Hyperosmolality induced by propylene glycol. A complication of silver sulfadiazine therapy. 1985

C L Fligner, and R Jack, and G A Twiggs, and V A Raisys

An 8-month-old male infant was treated with topical silver sulfadiazine for a burn and complicating toxic epidermal necrolysis involving 78% of his total body surface area. Transdermal absorption of propylene glycol from the silver sulfadiazine produced hyperosmolality with an increased osmolal gap. A peak propylene glycol concentration of 1,059 mg/dL was documented, and its osmotic effect was that predicted from its concentration. Our data support either zero-order elimination at a rate of 13.5 mg/dL/hr or first-order elimination with a half-life of 16.9 hours. Elevated concentrations of propylene glycol may have contributed to the patient's cardiorespiratory arrest. The osmolal gap may be used as a screen for suspected propylene glycol intoxication in selected clinical settings.

UI MeSH Term Description Entries
D007223 Infant A child between 1 and 23 months of age. Infants
D008297 Male Males
D009823 Ointment Bases Various mixtures of fats, waxes, animal and plant oils and solid and liquid hydrocarbons; vehicles for medicinal substances intended for external application; there are four classes: hydrocarbon base, absorption base, water-removable base and water-soluble base; several are also emollients. Bases, Ointment
D009994 Osmolar Concentration The concentration of osmotically active particles in solution expressed in terms of osmoles of solute per liter of solution. Osmolality is expressed in terms of osmoles of solute per kilogram of solvent. Ionic Strength,Osmolality,Osmolarity,Concentration, Osmolar,Concentrations, Osmolar,Ionic Strengths,Osmolalities,Osmolar Concentrations,Osmolarities,Strength, Ionic,Strengths, Ionic
D011409 Propylene Glycols Derivatives of propylene glycol (1,2-propanediol). They are used as humectants and solvents in pharmaceutical preparations. Propanediols,Glycols, Propylene
D002056 Burns Injuries to tissues caused by contact with heat, steam, chemicals (BURNS, CHEMICAL), electricity (BURNS, ELECTRIC), or the like. Burn
D006323 Heart Arrest Cessation of heart beat or MYOCARDIAL CONTRACTION. If it is treated within a few minutes, heart arrest can be reversed in most cases to normal cardiac rhythm and effective circulation. Asystole,Cardiac Arrest,Cardiopulmonary Arrest,Arrest, Cardiac,Arrest, Cardiopulmonary,Arrest, Heart,Asystoles
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000287 Administration, Topical The application of drug preparations to the surfaces of the body, especially the skin (ADMINISTRATION, CUTANEOUS) or mucous membranes. This method of treatment is used to avoid systemic side effects when high doses are required at a localized area or as an alternative systemic administration route, to avoid hepatic processing for example. Drug Administration, Topical,Administration, Topical Drug,Topical Administration,Topical Drug Administration,Administrations, Topical,Administrations, Topical Drug,Drug Administrations, Topical,Topical Administrations,Topical Drug Administrations
D012837 Silver Sulfadiazine Antibacterial used topically in burn therapy. Brandiazin,Dermazin,Flamazine,Flammazine,SSD,SSD AF,Sicazine,Silvadene,Silvederma,Sulfafdiazine, Silver,Sulfargen,Thermazene,Silver Sulfafdiazine,Sulfadiazine, Silver

Related Publications

C L Fligner, and R Jack, and G A Twiggs, and V A Raisys
January 1990, The British journal of dermatology,
C L Fligner, and R Jack, and G A Twiggs, and V A Raisys
January 1990, BMJ (Clinical research ed.),
C L Fligner, and R Jack, and G A Twiggs, and V A Raisys
September 1983, Pediatrics,
C L Fligner, and R Jack, and G A Twiggs, and V A Raisys
July 1990, BMJ (Clinical research ed.),
C L Fligner, and R Jack, and G A Twiggs, and V A Raisys
January 1988, Intensive care medicine,
C L Fligner, and R Jack, and G A Twiggs, and V A Raisys
January 1996, Therapie,
C L Fligner, and R Jack, and G A Twiggs, and V A Raisys
May 1987, Critical care medicine,
C L Fligner, and R Jack, and G A Twiggs, and V A Raisys
September 1993, Food and chemical toxicology : an international journal published for the British Industrial Biological Research Association,
C L Fligner, and R Jack, and G A Twiggs, and V A Raisys
March 2013, AAPS PharmSciTech,
C L Fligner, and R Jack, and G A Twiggs, and V A Raisys
November 1978, International journal of dermatology,
Copied contents to your clipboard!