Sulfasalazine

-
Category: Aminosalicylates

Sulfasalazine is a combination of 5-aminosalicylic acid (‘5-ASA') and sulfapyridine; sulfapyridine acts only as a carrier to the colonic site of action but still causes side-effects. In the newer aminosalicylates, mesalazine (5-aminosalicylic acid), balsalazide (a prodrug of 5-aminosalicylic acid) and olsalazine (a dimer of 5-aminosalicylic acid which cleaves in the lower bowel), the sulphonamide-related side-effects of sulfasalazine are avoided, but 5-aminosalicylic acid alone can still cause side-effects including blood disorders (see recommendation below) and lupus-like syndrome also seen with sulfasalazine.
Cautions

  • Aminosalicylates should be used with caution in renal impairment, during pregnancy and breast-feeding; blood disorders can occur.
  • Blood disorders: Patients receiving aminosalicylates should be advised to report any unexplained bleeding, bruising, purpura, sore throat, fever or malaise that occurs during treatment. A blood count should be performed and the drug stopped immediately if there is suspicion of a blood dyscrasia.

Side-effects
Side-effects of the aminosalicylates include diarrhoea, nausea, vomiting, abdominal pain, exacerbation of symptoms of colitis, headache, hypersensitivity reactions (including rash and urticaria); side-effects that occur rarely include acute pancreatitis, hepatitis, myocarditis, pericarditis, lung disorders (including eosinophilia and fibrosing alveolitis), peripheral neuropathy, blood disorders (including agranulocytosis, aplastic anaemia, leucopenia, methaemoglobinaemia, neutropenia, and thrombocytopenia—see also recommendation above), renal dysfunction (interstitial nephritis, nephrotic syndrome), myalgia, arthralgia, skin reactions (including lupus erythematosus-like syndrome, Stevens-Johnson syndrome), alopecia.

Subscribe to Drugs Information Center by Email

Comments

Post a Comment

Popular posts from this blog

Treatment Guidelines for Malaria Contd...

-
Treatment regimens for uncomplicated malaria in adults _ Oral quinine sulphate 600 mg/8 h for 5e7 days plus doxycycline 200 mg daily (or clindamycin 450 mg/8 h for pregnant women) for 7 days _ Atovaquoneeproguanil (Malarone_): 4 ‘standard’ tablets daily for 3 days or _ Co-artem ((artemetherelumefantrine_): if weight > 35 kg, 4 tablets  then 4 tablets at 8, 24, 36, 48 and 60 h   Child Initial dose 10 mg/kg/base then 5 mg/kg  base 6e8 h later and on days 2 and 3   However, both of these newer regimens need to be taken for only 3 days. In contrast, quinine needs to be taken for 5e7 days and is often associated with ‘‘cinchonism’’ (nausea, deafness and ringing in the ears), which often results in poor adherence. Although international recommendations suggest that quinine should be  taken for 7 days in endemic areas, 2  UK experience suggests  that 5 days treatment is adequate for the vast majority of cases. Quinine should be combined with a second drug (doxycycline for adults or clindam...
Read more

Basics of Oral Anti-diabetic drugs

-
The sulfonylureas and meglitinides increase the secretion of insulin by the pancreas. _ Metformin inhibits glucose production by the liver and decreases insulin resistance. _ The alpha-glucosidase inhibitors delay absorption of glucose by the intestine. _ The thiazolidinediones decrease insulin resistance. _ The dipeptidyl peptidase 4 inhibitors promote the release of insulin from the pancreas after eating a meal. It is  necessary  to know before starting these drugs that  all the diabetes drugs have the potential to cause side effects and lifestyle changes have benefits to your health beyond controlling blood sugar, most doctors will recommend you try diet and lifestyle modifications first — before you try a drug. Subscribe to Drugs Information Center by Email
Read more

Ranexa

-
Ranexa is an anti-anginal medication. It works by improving blood flow to help the heart work more efficiently. Ranexa is used to chronic treat angina (chronic chest pain) when other medications have not helped the condition. It should be used in combination with another medicine (eg, amlodipine, beta-blockers, nitrates). You should not take Ranexa if you have liver disease, hypokalemia (low levels of potassium in your blood), or a personal or family history of "Long QT syndrome." Ranexa should not be taken together with certain medicines to treat heart rhythm disorders, malaria, infections, mental illness, pain, cancer, or stomach disorders. Before you take Ranexa, tell your doctor about all other medications you are using. Ranexa is not for use during an acute (emergency) attack of angina. Continue using any other medicines prescribed by your doctor (such as nitroglycerin) to treat acute angina. Chronic angina is often treated with a combination of different drugs. To best ...
Read more