SULFACETAMIDE SODIUM (sul-fa-see'ta-mide)
AK-Sulf, Bleph 10, Cetamide, Isopto Cetamide, Ophthacet, Sebizon, Sodium Sulamyd, Sulf-10 Sulfacetamide Sodium/Sulfur Sulfacet, Rosula Classifications: sulfonamide antibiotic; Therapeutic: antibiotic; sulfonamide Prototype: Sulfisoxazole Pregnancy Category: B, D (near term)
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Availability
Sulfacetamide: 10% lotion; 1%, 10%, 15%, 30% solution; 10% ointment
Sulfacetamide/Sulfur: 10%/5% gel, lotion
Action
Highly soluble sulfonamide that exerts bacteriostatic effect by interfering with bacterial utilization of PABA, thereby
inhibiting folic acid biosynthesis required for bacterial growth.
Therapeutic Effect
Effective against a wide range of gram-positive and gram-negative microorganisms.
Uses
Ophthalmic preparations are used for conjunctivitis, corneal ulcers, and other superficial ocular infections and as adjunct
to systemic sulfonamide therapy for trachoma. The topical lotion is used for scaly dermatoses, seborrheic dermatitis, seborrhea
sicca, and other bacterial skin infections.
Contraindications
Hypersensitivity to sulfonamides or to any ingredients in the formulation; neonates, pregnancy (category D near term). Safe
use in children not known.
Cautious Use
Application of lotion to denuded or debrided skin; lactation, pregnancy (category B).
Route & Dosage
Conjunctivitis Adult: Ophthalmic 13 drops of 10%, 15%, or 30% solution into lower conjunctival sac q23h, may increase interval as
patient responds or use 1.52.5 cm (?1 in.) of 10% ointment q6h and at h.s.
Seborrhea, Rosacea Adult: Topical Apply thin film to affected area 13 times/d
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Administration
Instillation
- Be aware that ophthalmic preparations and skin lotion are not interchangeable.
- Check strength of medication prescribed.
- See patient instructions for instilling eye drops.
- Discard darkened solutions; results when left standing for a long time.
- Store at 8°15° C (46°59° F) in tightly closed containers unless otherwise directed.
Adverse Effects (≥1%)
Special Senses: Temporary stinging or burning sensation, retardation of corneal healing associated with long-term use of ophthalmic ointment.
Body as a Whole: Hypersensitivity reactions (
Stevens-Johnson syndrome, lupus-like
syndrome), superinfections with nonsusceptible organisms.
Interactions
Drug: Tetracaine and other
local anesthetics derived from paba may antagonize the antibacterial effects of
sulfonamides;
silver preparations may precipitate sulfacetamide from solution.
Pharmacokinetics
Absorption: Minimal systemic absorption, but may be enough to cause sensitization.
Metabolism: In liver to inactive metabolites.
Elimination: In urine.
Nursing Implications
Assessment & Drug Effects
- Discontinue if symptoms of hypersensitivity appear (erythema, skin rash, pruritus, urticaria).
Patient & Family Education
- Wash hands thoroughly with soap and running water (before and after instillation).
- Examine eye medication; discard if cloudy or dark in color.
- Avoid contaminating any part of eye dropper that is inserted in bottle.
- Tilt head back, pull down lower lid. At the same time, look up while drop is being instilled into conjunctival sac. Immediately
apply gentle pressure just below the eyelid and next to nose for 1 min. Close eyes gently, so as not to squeeze out medication.
- Report purulent eye discharge to physician. Sulfacetamide sodium is inactivated by purulent exudates.