BURNS MEDS -- module 4

BURNS MEDS -- module 4

silver sulfadiazine (silvadene)

— USED for 2nd & 3rd degree burns

— MOA → releases silver ions & disrupts bacterial cell walls (unable to reproduce)

• apply 1/16 in layer — reapply after dressing changes/hydrotherapy

• AVOID applying to face, newborns <2 months, during pregnancy

• AVOID giving to patients with sulfa allergies & G6PD deficiency

• monitor for → skin reactions, delayed healing, rare systemic effects

• cons → poor eschar penetration (doesnt go over thick fibrin) — delays healing & increase infection risk

— STORY → I usually wear my 1/16 silver james avery rings. I try to keep away from my pregnant aunt & her newborn baby (<2 months) because it can be dangerous. I also try not to put them near my face cus then I get pimples. I also stay away from people allergic to jewelry or with deficiencies. I constantly watch for skin reactions with the jewelry.

paraffin ointment (anabolic steroid)

• FIRE hazard awareness → dont touch or put near clothes

• fall risk prevention

• safe applicable techniques

• reaction monitoring

— STORY → paraffin = FIRE & FALL — monitor reactions

oxandrolone (anabolic steroid)

• counteracts hypermetabolism

• preserves lean body mass → help not digest own muscle

• improves weight gain & nitrogen balance

• no mortality benefit; infection risk unchanged

— STORY → My friend alexandra takes her steroids to help with her weigh gain & nitrogen balance. She goes to the gym a lot, so she preserves a lot of lean body mass. However, if her metabolism is fast, she doesnt take it (hypermetabolism).

propranol

• non selective beta blocker used to counteract burn induced hypermetabolism

• indicated for >20% TBSA burns once hemodynamically stable (post resuscitation)

• proven to decrease cardiac rate pressure product without increasing complications

• AVOID in patients with COPD, asthma, tachycardia — keep close watch

— STORY → I used to have band rehearsal during summer. We were all over 20 y/o, so we would move props and sometimes get too hot, leading to burns. So we always took our meds to prevent hypermetabolism from the burn. We also tried to be careful as it could reduce our HR. The students with heart/breathing conditions had to be watched closely (COPD, asthma, tachycardia).

bacitracin

• used for small superficial partial thickness burns, especially on the face → provides gentle antimicrobial coverage (gram positive)

• sulfur based

• non cytotoxic to healing tissue; preferred for small superficial burns

• apply thinly with non stick gauze ; change daily per wound care guidelines

• does NOT cover MRSA ; AVOID in deeper or heavily contaminated burns

• monitor for allergic rash with prolonged contact on intact skin

• safe & painless option for facial — minimal tissue irritating

— STORY → Back in the day I fell and got a small superficial burn on my face. I applied thin sulfur base cream with gauze. I monitored for any allergic rashes. The cream felt painless & safe on my face.

acyclovir → class: antiviral

— USED for viral/herpes infections — treats non HIV viral infections & herpes zoster infections

• CNS effects — report tox signs → headache & vertigo

• AVOID nephrotoxic drugs

• topical → burning, itching, redness

• oral → N/V/D — monitor GI & take w/ food

• IV → renal toxicity, thrombophlebitis — infuse slowly & hydrate

— STORY → I was riding my cycle (acyclovir) and got a viral infection. I took my PO meds with food so I wouldnt feel N/V/D. I then went to the doctor to get an IV, and they infused it slow & made sure I didnt have thrombophlebitis or renal toxicity. They also checked for burning, itching & redness.