The sulfanilamides, familiar to everyone, have proven themselves since ancient times, because they were discovered even before the appearance of penicillin. At present, these drugs in medical activities have somewhat lost their value, since they have been replaced by more effective modern medicines. However, for the treatment of certain diseases they are still indispensable.
What are sulfonamides?
Sulfanilamides are antimicrobial drugs manufactured using modern technology and related to sulfanilic acid derivatives.
An antibiotic of this short-acting series is streptocide. He is one of the first representatives of this group of antibacterial agents. It has a wide spectrum of action. The drug is synthesized in the form of a white crystalline powder, odorless and tasteless, the aftertaste is sweet.
The antibiotic can also be found in the form of sodium sulfanilamide, a white powder readily soluble in water. Also available in tablet form. Sodium sulfanilamide is able to inhibit the vital functions of rods and cocci, affect malaria, protea, nocardia, plasmodia, toxoplasma, chlamydia, and has a bacteriostatic effect. Sulfanilamide drugs are used to treat diseases caused by pathogens resistant to antibacterial drugs.
Classification of sulfonamides
Sulfanilamides are medicines that are inferior to modern antibacterial drugs in their activity. They are highly toxic, which means that their range of indications is very limited. Sulfanilamide preparations, depending on their properties and pharmacokinetics, are classified into 4 groups:
- Sulfanilamide preparations that are quickly and easily absorbed from the gastrointestinal tract. They are used for systemic antibacterial therapy of infectious diseases caused by microorganisms sensitive to sulfanilamides: Sulfadimethoxin, Etazol, Sulfadimizin, Sulfacarbamide, Sulfamethizole.
- Sulfanilamides, which are slowly and not completely absorbed from the gastrointestinal tract, while creating a high concentration in the small and large intestines: Ftazin, Sulgin, Etazol-sodium, Phthalazole.
- Sulfanilamides, which are applied superficially or externally to obtain a local effect. Sulfacyl sodium (Sulfacetamide, Albutsid), silver sulfadiazine (Dermazin), Streptocid ointment 10%, Mafenida acetate ointment 10% have proven themselves to be excellent in treating eye diseases.
- Salazosulfanilamides, which are nitrogen compounds of sulfanilamides and salicylic acid: Salazomethoxin, Sulfasalazine. The list of sulfanilamide preparations is quite extensive.
The main mechanisms of action
The choice of a drug for the treatment of the patient is determined by the properties of the pathogen, because the main mechanism of action of sulfonamides is to inhibit sensitive microorganisms in cells synthesizing folic acid. It is precisely because of this that some medicines, for example, Methionomix or Novacon, cannot be combined with them, because they can weaken the effect of sulfonamides. The key action is the metabolic disorder of microorganisms, as well as the blocking of their growth and reproduction.
Release Forms
All sulfanilamide preparations have the same formula, but different pharmacokinetics depending on the structure. There are release forms in the form of a solution for intravenous administration: “Streptocid”, “Sodium sulfacetamide”. Some are intended for intramuscular administration: “Sulfadoxine”, “Sulfalen”. Combined dosage forms of sulfonamides can be administered in both ways. Children are prescribed sulfanilamide topical preparations or in the form of tablets: “Cotrifarm”, “Co-trimoxazole-Rivofarm”.
Indications
The main indications for the use of the sulfonamide group are:
- acne (acne vulgaris), inflammation of the hair follicle, erysipelas;
- burns of I and II degree;
- streptococcal impetigo ;
- pyoderma, boils, carbuncles;
- infected wounds of various nature;
- purulent-inflammatory skin diseases;
- tonsillitis;
- eye diseases;
- bronchitis.
List of sulfonamide drugs
Sulfanilamides are drugs that, depending on the period of circulation, are divided into drugs: quick, medium, long (long) and extra long. It is very difficult to make a list of all the drugs in this group, so below we will give a table with sulfanilamides only long-acting:
- Argadine is the main active substance: silver sulfadiazine. Indications for use are superficial infected burns and wounds, skin grafts, abrasions.
- Argosulfan is the main active substance: silver sulfadiazine. Burns of various etiologies and all degrees, purulent wounds, frostbite, abrasions, cuts, infected dermatitis, pressure sores, trophic ulcers.
