磺胺米隆凝胶的制备与质量控制

<正>磺胺米隆抗菌谱广,对多种革兰阴性及革兰阳性菌都有效,对绿脓杆菌有较强的作用且不受脓液、坏死组织、对氨基苯甲酸等的影响,能迅速渗入创面及焦痂,临床上多用于烧伤感染及化脓性创面的局部应用[1]。目前在临床上应用的制剂,多为软膏剂、溶液制剂,笔者试制了磺胺米隆的凝胶制剂,认为该制剂具有制备方便、处方合理、质量可控及应用方便等特点,介绍如下。     

双波长测定磺胺嘧啶银霜的含量

磺胺嘧啶银霜是医院外用制剂,用于烧伤感染及化脓创面,特别适用于绿脓杆菌的感染,在紫外分光光度法测定中,由于霜剂含有其他成分干扰测定,故本实验用双波长消除干扰,测定磺胺嘧啶银霜的含量.     

半暴露灯烤治疗烧伤创面绿脓杆菌感染

目的研究烧伤创面绿脓杆菌感染的各种局部创面治疗方法的效果。方法烧伤创面随机分组后，按照创面用1％磺胺嘧啶银霜（SD-Ag霜）外敷每天换药、用0．5％碘伏液纱布覆盖包扎每天换药、用0．5％碘伏液纱布覆盖半暴露＋灯烤、用0．9％氯化钠液纱布覆盖半暴露＋灯烤四种方武处理局部创面，对比处理后第3天创面感染情况及第5天创面细菌培养情况。结果 半暴露＋灯烤处理后全部创面感染均得到有效控制（100％），而磺胺嘧啶银霜外敷组效果不明显（15．3％），碘伏液纱布覆盖包扎组最差（7．8％）；第5天创面细菌培养半暴露＋灯烤处理后细菌培养无菌生长率为100％，而磺胺嘧啶银糟外敷组为8．3％，碘伏液纱布掰盖包扎组为0％．结论半蒙露灯烤在烧伤创面绿脓杆菌感染治疗中疗被显著。     

枯矾液对烧伤创面绿脓杆菌感染的疗效观察

在烧伤创面中，绿脓杆菌是常见的菌种。绿脓杆菌感染不但对伤面的愈合很不利，严重感染还常危及病人的生命。创面用药对控制局部感染、改善全身状况都是非常必要的，而绿脓杆菌对目前常用的创面外用药如磺胺嘧啶银、磺胺嘧啶锌等都易产生耐药性，效果不好。我院1990年开始应用10%枯矾液外用治疗烧伤剖面绿脓杆菌感染，效果比较显，报告如下。     

烫创油缓解磺胺嘧啶银霜对创面疼痛刺激作用的临床观察

目的 研究磺胺嘧啶银霜中加入烫创油后再涂抹于烧／烫伤创面可明显缓解磺胺嘧啶银霜对创面的疼痛刺激。方法 选择126例烫／烧伤患者，以Ⅱ度创面为主，采用磺胺嘧啶银霜和烫创油的混合勿(治疗组)与磺胺嘧啶银霜(对照组)对照治疗，分别观察两种方法处理后创面疼痛随时间发展缓解的差异。结果 与对照组相比，治疗组创面疼痛缓解及消失快，效果明显。结论 烫创油缓解黄胺嘧啶银霜对创面疼痛刺激作用效果显著。     

三黄霜与磺胺嘧啶银治疗96例轻,中度烧伤疗效比较

本文对９６例总面积≤３０％Ⅱ度热烧伤创面分别采用三黄霜与磺胺嘧淀银治疗作对照研究，结果显示，三黄霜组在创面愈合时间比磺胺嘧啶银组短，提示三黄霜有抑制创面感染，促进创面愈合的作用。且费用低廉。     

磺胺嘧啶银包装及剂型改进的建议

磺胺嘧啶银(SD-Ag)对绿脓杆菌具有强大的抑制作用。其特点是既保持了磺胺嘧啶及硝酸银的抗菌作用，局部用药又无副作用。临床上常用于烧伤创面的治疗。目前，医院用的SD-Ag多是大包装，这给运输、存放和应用带来很多不便。     

磺胺嘧啶银的研究进展

磺胺嘧啶银是由磺胺嘧啶和硝酸银化合而成的,具有银的收敛作用和磺胺嘧啶的抗菌消炎作用,主要用于烧伤创面治疗的外用药。临床对控制、预防、杀灭绿脓杆菌以及促进创面愈合、植皮、新生均有作用。磺胺嘧啶银除了用于烧伤创面的感染外,还可用于褥疮创面治疗、治疗局部冻伤、由MRSA感染的溃疡及慢性唇炎的治疗等。现将磺胺嘧啶银的研究进展综述如下。     

磺胺嘧啶银霜剂的改进

磺胺嘧啶银霜剂的改进刘腊娥，张万新，张政，汪滨（中国人民解放军第１６３医院长沙４１０００３）磺胺嘧啶银霜剂为广谱抗菌药，具有收敛作用。临床用于烧伤感染及化脓创面，特别适用于预防或治疗绿脓杆菌的感染。其原处方为中国人民解放军海军后勤部卫生部编，由磺胺嘧...     

