SULFONAMIDE

also spelled Sulphonamide, any member of a class of chemical compounds, the amides of sulfonic acids. The class includes several groups of drugs used in the treatment of bacterial infections, diabetes mellitus, edema, hypertension, and gout. The bacteriostatic sulfonamide drugs, often called sulfa drugs, include sulfanilamide (q.v.) and numerous compounds closely related to it. Other groups of sulfonamide drugs have been developed by exploiting observations made during clinical evaluation of sulfanilamide derivatives. Examples of these drugs are probenecid (q.v.), introduced as an agent for intensifying the action of penicillin but now principally used in treating gout; acetazolamide and furosemide, which are diuretics; and tolbutamide (q.v.), a hypoglycemic. Chlorothiazide and hydrochlorothiazide are effective both as diuretics and in reducing blood pressure. Sulfonamides are oily liquids or crystalline solids that are almost always prepared by the reaction of a sulfonyl chloride with ammonia or an amine, most commonly in the presence of caustic alkali. The first sulfonamide drug, introduced in 1932, was a red azo dye called Prontosil (q.v.). As new sulfonamides were synthesized, more effective and less toxic agents were discovered. Some, which are not absorbed, can be administered orally to treat specific localized infections in the gastrointestinal tract. Others are absorbed slowly or excreted slowly and therefore are longer acting. All the sulfonamides are capable of causing drug intoxication (poisoning), and some patients are hypersensitive to them. The commonest side effects are nausea, vomiting, and mental confusion. The signs of hypersensitivity are fever and skin eruptions. Signs of intoxication include anemia, which results from destruction of red blood cells, and leukopenia, which results from the destruction of white blood cells. Irritation of the kidneys and obstruction of the free flow of urine are undesirable reactions that can be prevented.