- "Norsulfazole" - the main active substance: norsulfazole. Infectious diseases caused by pneumococcus, staphylococcus, hemolytic streptococcus, E. coli, gonococcus, gonorrhea, pneumonia, dysentery, cerebral meningitis.
- Oriprim is the main active substance: sulfamethoxazole. Indications - infectious diseases of the genitourinary organs, ENT organs, gastrointestinal tract, respiratory organs, skin and soft tissues.
- Pyrimethamine is the main active substance: pyrimethamine. Preventive and therapeutic therapy for malaria, primary polycythemia, toxoplasmosis.
- "Prontosil" (red streptocid) - the main active substance: sulfonamide. Indications are puerperal sepsis, streptococcal pneumonia, erysipelas of the epidermis.
List of combination sulfa drugs
The use of sulfonamides is quite common. Many strains of microorganisms have learned to mutate and adapt to antibiotics. And therefore, representatives of medicine have created combined sulfa drugs in which the main active ingredient is combined with trimethoprim. Here is a table of these sulfa drugs:
- Bactrim is the main active substance: sulfamethoxazole, trimethoprim. Infectious diseases of the lower and upper respiratory tract, urinary tract, kidneys, gastrointestinal tract, soft tissues, skin and other bacterial infections.
- “Berlocide” - the main active substance: sulfamethoxazole, trimethoprim. Infectious diseases of the respiratory tract, throat, nose, ear, genitourinary tract, kidneys, nocardiosis, brucellosis, South American blastocycosis, etc.
- "Duo-Septol" - the main active substance: sulfamethoxazole, trimethoprim. Infections of the gastrointestinal tract, respiratory tract, soft tissues and skin, urogenital infections, septicemia, brucellosis, meningomyelitis.
- “Ciplin” - the main active substance: sulfamethoxazole, trimethoprim. Infectious diseases of the respiratory tract, urinary tract, gastrointestinal tract, soft tissues and skin, ENT organs, urogenital infections.
Recommendations for use
How to treat sulfonamides? These antibacterial agents can be prescribed both locally and orally. The instructions for the use of sulfa drugs say that children under the age of one year should use the drug at 0.05 g, at the age of two to five years - at 0.3 g, at the age of six to twelve years - at 0.6 g. Adults are shown to take 0.5-1.3 g about five times a day. The general course of therapy is prescribed by a doctor and depends on the severity of the disease. Most often, the duration of the drug is a week. Each sulfanilamide drug should be washed down with alkaline water. Also, products containing sulfur should be included in the patient's diet to prevent crystallization and to maintain the general reaction of urine.
The effect of sulfonamides is not always positive. There may be negative reactions from the body.
Side effects
During prolonged and uncontrolled use of sulfonamide drugs, side effects may appear. These include various allergic reactions of the body, headaches, dizziness, nausea, vomiting. With systemic absorption into the blood, sulfanilamide preparations are able to pass through the placenta, and then penetrate the blood of a child being born, while exerting a toxic effect. It is because of this that pregnant women are advised to carefully use and strictly follow the treatment regimen prescribed by a specialist.
Contraindications to the use of sulfanilamide drugs are:
- individual hypersensitivity in the main active ingredient of the drug;
- low hemoglobin content;
- violation of hemoglobin synthesis;
- impaired liver or kidney function;
- diseases of the blood-forming organs and blood;
- azotemia.
The mechanism of sulfonamides we examined above.
Cost of sulfonamide drugs
Sulfanilamide preparations can be purchased at the pharmacy or ordered through the online store. The advantage of the latter purchase method is that when ordering several drugs at the same time, the price difference will be noticeable, because you will have to pay extra for the purchase of one medicine. Sulfanilamide preparations of domestic production are much cheaper. Here is an approximate price:
- "Sulfanilamide" (white streptocid) with a volume of 250 g of Swiss production will cost about 1900 rubles.
- "Biseptolum" (in a package of 20 tablets of 120 mg each) of Polish production will cost about 30 rubles.
- Sinersul with a volume of 100 ml of Croatian production will cost 300 rubles.
- "Sumerolim" (in a package of 20 tablets of 400 mg each) of Hungarian production will cost 115 rubles.
Now we know that these are sulfonamides.