ, sulfonamides, or bisulfites; group A betahemolytic streptococcal pharyngitis; megaloblastic anemia due to folate deficiency; creatinine clearance <15 mL/min; pregnancy (category C), lactation. Not recommended for infants <2 mo.

    NURSING IMPLICATIONS Assessment & Drug Effects

    Be aware that IV Septra contains sodium metabisulfite, which produces allergictype reactions in susceptible patients: Hives, itching, wheezing, anaphylaxis. Susceptibility (low in general population) is seen most frequently in asthmatics or atopic nonasthmatic persons. Lab tests: Baseline and followup urinalysis; CBC with differential, platelet count, BUN and creatinine clearance with prolonged therapy. Monitor coagulation tests and prothrombin times in patient also receiving warfarin. Change in warfarin dosage may be indicated. Monitor I&O volume and pattern. Report significant changes to forestall renal calculi formation. Also report failure of treatment (i.e., continued UTI symptoms). Older adult patients are at risk for severe adverse reactions, especially if liver or kidney function is compromised or if certain other drugs are given. Most frequently observed: Thrombocytopenia (with concurrent thiazide diuretics); severe decrease in platelets (with or without purpura); bone marrow suppression; severe skin reactions. Be alert for overdose symptoms (no extensive experience has been reported): Nausea, vomiting, anorexia, headache, dizziness, mental depression, confusion, and bone marrow depression.

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