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Trimethoprim/Sulfamethoxazole (Nursing)

by Rhonda Lawes

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      Slides 03-06 Aminoglycosides Sulfonamides Trimethoprim.pdf
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    00:01 Welcome to this mouthful right here. This is an official tongue twister, trimethoprim/sulfamethoxazole. Whoa, I didn't even do it there, did I? Trimethoprim/sulfamethoxazole.

    00:14 There we go, I made it.

    00:16 I think that's going to be the last time I say it, so we can make it through this video together.

    00:21 You'll see it up there on the top.

    00:23 This is a fixed combination of 2 medications, right? You got sulfamethoxazole and trimethoprim.

    00:29 So that's why you see the 2 names and the little hash mark in between.

    00:33 So we use these drugs together.

    00:36 We use it to treat UTI. Oh, hey, wait a minute.

    00:39 What other medication have we talked about to treat UTI? Yeah, just the one before right.

    00:46 See if you can jot the name of that medication in the margin of your notes.

    00:50 Now, we also use it to treat pneumocystis pneumonia, or PCP.

    00:54 It's an opportunistic fungi. A pneumonia is an infection in the lung.

    01:01 And, really, people that have to be severely immunocompromised, 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.

    01:17 Those are the groups of people who are at risk for PCP.

    01:20 It's an opportunistic fungi that if your immune system is functioning well, usually we can fight it off. But if you were immunocompromised, you're at risk for this specific bug.

    01:31 So, for this magic combination, we use it to treat UTIs, which is relatively minor.

    01:37 Then we use it to treat PCP, which is a really big deal, because these patients are already severely immunocompromised.

    01:45 So, the most common side effects with trimethoprim/sulfamethoxazole would be GI distress.

    01:51 Now, that's kind of a good one for you to file away because, really, any oral medication can upset someone's stomach.

    01:58 But I know personally, I have found that antibiotics are kind of the worst case scenario for having an upset stomach for me.

    02:05 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.

    02:12 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.

    02:24 So, what I want to focus on next is the worst side effect from trimethoprim.

    02:29 So you'll see that red box down there at the bottom.

    02:32 One of the biggest risks for trimethoprim is hyperkalemia.

    02:36 Now, let's break that word down. You may already know what it is, so just enjoy how smart you are.

    02:41 But for the rest of us mere mortals, let's look at hyperkalemia.

    02:46 Anytime you see "hyper," that means elevated or extra.

    02:49 Kalemia refers to potassium in the blood, so hyperkalemia means a high potassium blood level.

    02:59 So, this medication, particularly the trimethoprim part of it, can cause an elevated potassium.

    03:05 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.

    03:16 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.

    03:26 Now, the second side effect is birth defects.

    03:29 So you would not want to give trimethoprim to a patient who is pregnant.

    03:34 Okay, so even though we have these drugs together, we give them as a combination.

    03:38 We talked about the side effects, they're just the same as if we gave each one of these drugs separately.

    03:43 We focused on trimethoprim adverse effects being hyperkalemia, the elevated potassium, and birth defects.

    03:51 And the side effects for sulfamethoxazole are what we've already covered.


    About the Lecture

    The lecture Trimethoprim/Sulfamethoxazole (Nursing) by Rhonda Lawes is from the course Anti-Infective Drugs in Nursing. It contains the following chapters:

    • Trimethoprim/Sulfamethoxazole

    Included Quiz Questions

    1. A client with AIDS
    2. A client with a rib fracture
    3. A client with emphysema
    4. A pregnant client
    1. Gastrointestinal distress
    2. Body malaise
    3. Rashes
    4. Sleeping difficulties
    1. Hyperkalemia
    2. Hyponatremia
    3. Hypomagnesemia
    4. Hyperphosphatemia
    1. A pregnant client
    2. A geriatric client
    3. A client with liver disease
    4. A client with dementia

    Author of lecture Trimethoprim/Sulfamethoxazole (Nursing)

     Rhonda Lawes

    Rhonda Lawes


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