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SSD Cream
Overview
What is SSD Cream?
SSD™ (1% Silver Sulfadiazine Cream) and SSD AF™ (1%
Silver Sulfadiazine Cream), 1% are topical antibacterial preparations which
have as their active antimicrobial ingredient silver sulfadiazine. The active
moiety is contained within an opaque, white, water miscible cream base.
Each 1000 grams of SSD/SSD AF Cream contains 10 grams of silver sulfadiazine.
cetyl alcohol (SSD
Cream only), isopropyl myristate, polyoxyl 40 stearate, propylene glycol,
purified water, stearyl alcohol, sodium hydroxide, sorbitan monooleate, white
petrolatum; with 0.3% methyl paraben, as a preservative.
Silver
sulfadiazine has an emprical formula of
CHAgNOS, molecular weight
of 357.14 and structural formula as shown:
What does SSD Cream look like?
What are the available doses of SSD Cream?
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What should I talk to my health care provider before I take SSD Cream?
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How should I use SSD Cream?
Silver Sulfadiazine Cream is a topical antimicrobial drug indicated as
an adjunct for the prevention and treatment of wound sepsis in patients with
second and third degree burns.
Prompt institution of appropriate regimens for care of the burned
patient is of prime importance and includes the control of shock and pain. The
burn wounds are then cleansed and debrided; Silver Sulfadiazine Cream is then
applied under sterile conditions. The burn areas should be covered with Silver
Sulfadiazine Cream at all times. The cream should be applied once to twice
daily to a thickness of approximately one sixteenth of an inch. Whenever
necessary, the cream should be reapplied to any areas from which it has been
removed due to patient activity. Administration may be accomplished in minimal
time because dressings are not required. However, if individual patient
requirements make dressings necessary, they may be used. Reapply immediately
after hydrotherapy. Treatment with Silver Sulfadiazine Cream should be
continued until satisfactory healing has occurred or until the burn site is
ready for grafting. The drug should not be withdrawn from the therapeutic
regimen while there remains the possibility of infection except if a
significant adverse reaction occurs.
What interacts with SSD Cream?
Silver Sulfadiazine Cream is contraindicated in patients who are hypersensitive to silver sulfadiazine or any of the other ingredients in the preparation.
Because sulfonamide therapy is known to increase the possibility of kernicterus, Silver Sulfadiazine Cream should not be used on pregnant women approaching or at term, on premature infants, or on newborn infants during the first 2 months of life.
What are the warnings of SSD Cream?
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What are the precautions of SSD Cream?
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What are the side effects of SSD Cream?
Several cases of transient leucopenia have been reported in patients
receiving silver sulfadiazine therapy. Leucopenia associated with silver
sulfadiazine administration is primarily characterized by decreased neutrophil
count. Maximal white blood cell depression occurs within two to four days of
initiation of therapy. Rebound to normal leukocyte levels follows onset within
two to three days. Recovery is not influenced by continuation of silver
sulfadiazine therapy. The incidence of leucopenia in various reports averages
about 20%. A higher incidence has been seen in patients treated concurrently
with cimetidine.
Other infrequently occurring events include skin necrosis, erythema
multiforme, skin discoloration, burning sensation, rashes, and interstitial
nephritis. Reduction in bacterial growth after application of topical
antibacterial agents has been reported to permit spontaneous healing of deep
partial thickness burns by preventing conversion of the partial thickness to
full thickness by sepsis. However, reduction in bacterial colonization has
caused delayed separation, in some cases necessitating escharotomy in order to
prevent contracture.
Absorption of silver sulfadiazine varies depending upon the percent of
body surface area and the extent of the tissue damage. Although few have been
reported, it is possible that any adverse reaction associated with sulfonamides
may occur. Some of the reactions which have been associated with sulfonamides
are as follows: blood dyscrasias, agranulocytosis, aplastic anemia,
thrombocytopenia, leucopenia, hemolytic anemia, dermatologic reactions,
allergic reactions, Stevens-Johnson syndrome, exfoliative dermatitis,
gastrointestinal reactions, hepatitis, hepatocellular necrosis, CNS reactions,
and toxic nephrosis.
What should I look out for while using SSD Cream?
Silver Sulfadiazine Cream is contraindicated in patients who are
hypersensitive to silver sulfadiazine or any of the other ingredients in the
preparation.
