Burna 1% Cream

✔️ Uses of Burna 1% Cream

• Cuts
• Wounds
• Severe burns
• Post-operative wound dressing
• Bed sores

✔️ How does Burna 1% Cream work?

Burna 1% Cream works by inhibiting the bacterial enzyme dihydropteroate synthetase (the enzyme responsible for folic acid synthesis in bacteria) which leads to the blockade of DNA synthesis in bacteria resulting in the prevention and synthesis of bacterial growth in burn wounds, leg ulcers, and/or pressure sores in affected individuals.  

✔️ Side Effects of Burna 1% Cream

• Rashes
• Irritation
• Skin damage
• Burning sensation
• Skin Pigmentation
• Photosensitivity

✔️ Quick Suggestions:

• Silver Sulfadiazine prevents and treats infections of burn wounds.
• Clean the wound and then apply the cream to the affected area using a sterile gloved hand or a sterile spatula.
• Apply it once or twice daily and re-apply to any areas from which it gets removed due to activity. Burn areas should be covered with the cream at all times.
• Continue to use Silver Sulfadiazine as per the frequency and duration advised by your doctor.

✔️ Burna 1% Cream is indicated for-

• Topical prevention of bacterial colonization and infection in burn wounds.
• Other than burns, the topical antibacterial management of certain contaminated or infection-prone wounds.

✔️ Pharmacology

Silver sulfadiazine's antibacterial activity mechanism is not fully understood. However, when the drug is applied to the affected area, it induces secondary changes in the bacterial cell membrane. These changes include twisting and elongation of the cell, weakening the cell wall layer, and reducing the viability of susceptible strains.

The silver sulfadiazine molecule dissociates, and the silver component binds to the bacterial cells. Upon entering the bacterial cell wall, the silver component attaches to the bacterial deoxyribonucleic acid (DNA), preventing bacterial cell replication. Mammalian cells contain approximately 100 times more DNA than bacterial cells. The ratio of silver sulfadiazine to bacterial DNA is believed to be high enough to inhibit bacterial division, while the corresponding ratio to epithelial DNA is low enough not to impede epithelial cell regeneration.

The sulfadiazine moiety of the drug also provides bacteriostatic activity against susceptible organisms. In summary, silver sulfadiazine's mechanism of action involves interfering with bacterial cell division through interactions with bacterial DNA, while also exerting a bacteriostatic effect against sensitive bacteria.

✔️ Dosage & Administration of Burna 1% Cream

Topical/Cutaneous Treatment and prophylaxis of infection in severe burns:

• Adult: Apply the cream onto the affected area 1-2 times a day.

Child Dose:

• Burn Wound Infections (2°/3°)
  • <2 months: Contraindicated

2 months (1% cream): Apply the cream onto the affected area 1-2 times a day.

For burns:

• The burn wound should be cleaned before applying the cream over all the affected areas to a depth of 3-5mm.
• Reapply the cream to any area that has been removed by patient activity.
• In burns, the cream should be reapplied at least every 24 hours or more frequently if there is a large amount of exudate.

For hand burns:

• Enclose the whole hand in a clear plastic bag or glove before applying the Silver Sulphadiazine cream to the burn.
• Encourage the patient to move their hand and fingers.
• Change the dressing when an excessive amount of exudate has accumulated in the bag.

For leg ulcers/pressure sores:

• Fill the cavity of the ulcer with the cream to a depth of at least 3-5mm.
• Take care to prevent the spread of cream onto non-ulcerated areas, as prolonged contact can cause maceration of normal skin.
• Apply an absorbent pad or gauze dressing after the cream application, and use pressure bandaging as appropriate for the ulcer.
• Dressings should normally be changed daily, but for less exudative wounds, less frequent changes (every 48 hours) may be acceptable.

✔️ Interaction

Enzymatic debriding agents: The use of enzymatic debriding agents may not be suitable when used together with Silver sulfadiazine, as it could potentially inactivate these agents.

Oral hypoglycemic agents and phenytoin: In patients with large-area burns, the serum levels of sulfadiazine may reach therapeutic levels, leading to a possible potentiation of the effects of oral hypoglycemic agents and phenytoin. Therefore, it is advisable to monitor the blood levels of these medications in such patients.

Cimetidine: Co-administration of Cimetidine with Silver sulfadiazine in patients with large-area burns may increase the incidence of leukopenia (a decrease in white blood cells). Caution should be exercised when using these medications together in such cases.

✔️ Contraindications

• If you are allergic to silver or other ingredients of the product.
• The product should not be applied to bleeding wounds.

✔️ Pregnancy & Lactation

Pregnancy Category B. This drug should be used during pregnancy only if clearly justified, especially in pregnant women approaching or at term. It is not known whether Silver Sulfadiazine is excreted in human milk. A decision should be made, whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother. Pediatric Use Safety and effectiveness in pediatric patients have not been established.

✔️ Precautions & Warnings

• If there are impairments in hepatic (liver) and renal (kidney) functions, leading to reduced drug elimination, accumulation of Silver sulfadiazine may occur. In such cases, the decision to continue using the medication should be carefully considered in comparison to the therapeutic benefits achieved.
• In the treatment of burn wounds covering extensive areas of the body, the serum sulfa concentrations may reach levels similar to those seen in adults (8 mg% to 12 mg%). Therefore, in these patients, it is advisable to monitor serum sulfa concentrations. Regular monitoring of renal function and checking for sulfa crystals in the urine should also be done.
• Allergy or Sensitivity: If you experience any allergic reactions or sensitivity after using the product, discontinue its use and seek medical attention.
• Children and Infants: Consult a doctor before using Silver sulfadiazine cream on children and infants.
• Prolonged Use and Internal Wounds: Avoid using the cream for an extended duration or on internal wounds without medical supervision.
• Preparation for Procedures: Before undergoing any procedure where the presence of metal may cause issues, such as hyperbaric oxygenation (a surgical procedure to expedite healing), ensure that the wound is thoroughly cleaned and the cream is not present on the affected area.

✔️ Storage Conditions

Store in a cool and dry place away from direct sunlight. Keep it out of the reach of children and pets.