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The effects of trimethoprim causes a backlog of dihydrofolate (DHF) and this backlog can work against the inhibitory effect the drug has on tetrahydrofolate biosynthesis. This is where the sulfamethoxazole comes in; its role is in depleting the excess DHF by preventing it from being synthesised in the first place.
Trimethoprim (TMP) is an antibiotic used mainly in the treatment of bladder infections. [1] Other uses include for middle ear infections and travelers' diarrhea. [1] With sulfamethoxazole or dapsone it may be used for Pneumocystis pneumonia in people with HIV/AIDS.
Its Tmax (or time to reach maximum drug concentration in plasma) occurs 1 to 4 hours after oral administration. The mean serum half-life of sulfamethoxazole is 10 hours. [8] However, the half-life of the drug noticeably increases in people with creatinine clearance rates equal to or less than 30 mL/minute.
Drug fever; Periarteritis nodosa; Hepatic necrosis; Pancreatitis; Myelosuppression; Haemolysis [a] Stevens–Johnson syndrome [b] Drug reaction with eosinophilia and systemic symptoms; Toxic epidermal necrolysis [c] Ataxia [d] Clostridioides difficile colitis; Aseptic meningitis [e] Pseudomembranous colitis; Interstitial nephritis; Fulminant ...
Efavirenz may be used, but dose used depends on the patient's weight (600 mg daily if weight less than 50 kg; 800 mg daily if weight greater than 50 kg). Efavirenz levels should be checked early after starting treatment (unfortunately, this is not a service routinely offered in the US, but is readily available in the UK).
The β-lactam core structures. (A) A penam.(B) A carbapenam.(C) An oxapenam.(D) A penem.(E) A carbapenem.(F) A monobactam.(G) A cephem.(H) A carbacephem.(I) An oxacephem. This is a list of common β-lactam antibiotics—both administered drugs and those not in clinical use—organized by structural class.
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