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Allergies and adverse reactions to sulfonamide medications are quite common. Two distinct categories of drugs are classified as sulfonamides: antibiotics and nonantibiotics. The two groups differ in their chemical structure, use, and the rate at which adverse reactions occur. Cross-reactivity between the two groups has been implied in the past, but is suspect. Acetazolamide, from the nonantibiotic group, is routinely used in the prevention and treatment of high altitude issues and may not need to be avoided in individuals with a history of sulfonamide allergy. This review addresses the differences between the groups and the propensity for intergroup and intragroup adverse reactions based on the available literature. We also examine the different clinical presentations of allergy and adverse reactions, from simple cutaneous reactions with no sequelae through Stevens-Johnson syndrome and anaphylaxis, with risk for significant morbidity and mortality. We offer a systematic approach to determine whether acetazolamide is a safe option for those with a history of allergy to sulfonamides.

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Summary16 samples of Ordovician basic volcanic rocks of the South Connemara Group, which abut the southern side of the metamorphic rocks of the Connemara massif in western Ireland, have been analysed for both major and trace elements. Although subject to low grade regional metamorphism and subsequently hornfelsed by the Galway Granite (400 Ma), their immobile element contents do not appear to be significantly disturbed. These elements characterise the metabasites of the South Connemara Group as ocean floor basalts having their origins in a marginal basin. The Skird Rocks Fault, separating the South Connemara Group from high grade metamorphic rocks of the Connemara massif, is consequently regarded as the northern margin of the vestiges of the lapetus Ocean which can be traced into, and along, the Southern Uplands Fault.