Antiseptic, wound cauterization, degranulation of tissue (warts, corns): Note: Specific application techniques, frequency, and duration may vary with specific use (eg, warts vs burns); refer to institutional protocols.
Children and Adolescents (Ebrahimi 2007; Kwok 2012; Tompkins 1988): Topical:
Sticks: Apply to mucous membranes and other moist skin surfaces only on area to be treated
Topical solution: Apply a cotton applicator dipped in solution on the affected area 2 to 3 times/week for 2 to 3 weeks
(For additional information see "Silver nitrate: Drug information")
Anti-infective (0.5% solution): Topical: Use as directed.
Granulation tissue removal, wound cauterization: Topical: Sticks: Apply to affected area; application may be repeated every 24 hours for a total of 3 applications for granulation tissue (McGrath 1990) or once weekly (over several weeks if needed) for pyogenic granuloma (Quitkin 2003).
Excipient information presented when available (limited, particularly for generics); consult specific product labeling.
Applicator sticks, topical: Silver nitrate 75% and potassium nitrate 25%
Solution, topical: 0.5% (960 mL); 10% (30 mL); 25% (30 mL); 50% (30 mL)
Yes
For topical use only. Applicators are not for ophthalmic use. If applicator sticks are used on dry skin, dip the applicator tip in water immediately before use. Applicator sticks may be bent or shaped for easier access to target area.
Topical: Applicator sticks are not for ophthalmic use. If applicator sticks are used on dry skin, dip the applicator tip in distilled, deionized, or purified water immediately before use and apply by holding, rubbing, or rotating the tip along the affected tissue. One silver nitrate applicator is generally sufficient for each application. The action of the silver nitrate can be stopped by washing the area with saline solution (0.9% sodium chloride). Using saline solution to wet the applicator tips, or residual saline from wound flushing/washing, will interfere with the action of silver nitrate resulting in cauterization failure. Only use distilled, deionized, or purified water to wet applicator tips. Blot dry wounds that have been flushed/washed with saline prior to applying silver nitrate. Apply to mucous membranes and other moist skin surfaces only on area to be treated.
Must be stored in a dry place. Store in a tight, light-resistant container. Exposure to light causes silver to oxidize and turn brown. Dipping in water causes oxidized film to readily dissolve.
Astringent; cauterization of skin or mucous membranes; germicidal; treatment of helomas; removal of granulation tissue, corns, and warts (All indication: FDA approved in pediatric patients [age not specified] and adults)
The following adverse drug reactions and incidences are derived from product labeling unless otherwise specified. Frequency not defined.
Dermatologic: Burning sensation of skin, skin discoloration, skin irritation
Hematologic & oncologic: Methemoglobinemia
There are no contraindications listed in the manufacturer’s labeling.
Concerns related to adverse effects:
• Chemical burn: Silver nitrate is a caustic agent and inappropriate use may cause chemical burns. Skin contact time with applicator sticks should be extremely short when used in neonates or on thin delicate skin. Wear chemical-resistant gloves and other appropriate personal protective equipment while using this product. Take care to confine the silver nitrate to the area being treated by using an appropriate physical or chemical barrier to prevent staining or burning of untreated tissue.
• Skin discoloration: Prolonged use may result in skin discoloration. Silver salts stain tissue black due to deposition of reduced silver. The stain gradually disappears within a period of 2 weeks. Prolonged ingestion or absorption of silver compounds leads to deposition of silver in connective tissues, producing a slate-blue discoloration of the skin known as argyria. This discoloration may also appear on mucous membranes, such as the margins of gums. The sclera of the eye is also stained.
Other warnings/precautions:
• Appropriate use: Do not use applicator sticks on the eyes. Do not use topical solution on mucous membranes.
None known.
Cellulose (Oxidized Regenerated): Silver Nitrate may diminish the therapeutic effect of Cellulose (Oxidized Regenerated). Risk X: Avoid combination
Free silver ions precipitate bacterial proteins by combining with chloride in tissue forming silver chloride; coagulates cellular protein to form an eschar; silver ions or salts or colloidal silver preparations can inhibit the growth of both gram-positive and gram-negative bacteria. This germicidal action is attributed to the precipitation of bacterial proteins by liberated silver ions. Silver nitrate coagulates cellular protein to form an eschar, and this mode of action is the postulated mechanism for control of benign hematuria, rhinitis, and recurrent pneumothorax.
Misc (Arzol Silver Nit Applicators External)
75-25% (per each): $0.67
Solution (Silver Nitrate External)
0.5% (per mL): $0.09
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