Welcome to this mouthful right here.
This is an official tongue twister,
I didn't even do it there, did I?
There we go, I made it.
I think that's going to be
the last time I say it,
so we can make it through
this video together.
You'll see it up there on the top.
This is a fixed combination of
2 medications, right?
You got sulfamethoxazole and trimethoprim.
So that's why you see the 2 names and
the little hash mark in between.
So we use these drugs together.
We use it to treat UTI. Oh, hey, wait a minute.
What other medication have we
talked about to treat UTI?
Yeah, just the one before right.
See if you can jot the name
of that medication
in the margin of your notes.
Now, we also use it to treat pneumocystis
pneumonia, or PCP.
It's an opportunistic fungi. A pneumonia
is an infection in the lung.
And, really, people that have to be
like someone who's on chemotherapy
for cancer, someone who is an
AIDS patient, someone who's a
transplant patient who's on
medications that we use to suppress
their immune system
so they don't reject their organ.
Those are the groups of people
who are at risk for PCP.
It's an opportunistic fungi that if your
immune system is functioning well,
usually we can fight it off. But if you
you're at risk for this specific bug.
So, for this magic combination,
we use it to treat UTIs,
which is relatively minor.
Then we use it to treat PCP,
which is a really big deal,
because these patients are already
So, the most common side effects with
would be GI distress.
Now, that's kind of a good one for
you to file away because, really,
any oral medication can upset
But I know personally, I have found
that antibiotics are kind of
the worst case scenario for having
an upset stomach for me.
So anytime I have to take an
antibiotic, I pretty much
know that there's going to be some GI
distress that goes along with it.
Now the adverse effects for
this combination --
remember, it's 2 separate drugs
that are given together --
the adverse effects are like if I gave
you trimethoprim by itself,
or sulfamethoxazole by itself.
So, what I want to focus on next is the
worst side effect from trimethoprim.
So you'll see that red box down
there at the bottom.
One of the biggest risks for trimethoprim
Now, let's break that word down.
You may already know
what it is, so just enjoy how smart you are.
But for the rest of us mere mortals,
let's look at hyperkalemia.
Anytime you see "hyper," that
means elevated or extra.
Kalemia refers to potassium in the blood,
so hyperkalemia means a high
potassium blood level.
So, this medication, particularly
the trimethoprim part of it,
can cause an elevated potassium.
That's really a big concern
because elevated potassium can start
messing with your cardiac rhythms,
so we want to be really careful about
that and monitor that in our patients.
Also, if your patients have any
other medical problems
that cause them to already have an
elevated potassium level,
we're going to be very cautious
with this drug combination.
Now, the second side effect
is birth defects.
So you would not want to give trimethoprim
to a patient who is pregnant.
Okay, so even though we have these drugs
together, we give them as a combination.
We talked about the side effects,
they're just the same as if we gave
each one of these drugs separately.
We focused on trimethoprim adverse
effects being hyperkalemia,
the elevated potassium, and birth defects.
And the side effects for sulfamethoxazole
are what we've already covered.