SULFACETAMIDE SODIUM

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)

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 1–3 drops of 10%, 15%, or 30% solution into lower conjunctival sac q2–3h, may increase interval as patient responds or use 1.5–2.5 cm (?–1 in.) of 10% ointment q6h and at h.s.

Seborrhea, Rosacea
Adult: Topical Apply thin film to affected area 1–3 times/d

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.

Common adverse effects in italic, life-threatening effects underlined; generic names in bold; classifications in SMALL CAPS; Canadian drug name; Prototype drug

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