磷霉素钙防治烧伤创面绿脓杆菌感染

同部抗菌药物能有效地防治烧伤创面侵袭性感染。目前临床应用最多的是磺胺嘧啶银,但其穿透焦痂的能力较差。体外实验显示,磷霉素对绿脓杆菌具有良好的抗菌活性,且分子量小,易于弥散入组织。为探讨磷霉素钙应用于烧伤创面的可能性,我们测定了焦痂下磷霉素钙的浓度,并对其在烧伤创面的抗绿脓杆菌效果进行观察。     

复方磺胺米隆凝胶的制备及质量控制

目的:建立复方磺胺米隆凝胶制备及质量控制方法。方法:以醋酸磺胺米隆和盐酸达克罗宁为主药,以羧甲基纤维钠和甘油为基质,制备水溶性凝胶,以紫外分光光度法测定含量。结果:凝胶pH6.0~7.0,其他各项检查均符合有关规定,醋酸磺胺米隆平均回收率为99.49%,RSD为0.84%;盐酸达克罗宁回收率为100.2%,RSD为0.84%。结论:该制剂制备工艺简单,性质稳定,质量可控。     

Allergic contact dermatitis to mafenide acetate: a case series and review of the literature

Burn patients with extensive involvement of body surface area (BSA >30%) represent a challenge in wound treatment. Multiple topical agents may be used for cleansing, barrier protection, and antimicrobial control leading to complications of contact and/or irritant dermatitis, which may further complicate re-epithelization and eventual wound healing. We present 4 patients who sustained extensive burns during Operation Iraqi Freedom/Operation Enduring Freedom and later developed contact dermatitis to mafenide acetate, a common topical antimicrobial used in burn care treatment, also known as Sulfamylon (alpha-amino-p-toluenesulfonamide monoacetate). All patients who were patch tested to mafenide acetate 7% solution were positive. A rechallenge with mafenide acetate resulted in recrudescence of the eruption in 2 out of the 4 patients. Though cutaneous reactions to mafenide acetate were reported by Yaffe and Dressler in 1969, the most recent case reports are from 1995. This paper presents more recent examples of cutaneous reactions to mafenide acetate, while also reviewing the literature.     

Methylamine but not mafenide mimics insulin-like activity of the semicarbazide-sensitive amine oxidase-substrate benzylamine on glucose tolerance and on human adipocyte metabolism

It has been reported that benzylamine reduces blood glucose in rabbits, stimulates hexose uptake, and inhibits lipolysis in mouse, rabbit, and human adipocytes. In the presence of vanadate, benzylamine is also able to improve glucose disposal in normoglycaemic and diabetic rats. Such insulin-mimicking properties are the consequence of hydrogen peroxide production during benzylamine oxidation by semicarbazide-sensitive amine oxidase (SSAO). The aim of the study was to determine whether other SSAO-substrates could share such potential antidiabetic properties. Thus, mafenide, a synthetic antimicrobial sulfonamide structurally related to benzylamine, and which has been recently reported to interact with SSAO, was tested in the above mentioned models, in parallel with methylamine, a proposed endogenous SSAO-substrate. All tested amines stimulated glucose uptake and inhibited lipolysis in rat and mouse fat cells. Methylamine and benzylamine, but not mafenide, reduced the hyperglycaemic response during a glucose tolerance test in rabbits while the three amines tested were devoid of insulin-releasing activity under both in vivo and in vitro conditions. In human adipocytes, mafenide did not stimulate glucose transport since it was not a high-affinity substrate for SSAO and generated less hydrogen peroxide than benzylamine or methylamine. Therefore, mafenide could not be considered as an antidiabetic drug despite being oxidized and exhibiting insulin-mimicking effects in rat and mouse adipocytes. By contrast, the endogenous substrate methylamine improved glucose utilization in all in vitro and in vivo models, leading to consider novel SSAO substrates as drugs with potential anti-hyperglycaemic properties.