Because sulfonamide therapy is known to increase the possibility of
kernicterus, Silver Sulfadiazine Cream should not be used on pregnant women
approaching or at term, on premature infants, or on newborn infants during the
first 2 months of life.
There is a potential cross-sensitivity between silver sulfadiazine and
other sulfonamides. If allergic reactions attributable to treatment with
silver sulfadiazine occur, continuation of therapy must be weighed against the
potential hazards of the particular allergic reaction.
Fungal proliferation in and below the eschar may occur. However, the
incidence of clinically reported fungal superinfection is low.
The use of Silver Sulfadiazine Cream in some cases of
glucose-6-phosphate dehydrogenase-deficient individuals may be hazardous, as
hemolysis may occur.
What might happen if I take too much SSD Cream?
Sorry No Records found
How should I store and handle SSD Cream?
Store LONHALA Inhalation Solution in the protective foil pouch at 20°-25°C (68°-77°F) [see USP Controlled Room Temperature]. Always use the MAGNAIR Replacement Handset parts that come with each LONHALA MAGNAIR refill prescription. Keep out of the reach of children. Store LONHALA Inhalation Solution in the protective foil pouch at 20°-25°C (68°-77°F) [see USP Controlled Room Temperature]. Always use the MAGNAIR Replacement Handset parts that come with each LONHALA MAGNAIR refill prescription. Keep out of the reach of children. Store LONHALA Inhalation Solution in the protective foil pouch at 20°-25°C (68°-77°F) [see USP Controlled Room Temperature]. Always use the MAGNAIR Replacement Handset parts that come with each LONHALA MAGNAIR refill prescription. Keep out of the reach of children. Product: 50090-2288NDC: 50090-2288-0 50 g in a TUBE Product: 50090-2288NDC: 50090-2288-0 50 g in a TUBE
Clinical Information
Chemical Structure
No Image foundClinical Pharmacology
Silver sulfadiazine has broad antimicrobial activity. It is
bactericidal for many gram-negative and gram-positive bacteria as well as being
effective against yeast. Results from testing are listed below. Sufficient data have been obtained
to demonstrate that silver sulfadiazine will inhibit bacteria that are
resistant to other antimicrobial agents and that the compound is superior to
sulfadiazine. Studies utilizing radioactive micronized silver sulfadiazine,
electron microscopy, and biochemical techniques have revealed that the
mechanism of action of silver sulfadiazine on bacteria differs from silver
nitrate and sodium sulfadiazine. Silver sulfadiazine acts only on the cell
wall to produce its bactericidal effect.
Results of Testing With
Silver Sulfadiazine Cream, 1% Concentration of Silver Sulfadiazine Number of
Sensitive Strains / Total Number of Strains Tested
Genus and Species 50 micrograms/mL 100
micrograms/mL
Pseudomonas Aeruginosa 130/130 130/130
Xanthomonas (Pseudomonas)
Maltophilia 7/7
7/7
Enterobacter Species 48/50
50/50
Enterobacter cloacae 24/24
24/24
Klebsiella Species 53/54
54/54
Escherichia Coli 63/63
63/63
Serratia Species 27/28
28/28
Proteus Mirabilis 53/53
53/53
Morganella Morganii 10/10
10/10
Providencia Rettgeri 2/2
2/2
Proteus Vulgaris 2/2
2/2
Providencia Species 1/1
1/1
Citrobacter Species 10/10
10/10
Acinetobacter Calcoaceticus 10/11 11/11
Stahylococcus Aureus 100/101 101/101
Staphylococcus Epidermidis 51/51 51/51
B-Hemolytic Streptococcus 4/4 4/4
Enterococcus Species 52/53 53/53
Corynebacterium Diphtheriae 2/2 2/2
Clostridium Perfringens 0/2
2/2
Clostridium Perfringens 0/2
2/2
Candida Albicans 43/50
50/50
Silver sulfadiazine is not a carbonic anhydrase inhibitor and may be
useful in situations where such agents are contraindicated.
Non-Clinical Toxicology
Silver Sulfadiazine Cream is contraindicated in patients who are hypersensitive to silver sulfadiazine or any of the other ingredients in the preparation.Because sulfonamide therapy is known to increase the possibility of kernicterus, Silver Sulfadiazine Cream should not be used on pregnant women approaching or at term, on premature infants, or on newborn infants during the first 2 months of life.
