WordNet

made from or largely consisting of silver; "silver bracelets"
a soft white precious univalent metallic element having the highest electrical and thermal conductivity of any metal; occurs in argentite and in free form; used in coins and jewelry and tableware and photography (同)Ag, atomic number 47
coins made of silver
make silver in color; "Her worries had silvered her hair"
turn silver; "The mans hair silvered very attractively"
having the white lustrous sheen of silver; "a land of silver (or silvern) rivers where the salmon leap"; "repeated scrubbings have given the wood a silvery sheen" (同)silvern, silvery
coat with a layer of silver or a silver amalgam; "silver the necklace"
a sulfa drug used in treating meningitis and pneumonia and other infections

PrepTutorEJDIC

『銀』(金属元素;化学記号は『Ag』) / (商品・通貨基準としての)銀 / 『銀貨』(一般に銀白色の)硬貨 / 《集合的に》『銀(銀めっき)の食器類』,銀器 / 『銀製の』,銀めっきした / 銀色の,銀白色の / …‘に'銀めっきする / 《文》…‘を'銀色にする / 銀色になる

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/07/26 23:25:51」(JST)

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Silver sulfadiazine (INN, or silvadene) is a topical sulfonamide/silver^[1] antibacterial used as a topical cream on burns. Evidence regarding its usefulness in burns is poor.^[2] Tentative evidence has found that silver sulfadiazine may increase healing times – wounds may take longer to heal if treated with this drug, so it is not recommended by the authors of a Cochrane review.^[2]

Silver sulfadiazine is typically delivered in a 1% cream or aqueous suspension. Brand names include 'Silvadene (a genericized trademark), Silverex, Silverol, Silvazine, Flamazine, Thermazene, BurnHeal, and SSD.^[3]

It is on the World Health Organization's List of Essential Medicines, the most important medications needed in a basic health system.^[4]

Medical uses

Evidence regarding its usefulness in burns is poor.^[2] A 2012 review found that topical silver may worsen healing time compared to controls and showed no evidence of effectiveness in preventing wound infection.^[5] A Cochrane systematic review from 2008 found that most of the trials had methodological shortcomings and thus are of little use.^[2] Another Cochrane systematic review from 2010 concluded, "There is insufficient evidence to establish whether silver-containing dressings or topical agents promote wound healing or prevent wound infection".^[6] Other reviews of the evidence have also concluded, "[the] quality of the trials was limited".^[7] Cochrane has raised concerns about delays in time to wound healing and an increased number of dressing applications when SSD is used.^[2]

Adverse 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 1.0% of patients show hypersensitivity reactions such as rashes or erythema multiforme.^[8] This reaction is 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 light. 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.^[8]

Interactions

Proteases such as 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 such as vitamin K antagonists.^[8]

Pharmacokinetics

The chemical 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.^[8]

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.
^ ^a ^b ^c ^d ^e 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. The use of silver sulphadiazine (SSD) as a comparator on burn wounds for the full duration of treatment needs to be reconsidered, as a number of studies showed delays in time to wound healing and increased number of dressing applications in patients treated with SSD dressings
^ http://www.drugs.com/mtm/ssd.html This source names Silvadene, SSD, SSD AF, Thermazene
^ "WHO Model List of EssentialMedicines" (PDF). World Health Organization. October 2013. Retrieved 22 April 2014.
^ Aziz, Z; Abu, SF; Chong, NJ (May 2012). "A systematic review of silver-containing dressings and topical silver agents (used with dressings) for burn wounds.". Burns : journal of the International Society for Burn Injuries 38 (3): 307–18. doi:10.1016/j.burns.2011.09.020. PMID 22030441.
^ Storm-Versloot, MN; Vos, CG; Ubbink, DT; Vermeulen, H (Mar 17, 2010). Storm-Versloot, Marja N, ed. "Topical silver for preventing wound infection". Cochrane database of systematic reviews (Online) (3): CD006478. doi:10.1002/14651858.CD006478.pub2. PMID 20238345.
^ Lo SF, Hayter M, Chang CJ, Hu WY, Lee LL (2008). "A systematic review of silver-releasing dressings in the management of infected chronic wounds". Journal of clinical nursing 17 (15): 1973–85. doi:10.1111/j.1365-2702.2007.02264.x. PMID 18705778.
^ ^a ^b ^c ^d Jasek, W, ed. (2007). Austria-Codex (in German) 2 (62 ed.). Vienna: Österreichischer Apothekerverlag. pp. 3270–1. ISBN 978-3-85200-181-4.

