Dermazine

Dermazin is a chemotherapeutic agent of the antibacterial type used to treat dermatological diseases. It belongs to the sulfonamide group.

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Indications Dermazina

It is used to prevent the development of infections or to treat infected burns, ulcers, abrasions, as well as bedsores and superficial wounds with weak exudation. It is also used to prevent possible infection during skin grafting.

Release form

Released in the form of cream in tubes of 50 g. Inside the package there is 1 tube of cream.

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Pharmacodynamics

Dermazin is a local chemotherapeutic drug with antimicrobial properties. The cream is used to treat infected wounds (including burns).

On the wound surface, the substance silver sulfadiazine undergoes disintegration. In the process, there is a continuous and slow release of silver ions contained in it. These elements are synthesized with bacterial DNA, and at the same time slow down the reproduction and growth of microbial cells, without affecting the subcutaneous layers and skin cells.

The cream has a wide range of antimicrobial action, which includes almost all types of bacteria that cause infection of burns and other wounds on the skin.

The minimum level of active substance of the drug required to inhibit certain important microbes (in vitro):

• ≤50 μg/ml: bacteria such as Pseudomonas aeruginosa, Pseudomonas maltophilia, Enterobacter cloacae, Escherichia coli, Proteus, as well as Morgan bacteria, Citrobacter, Providencia, Streptococcus pyogenes and Corynebacterium diphtheriae with Mucor pussilus;
• ≤100 μg/ml: microbes such as Klebsiella, Enterobacter, Acinetobacter, Enterococci and Staphylococci, Serratia, Clostridium perfringens, dermatophytes, Aspergillus flavus with Aspergillus fumigatus, and Candida albicans.

For microorganisms Herella, herpes and Rhizopus nigricans this indicator is ≤10 μg/ml.

The substance can penetrate into exudate and necrotic tissue. This effect is very important because systemic antibiotics are not effective against bacterial flora inside necrotic tissue.

Pharmacokinetics

During prolonged therapy for burns on large areas of the body, the drug can be absorbed into the body. The sulfonamide levels in the serum are proportional to the size of the burn area and the amount of cream applied. The pigmentation (argyrosis) that develops as a result of silver deposition is insignificant, since the active substance of the drug has a systemic absorption.

About 60% of the drug taken orally is excreted unchanged in the urine. The half-life is 10 hours. In people with anuria, this time period can be extended to 22 hours.

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Dosing and administration

The medicine is used for local external treatment. The appropriate treatment regimen is prescribed taking into account the depth and area of the wound received by the patient.

Before the procedure, the wound/burn surface must be cleaned. Then the cream is applied (a layer of approximately 2-4 mm) to the damaged area. The medicine must be applied using a sterile spatula or by hand, which must first be covered with a sterile glove. You can also use a sterile gauze pad, which is treated with cream and applied to the wound. For moderate lesions, 1 procedure per day is sufficient, and in more severe cases, 2 treatments per day are required.

Before each new procedure, it is necessary to wash the burn area with a sodium chloride solution (0.9%) or a disinfectant solution - to remove the remains of the previously applied cream, as well as exudate. After finishing the treatment, it is allowed to apply a bandage to the wound.

The dose size does not depend on the patient's age. The cream should be applied until the affected area is completely healed or until the wound is ready for the necessary surgical operation. When using Dermazin without a doctor's prescription, you must consult with him if no changes in the patient's condition have occurred after 7 days of therapy.

The cream does not leave stains on clothes.

In case of liver or kidney problems.

In case of treatment of a large area of skin with cream, it is necessary to monitor liver and kidney function, as well as blood parameters (level of formed components of blood). Also, the patient should drink plenty of alkaline drinks.

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Use Dermazina during pregnancy

Given the small number of studies and the risk (systemically used sulfonamides displace bilirubin located at the sites of synthesis with albumin (inside the plasma), due to which the newborn may develop hyperbilirubinemia or bilirubin encephalopathy), Dermazin is prohibited for use during pregnancy. The substance silver sulfadiazine should also be prescribed with caution to women who are planning a pregnancy.

It is known that sulfonamides increase the likelihood of nuclear jaundice in newborns, which is why the cream cannot be used during lactation.

Contraindications

Main contraindications:

• intolerance to sulfonamides with silver sulfadiazine, and also other elements of the drug;
• presence of porphyria;
• a deficiency of the substance G6PD caused by genetic factors (if large areas of skin are treated with the cream, hemolysis may develop);
• burns and purulent wounds with abundant exudation (no practical use);
• premature infants, as well as newborns and children under 3 months of age (due to the risk of developing nuclear jaundice).

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Side effects Dermazina

Using the cream may cause the following side effects:

• reactions of the hematopoietic system: development of leukopenia and increase in serum osmolarity. Transient leukopenia often does not require discontinuation of the drug or other special procedures. It is necessary to monitor the patient's blood values;
• manifestations from the subcutaneous layer and dermatological pathologies: the appearance of redness, burning, irritation and itching, as well as increased sensitivity, rashes, pain during application and the acquisition of a gray tint by the skin under the influence of sunlight (development of argyrosis). In addition, photosensitivity, skin necrosis, contact dermatitis, hyperpigmentation, as well as rhinitis with asthma of an allergic nature develop.

Due to the prolonged course of treatment for burns with a large area of damage (especially severe burns), sometimes side effects developed that are typical of internal use of sulfadiazine. Among them are vomiting, glossitis and nausea with diarrhea, as well as convulsions, headaches and joint pain. In addition, a feeling of confusion, thrombocytopenia or leukopenia, anemia with eosinophilia, functional liver disorder or its necrosis, hospital fever and tubulointerstitial nephritis develop. Crystalluria, nodular erythema, dermatological reactions and allergies, TEN and Stevens-Johnson syndrome may occur. The development of cholestatic hepatosis, exfoliative dermatitis and vitamin B9 deficiency have also been noted.

Systemic absorption of the drug component rarely leads to the occurrence of adverse reactions associated with the systemic use of sulfonamides.

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Overdose

As a result of drug overdose, adverse reactions characteristic of systemic use of any sulfanilamide may occur. Long-term use of the substance in high doses can increase the silver level inside the serum. But all these values return to normal after the end of therapy.

In patients with severe burns, a significant increase in serum osmolarity was observed in the case of prolonged therapy. This disorder may develop due to increased resorption of the drug's constituent element, propylene glycol, through the damaged skin.

Therapy is aimed at eliminating the disturbances. Monitoring of blood counts and renal function may also be necessary. Absorbed sulfadiazine is effectively removed by peritoneal dialysis or hemodialysis.

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Interactions with other drugs

In the case of a combination of silver sulfadiazine with enzymatic drugs that cleanse wounds, inactivation of the latter is possible.

When combined with cimetidine, the incidence of leukopenia may increase.

During therapy for extensive burns, after the active component of Dermazin has reached a therapeutic level within the serum, it is necessary to take into account that the effectiveness of systemic drugs may be subject to change.

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Storage conditions

Dermazin should be kept in a place inaccessible to children. The temperature in the room should not exceed 25°C.

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Shelf life

Dermazin is permitted to be used for a period of 3 years from the date of manufacture of the drug.