Dermazin

Dermazin is a chemotherapeutic agent of antibacterial type, used for the treatment of dermatological diseases. It belongs to the group of sulfonamides.

[1]

Indications of the dermazin

It is used to prevent the development of infections or the treatment of burns, ulcers, abrasions, as well as pressure sores and wounds of superficial type that have weak exudation. It is also used to prevent possible infection in the process of skin transplantation.

Release form

Release in the form of cream in tubes with a volume of 50 g. Inside the package - 1 tube with cream.

[2]

Pharmacodynamics

Dermazin is a local chemotherapeutic medicine with antimicrobial properties. The cream is used in the treatment of infected wounds (among such burns).

On the surface of the wound, the silver sulfadiazine substance is decomposed. In this process, a continuous and slow release of the silver ions contained therein occurs. These elements are synthesized from bacterial DNA, and at the same time slow down the growth and growth of microbial cells, without affecting the subcutaneous layers and skin cells.

The cream has a large range of antimicrobial effects, which includes almost all types of bacteria that provoke infection of burns and other wound lesions on the skin.

The minimum level of active drug LS, necessary to slow down certain important microbes (in vitro):

• ≤50 μg / ml: bacteria such as Pseudomonas malignantis, Pseudomonas maltophilia, Enterobacter cloaca, Escherichia coli, Proteus, and in addition Morgan bacteria, Citrobacter, Providence, Streptococcus pyogenes and diphtheria corynebacterium with Mucor pussilus;
• ≤100 μg / ml: microbes such as klebsiella, enterobacter, acitetobacter, enterococcus and staphylococcus, serration, clostridium perfringence, dermatophytes, aspergillus yellow with aspergillus smoking, and candida albicans.

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

The substance can pass into the exudate and dead tissue. This effect is very important, because as systemic antibiotics are not effective against the flora of bacteria inside dead tissue.

Pharmacokinetics

During prolonged therapy for burns in large areas of the body, the drug can be absorbed into the body. The indices of the sulfonamide inside the serum are proportional to the size of the burn area, as well as the amount of the applied cream. The pigmentation (argirose) developing as a result of the deposition of silver is insignificant, since the active substance of LS has systemic absorption.

About 60% of the ingested medication is excreted unchanged together with the urine. The half-life is 10 hours. In persons with anuria, this time interval can be extended to 22 hours.

[3]

Dosing and administration

The drug is used for local external treatment. A suitable treatment regimen is prescribed taking into account the depth and area of the patient's wound.

Before the procedure, it is necessary to clean the wound / burn surface. Then the application of the cream (a layer of approximately 2-4 mm) is performed on the damage site. Apply the medicine with a sterile spatula or a hand, on which you must first put on a sterile glove. You can also use a sterile gauze cloth, which is treated with cream and applied to the wound. For lesions of moderate type, the first procedure is sufficient for the day, and in more severe cases 2 treatments per day are required.

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

Dose sizes do not depend on the age of the patient. Apply the cream to the full healing of the affected area or until the wound is ready for the necessary surgical operation. When using Dermazin without a doctor's appointment, it is necessary to consult with him, if at the end of the 7th day of therapy there is no change in the patient's condition.

There are no stains from the cream on clothes. 

In disorders of the liver or kidneys.

In the case of cream treatment of a large area of the skin, it is necessary to monitor hepatic and renal function, as well as blood indices (the level of the blood constituents). Also, the patient should drink plenty of alkaline drink.

[7]

Use of the dermazin during pregnancy

In view of the small number of studies and also the risk (used systemically sulfonamides displace the bilirubin (inside the plasma) located on the synthesis sites with albumin, which can lead to the development of hyperbilirubinemia or bilirubin encephalopathy in the newborn). Dermazin is forbidden to use during pregnancy. The substance of silver sulfadiazine should also be carefully administered to women who are in the period of pregnancy planning.

It is known that sulfonamides potentiate the probability of a newborn having a nuclear jaundice, so that the cream can not be used in lactation.

Contraindications

The main contraindications:

• intolerance to sulfanilamides with silver sulfadiazine, and in addition to other elements of the drug;
• the presence of porphyria;
• the lack of G6PD substance due to genetic factors (in case of cream treatment of large areas of the skin, hemolysis may develop);
• burns and purulent wounds, with abundant exudation (lack of expediency of application);
• premature infants, as well as newborns and children younger than 3 months (due to the risk of nuclear jaundice).

[4]

Side effects of the dermazin

The use of the cream can cause such side effects:

• reactions of the hematopoietic system: development of leukopenia and an increase in serum osmolality. Transient leukopenia often does not require withdrawal of the medication or other special procedures. It is required to track the patient's blood values;
• manifestations of the subcutaneous layer and dermatological pathologies: the appearance of redness, burning, irritation and itching, and in addition, increased sensitivity, rashes, pain during application and the purchase of a gray skin under the influence of sunlight (development of argirose). In addition, photosensitivity, skin necrosis, contact form of dermatitis, hyperpigmentation, as well as rhinitis with asthma, which is allergic in nature, develops.

Due to the prolonged course of treatment for burns with a large area of injury (especially severe burns), the side effects that are characteristic of the internal reception of sulfadiazine sometimes developed. Among them, vomiting, glossitis and nausea with diarrhea, as well as convulsions, headaches and joint pain. In addition, there is a feeling of confusion, thrombocyto- or leukopenia, anemia with eosinophilia, functional liver disorder or its necrosis, hospital fever and tubulointerstitial nephritis. Perhaps the appearance of crystalluria, erythema nodular type, dermatological reactions and allergies, TEN and Stevens-Johnson syndrome. There was also a development of cholestatic hepatosis, exfoliative form of dermatitis and vitamin B9 deficiency.

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

[5], [6]

Overdose

As a result of an overdose of drugs can appear negative reactions, characteristic of the systemic use of any sulfonamide. Prolonged use of the substance in high doses can increase the silver index inside the serum. But all these values come back to normal after the end of therapy.

In patients with severe burns in the case of prolonged therapy, there was a significant increase in serum osmolality. This disorder can develop due to increased resorption through the affected skin of the composite element of the drug, propylene glycol.

Therapy is aimed at eliminating violations. It may also require monitoring of blood counts and renal function. Absorbed sulfadiazine is effectively excreted by peritoneal dialysis or hemodialysis.

[8], [9]

Interactions with other drugs

In the case of a combination of silver sulfadiazine with enzyme drugs that purify wounds, it is possible to inactivate the latter.

When combined with cimetidine, there may be more cases of leukopenia.

During therapy with extensive burns, once the active ingredient of Dermasin has been reached at the therapeutic level inside the serum, it must be taken into account that the effectiveness of systemic drugs can be altered.

[10]

Storage conditions

Dermazin should be kept out of the reach of children. The temperature value in the room is not more than 25 ° С.

[11],

Shelf life

Dermazin is allowed to be used in the period of 3 years from the date of manufacture of the medicinal product.