Clinical Medications WorksheetGeneric NameSilver sulfadiazine

Trade NameSilvadene

ClassificationAnti-infectives (topical)

Doseinexact

Routetopical

Time/frequencybid

Peakunknown

OnsetOn contact

DurationAs long as applied

Normal dosage rangeApply 1% cream 1-2 times daily in layer 1.5-mm thick

Why is your patient getting this medicationPrevention and treatment of wound sepsis in patients with 2nd- and 3rd-degree burns.

For IV meds, compatibility with IV drips and/or solutionsN/A

Mechanism of action and indications(Why med ordered)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 membrane and cell wall to produce its bactericidal effect.

Nursing Implications (what to focus on) Contraindications/warnings/interactionsHypersensitivity (cross-sensitivity with sulfonamides may occur), Impaired hepatic or renal function.Common side effectsNo common or life-threatening side effects

Interactions with other patient drugs, OTC or herbal medicines (ask patient specifically)None for this patient

Lab value alterations caused by medicineMonitor renal function studies and CBC periodically when applied to large area, because systemic absorption may cause nephritis and reversible leukopenia. Decrease in neutrophil count is greatest 4 days after initiation of therapy; levels usually normalize after 2-3 days.Be sure to teach the patient the following about this medicationExplain purpose of medication to patient and family. This medication will not stain skin.

Nursing Process- Assessment(Pre-administration assessment)Assess burned tissue for infection (purulent discharge, excessive moisture, odor, and culture results) and sepsis (WBC, fever, or shock) prior to and throughout course of therapy.

AssessmentWhy would you hold or not give this med?Hypersensitivity reaction (rash, itching, or burning) at and surrounding sites of application.

EvaluationCheck after givingPrevention and treatment of infection in 2nd- and 3rd-degree burns. Therapy is continued until burn is healed or skin graft is performed.