shevyatiwari's version from 2015-04-23 06:58

Section 1

Question Answer
Trimethoprim inhibits DHFRT
Sulfamethoxazole inhibits DHFRF, Dihydropteroatet synthesis
Folate depeletion occurs equally in bacterial and human cellsF, more selective in bacterial cells
Trimethoprim binds to DHFR 10 times more in bacteria than humansF, 50000-100000 times more
Comes in a ratio of 1:8F, 1:5
BactericidalF, bacteriostatic. Synergistic
Effective against bacteroids and clostridiumF, poor against anaerobes
Poor oral absorptionF, well absorbed
Half lives are unchanged in renal impairmentF, prolonged
Enter breast milkT
Cross the placentaT
Metabolised in the liverT
Mostly renal clearanceT
GI S/E, tinnitus, headache can occurT
C diff is reported when given for PJPT
Hypersensitivity seen in 4-5% of normal and 15% of HIV patentsT
Hypersensitivty manifests in the first 5-6 weeksF, 1-2 weeks
Avoid in those who have first degree relatives with SJS/TENs associated with itT
Avoid if previous sulphonamide allergyT
Agranulocytosis pancytoopenias, hypoprothrombinemia, aplastic anaemia, pure red cell aplasia are possible S/ET
G6PD deficiency makes one prone to haemolytic anaemiaT
Use in caution if folate deficiency or pre existing megaloblastosisT
Megaloblastosis is not a risk factor for the development of haematopoietic S/EF, it is a RF
FBP at baseline and fortnightly is reasonableF, monthly, not fortnightly
Cat CT
Jaundice, haemolytic anaemia, kernicterus are related to sulphonamide ingestion early in pregnancyF, near term
Premature infants should not be exposed to breast milk as SMX competes with bilirubin binding to plasma albuminT
Decreases dapsone levelsF increases
Can cause hypokalaemia if used with an ACE IF, hyperkalaemia
Increases risk of haematological S/E on MtxT
Increase phenytoin causes phenytoin toxicityT
Inhibits metabolism of warfarin -> increased anticoagulant effectT
Toxic delerium is reported with co administration of amantadineT
Nephrotoxicity is irreversible iwith cyclosporineF, reversibel
Renal insufficiency is not a RF for S/EF, it is

Section 2

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