UpToDate Contents

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1. 熱傷の局所治療：外用抗菌薬と被覆材 local treatment of burns topical antimicrobial agents and dressings
2. 軽症熱傷の治療 treatment of minor thermal burns
3. 下肢慢性静脈疾患の内科的マネージメント medical management of lower extremity chronic venous disease
4. 褥瘡の感染性合併症 infectious complications of pressure ulcers
5. 血管内カテーテル感染症の予防 prevention of intravascular catheter related infections

English Journal

Solid-state encapsulation of Ag and sulfadiazine on zeolite Y carrier.

Mavrodinova V1, Popova M2, Yoncheva K3, Mihály J4, Szegedi Á5.
Journal of colloid and interface science.J Colloid Interface Sci.2015 Nov 15;458:32-8. doi: 10.1016/j.jcis.2015.07.026. Epub 2015 Jul 13.
HYPOTHESIS: A new simplified procedure for encapsulation of antibacterial silver nanoparticles by Solid-state Ion Exchange (SSIE) procedure over zeolite Y, followed by deposition of sulfadiazine (SD) by dry mixing was examined for the preparation of topical antibacterial formulations. The ion-exchan
PMID 26203589

Development of silver sulfadiazine loaded bacterial cellulose/sodium alginate composite films with enhanced antibacterial property.

Shao W1, Liu H2, Liu X3, Wang S2, Wu J2, Zhang R2, Min H4, Huang M2.
Carbohydrate polymers.Carbohydr Polym.2015 Nov 5;132:351-8. doi: 10.1016/j.carbpol.2015.06.057. Epub 2015 Jun 25.
Sodium alginate (SA) and bacterial cellulose (BC) are widely used in many applications such as scaffolds and wound dressings due to its biocompatibility. Silver sulfadiazine (AgSD) is a topical antibacterial agents used as a topical cream on burns. In the study, novel BC/SA-AgSD composites were prep
PMID 26256359

Japanese Journal

MRSA形成のバイオフィルムに対するスルファジアジン銀の殺菌効果

田尻豊和,自見至郎,TANG Keika [他]
福岡大学医学紀要 = Medical bulletin of Fukuoka University 42(1), 119-129, 2015-03
NAID 40020460533

MRSA形成のバイオフィルムに対するスルファジアジン銀の殺菌効果

田尻豊和,自見至郎,譚佳梁,重森健,原周司,大慈弥裕之
福岡大学医学紀要 42(1), 119-129, 2015-03
NAID 110009890540

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★リンクテーブル★

リンク元	「スルファジアジン銀」「sulfadiazine silver」
関連記事	「silver」「sulfadiazine」

「スルファジアジン銀」

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; category	B (not recommended in late pregnancy);
Legal status	℞ (Prescription only);
Routes of; administration	Topical
Pharmacokinetic data
Bioavailability	<1% (silver), 10% (sulfadiazine)
Protein binding	High (silver)
Excretion	2/3 renal (sulfadiazine)
Identifiers
CAS Registry 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
Molecular mass	357.14 g/mol
	SMILES [Ag+].O=S(=O)([N-]c1ncccn1)c2ccc(N)cc2 ;
	InChI 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
Melting point	285 °C (545 °F)
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　　[★]

英: silver sulfadiazine、sulfadiazine silver
同: ゲーベンクリーム
関: スルファジアジン

自己融解によるデブリドマンを促進し、また抗菌作用を有する。
薬剤の壊死組織への浸透力が強く、バイオフィルム内の菌にも効果を有する。
緑膿菌に強い抗菌作用がある。
壊死組織を伴う汚染創や褥瘡、深達性の熱傷にも使用される。
乳剤性基剤(水中油型)のため、滲出液が多いときは創面の浮腫を来すおそれがあり、不適である。
使用方法：創部に2-3mmの厚さで塗布し、同程度の厚さのガーゼで被覆する。ガーゼ交換の際には、付着しているゲーベンクリームを除去してから塗布する。
薬価：ゲーベンクリーム1%1g \12.6/g
製品単位：ゲーベンクリーム500g
ゲーベンクリームの場合、スルファジアジン銀が薬効成分であり、基剤はセタノール，ミリスチン酸イソプロピル，プロピレングリコール，メチルパラベン，ブチルパラベンとなる。