There is a potential cross-sensitivity between silver sulfadiazine and other sulfonamides. If allergic reactions attributable to treatment with silver sulfadiazine occur, continuation of therapy must be weighed against the potential hazards of the particular allergic reaction.
Fungal proliferation in and below the eschar may occur. However, the incidence of clinically reported fungal superinfection is low.
The use of Silver Sulfadiazine Cream in some cases of glucose-6-phosphate dehydrogenase-deficient individuals may be hazardous, as hemolysis may occur.
Although ranitidine has been reported to bind weakly to cytochrome P-450 , recommended doses of the drug do not inhibit the action of the cytochrome P-450-linked oxygenase enzymes in the liver. However, there have been isolated reports of drug interactions that suggest that ranitidine may affect the bioavailability of certain drugs by some mechanism as yet unidentified (e.g., a pH-dependent effect on absorption or a change in volume of distribution).
Increased or decreased prothrombin times have been reported during concurrent use of ranitidine and warfarin. However, in human pharmacokinetic studies with dosages of ranitidine up to 400 mg per day, no interaction occurred; ranitidine had no effect on warfarin clearance or prothrombin time. The possibility of an interaction with warfarin at dosages of ranitidine higher than 400 mg per day has not been investigated.
In a ranitidine-triazolam drug-drug interaction study, triazolam plasma concentrations were higher during b.i.d. dosing of ranitidine than triazolam given alone. The mean area under the triazolam concentration time curve (AUC) values in 18- to 60-year-old subjects were 10% and 28% higher following administration of 75 mg and 150 mg ranitidine tablets, respectively, than triazolam given alone. In subjects older than 60 years of age, the mean AUC values were approximately 30% higher following administration of 75 mg and 150 mg ranitidine tablets. It appears that there were no changes in pharmacokinetics of triazolam and α-hydroxytriazolam, a major metabolite, and in their elimination. Reduced gastric acidity due to ranitidine may have resulted in an increase in the availability of triazolam. The clinical significance of this triazolam and ranitidine pharmacokinetic interaction is unknown.
If hepatic and renal functions become impaired and elimination of the drug decreases accumulation may occur and discontinuation of Silver Sulfadiazine Cream should be weighed against the therapeutic benefit being achieved.
In considering the use of topical proteolytic enzymes in conjunction with Silver Sulfadiazine Cream, the possibility should be noted that silver may inactivate such enzymes.
Laboratory Tests:
Absorption of the propylene glycol vehicle has been reported to affect serum osmolality, which may affect the interpretation of laboratory tests.
Several cases of transient leucopenia have been reported in patients receiving silver sulfadiazine therapy. Leucopenia associated with silver sulfadiazine administration is primarily characterized by decreased neutrophil count. Maximal white blood cell depression occurs within two to four days of initiation of therapy. Rebound to normal leukocyte levels follows onset within two to three days. Recovery is not influenced by continuation of silver sulfadiazine therapy. The incidence of leucopenia in various reports averages about 20%. A higher incidence has been seen in patients treated concurrently with cimetidine.
Other infrequently occurring events include skin necrosis, erythema multiforme, skin discoloration, burning sensation, rashes, and interstitial nephritis. Reduction in bacterial growth after application of topical antibacterial agents has been reported to permit spontaneous healing of deep partial thickness burns by preventing conversion of the partial thickness to full thickness by sepsis. However, reduction in bacterial colonization has caused delayed separation, in some cases necessitating escharotomy in order to prevent contracture.
Absorption of silver sulfadiazine varies depending upon the percent of body surface area and the extent of the tissue damage. Although few have been reported, it is possible that any adverse reaction associated with sulfonamides may occur. Some of the reactions which have been associated with sulfonamides are as follows: blood dyscrasias, agranulocytosis, aplastic anemia, thrombocytopenia, leucopenia, hemolytic anemia, dermatologic reactions, allergic reactions, Stevens-Johnson syndrome, exfoliative dermatitis, gastrointestinal reactions, hepatitis, hepatocellular necrosis, CNS reactions, and toxic nephrosis.
Reference
This information is obtained from the National Institute of Health's Standard Packaging Label drug database.
"https://dailymed.nlm.nih.gov/dailymed/"
While we update our database periodically, we cannot guarantee it is always updated to the latest version.
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