- Silver sulfadiazine
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Silver sulfadiazine 
Systematic (IUPAC) name Silver [(4-aminophenyl)sulfonyl](pyrimidin-2-yl)azanide Clinical data Trade names Silvadene AHFS/Drugs.com monograph MedlinePlus a682598 Pregnancy cat. B (not recommended in late pregnancy) Legal status ℞ Prescription only Routes Topical Pharmacokinetic data Bioavailability <1% (silver), 10% (sulfadiazine) Protein binding High (silver) Excretion 2/3 renal (sulfadiazine) Identifiers CAS number 22199-08-2 
ATC code D06BA01 PubChem CID 441244 DrugBank DB05245 ChemSpider 390017 UNII W46JY43EJR KEGG D00433 ChEBI CHEBI:9142 ChEMBL CHEMBL1200766 
Synonyms (4-Amino-N-2-pyrimidinylbenzenesulfonamidato-NN,01)-silver, sulfadiazine silver, silver (I) sulfadiazine, 4-amino-N-(2-pyrimidinyl)benzenesulfonamide silver salt, dermazine, geben, silvadene Chemical data Formula C10H9AgN4O2S Mol. mass 357.14 g/mol SMILES eMolecules & PubChem - InChI=1S/C10H9N4O2S.Ag/c11-8-2-4-9(5-3-8)17(15,16)14-10-12-6-1-7-13-10;/h1-7H,11H2;/q-1;+1
Key:UEJSSZHHYBHCEL-UHFFFAOYSA-N
Physical data Melt. point 285 °C (545 °F) 
(what is this?) sulfadiazine (verify)Silver sulfadiazine (INN, or silvadene) is a topical sulfonamide/silver[1] antibacterial used as a topical burn cream on burns, including chemical burns. It prevents the growth of a wide array of bacteria, as well as yeast, on the damaged skin.
Silver sulfadiazine is typically delivered in a 1% cream or aqueous suspension. Brand names include Sliverex, Silvadene (a genericized trademark), Silvazine, Flamazine, Thermazene, and SSD.[2]
Studies have found that silver sulfadiazine increases healing times; and it is therefore not recommended by the authors of a Cochrane review.[3]
Contents
Side effects
An aseptic exudate (a clear fluid) may form on the wound's surface. Burning and painful sensations are not uncommon but only temporary.
About 0.1 to 1% of patients show hypersensitivity reactions like rashes or erythema multiforme.[4] This is a reaction known from other sulfonamides including antibacterials, thiazide diuretics, and sulfonylurea antidiabetics; but data on the likelihood of cross-allergies are inconsistent.
Incorporation of the silver ions can lead to local argyria (discoloration of the skin), especially if the treated area is exposed to ultraviolet. Generalised argyria with silver accumulation in kidneys, liver and retina has only been found in association with excessive long-term use, or repeated use on severe and heavily inflamed burns. Possible consequences of generalised argyria include interstitial nephritis and anemia.[4]
Pharmacokinetics
The chemical itself is poorly soluble, and has only very limited penetration through the skin. Only when applied to large area burns or other lesions is absorption into the body a problem.[4]
Interactions
Proteases like trypsin and clostridiopeptidase, which are contained in ointments used for the removal of dead skin on wounds, can be inhibited by silver ions if applied simultaneously. When silver sulfadiazine is absorbed in significant amounts, it can increase effects and side effects of some drugs like vitamin K antagonist.[4]
Legal status
Certain brand names, such as Silvadene, are still listed as prescription only by the FDA, yet the active ingredient itself can be sold OTC.[5] CVS, as well as many other pharmacies, only sell the prescription form despite the availability of an OTC equivalent.
See also
References
- ^ Fisher NM, Marsh E, Lazova R (October 2003). "Scar-localized argyria secondary to silver sulfadiazine cream". J. Am. Acad. Dermatol. 49 (4): 730–2. doi:10.1067/S0190-9622(02)61574-9. PMID 14512929. http://linkinghub.elsevier.com/retrieve/pii/S0190962202615749.
- ^ http://www.drugs.com/mtm/ssd.html This source names Silvadene, SSD, SSD AF, Thermazene
- ^ Wasiak J, Cleland H, Campbell F (2008). "Dressings for superficial and partial thickness burns". Cochrane Database Syst Rev (4): CD002106. doi:10.1002/14651858.CD002106.pub3. PMID 18843629.
- ^ a b c d Jasek, W, ed (2007) (in German). Austria-Codex. 2 (62 ed.). Vienna: Österreichischer Apothekerverlag. pp. 3270–1. ISBN 3-85200-181-4.
- ^ http://www.amazon.com/dp/B0008KLQNM
Antibiotics and chemotherapeutics for dermatological use (D06) Antibiotics Tetracycline and derivativesOthersChemotherapeutics Aciclovir • Penciclovir • Idoxuridine • Edoxudine
Imiquimod/Resiquimod • Podophyllotoxin
Docosanol • Tromantadine • Inosine • Lysozyme • IbacitabineOtherSilver compounds Categories:- Silver compounds
- Sulfonamide antibiotics
- Antiseptics
- Pyrimidines
- InChI=1S/C10H9N4O2S.Ag/c11-8-2-4-9(5-3-8)17(15,16)14-10-12-6-1-7-13-10;/h1-7H,11H2;/q-1;+1
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