Antiseptic and disinfectants
Disinfectant - Designed to destroy the pathogen in an external environment, are used to disinfect premises, patient clothing, care, discharge, medical instruments.
Antiseptics - Used to destroy the pathogen on the surface of the human body (leather, mucous membranes, wound surfaces).
Features of antiseptics and disinfectants:
the mechanism of action is mainly associated with protein coagulation
bactericidal action nature
antimicrobial spectrum wide, no selectivity for a certain microflora
microflora addiction does not arise
toxicity is high, so the main application is local (rarely with resorbative goals)
a) chlorine preparations
In aqueous solutions, they form a chlorothic acid (HCLO), which in the acidic and neutral medium disintegrates to form atomic oxygen and chlorine. Oxygen oxidizes and coagulates the microbial cell proteins, and chlorine replaces H + in the amino group, forming a chlorinated protein, which leads to a violation of the formation of n-bonds between the polypeptide chains and the violation of the secondary protein structure. In an alkaline medium, chlorothic acid dissociates with the formation of hypochloride ion (CLO), which also has the properties of the oxidant, but its antimicrobial activity is lower than that of atomic O and CL. Therefore, with an increase in the pH, the effect of chlorine-containing antiseptics is reduced. The antimicrobial activity of drugs is determined by the presence of active chlorine.
Chloramine B. - A good antiseptic with a deodorizing effect. Contains 25-28% active chlorine. Does not irritate the skin. Used:
0.5 - 1% solution - handling of hands infected wounds
2-3% - Processing of objects of care, patient secretions
5% - processing of the secretion of the tuberculosis patient
b) iodine preparations
Elementary iodine has a powerful bactericidal activity, it coagulates proteins by providing a powerful regenerating effect.
Pharmacological effects of iodine:
antiseptic
anti-library
antifungal
expectorant
anti-skileotic (improves lipid exchange)
anti-ramp
solving
Alcohol iodine solution Applied when processing abrasion, scratches.
Iodinol It is used externally in chronic TOSillite, purulent otitis, trophic ulcers.
Biguanides.
Chlorhexidine Acts on bacteria, mushrooms of the genus Candida, Trichomonas. Does not act on disputes. Used in solutions for treating the hands of the surgeon and the operating field - 0.5% alcohol solution; under gingivitis, stomatitis, wound infections, in gynecological practice - 0.05% aqueous solution; For washing the bladder - 0.02% aqueous solution.
Oxidifiers:
Hydrogen peroxide - when contacting with tissues decomposes in two ways:
1. H 2 O 2 peroxidase H 2 O + O (antimicrobial action (oxidation))
2. H 2 O 2 Catalase H 2 + O 2 (mechanical cleansing of wounds)
As an antiseptic drug is not very active, the cleansing effect is mainly expressed due to foaming. Apply for the processing of contaminated and purulent wounds, for rinse of the mouth during stomatitis, angina. It has a hemostatic effect (due to the activation of thromboplastin and mechanical closure of small vessels; it is dangerous to rinse cavity (uterus, bladder) due to the possibility of embolism). Preparations: hydrogen peroxide solution diluted (3%), perhydro (concentrated solution).
Potassium Permanganat - as an antiseptic exhibits greater activity compared to hydrogen peroxide, because With its decomposition, atomic oxygen is released. It also has deodorizing properties. Solutions of the drug
(0, 01-0.1%) are used to wash wounds, mouth rinsing and throat, for douching, washing the urethra. Oxidizes alkaloids and some toxins, therefore, used for washing the stomach in the poisoning of alkaloids and with food toxicoinfections. Due to manganese oxide, an astringent effect has a binder, which is used to treat ulcers, burns (2-5% solution).
Metal compounds: These are generally cell meadows, associate thiol groups (SH-groups) enzymes and with proteins form albuminates. If the albuminate is dense - the action of astringent and bacteriostatic, if loose - the action of the migration and bactericidal.
According to the degree of solubility of albuminates, the metals are arranged in this way:
A row of Schmitherg
AlPB Zn.Cu.AGHg.
Solubility
Antimicrobial action
Nitrate of silver - Small concentrations (up to 2%) has an antimicrobial effect, in higher (5-10%) acts as an ignition means. In low concentrations, use in infectious diseases of the eyes (trachoma, conjunctivitis), and in higher - in the treatment of skin ulcers, erosions, cracks, as well as to remove excess granulations, warts.
Potargol, Collargol - organic preparations of silver.
Zinc Sulfat. and copper sulfat As antiseptics and binders are used in solutions of 0.1-0.25% in conjunctivitis, laryngitis, urethritis.
Mercury dichloride (Sulema) in 1: 1000 solutions are used for laundry disinfection, patient care objects. High-toxic.
Mercury oxide yellow - less toxic, used as an antiseptic in conjunctivitis, blefarites.
Acids and alkalis: interact with proteins, the nature of the action depends on the concentration of the substance.
Weak acids have a reversible astringent effect (formed in surface layers of gels). Strong acids are deeply denatured proteins, they have an ignition effect, dehydrate fabrics (dry-coagulative necrosis).
Weak alkali soften the epidermis dissolve the mucus, reduce its viscosity. Strong alkalines cause tissue necrosis with their discharge (collicration necrosis), deeply penetrate the tissue (deep burns).
Boric acidin the form of 2% of the solution, it is used in eye practice, 3% - during dermatitis, piederms.
Ammonia solution (Summer alcohol) has antiseptic and detergent properties. It is used to wash the hands of medical personnel, for the processing of premises.
Aldehydes and alcohols:
Formaldehyde- Used in the form of 40% solution (formalin). Acts on bacteria, mushrooms, viruses. Coagulates proteins, has a powerful antimicrobial effect. It has a flue action, takes water from surface layers of fabrics. Used to handle the hand, disinfection of tools, with increased sweating (0.5 - 1% solution), for canning fabrics, histological preparations, formalin pairs for disinfection of clothing.
Ethanol 70-95% denaturing proteins and has a bactericidal effect. At a concentration of 70% used to handle the surgeon and the patient's skin. In this concentration, ethyl alcohol has a deeper antiseptic effect on the skin (penetrates the swing and sweat glands). In concentrations, 90-95% is used for disinfection - disinfection of surgical instruments.
Detergents: These are cationic soaps, a substance with high surface activity. They accumulate on the cell membrane of the microorganism, change the surface tension, increase the permeability, which leads to swelling and death of the microorganism.
Cetylpyridia chloride As part of the drug "Cerigel"used to handle hands.
Antiseptics of the aromatic series:
Phenol (carbolic acid) is the oldest antiseptic, the standard for assessing the antiseptic activity of other drugs (phenolic coefficient).
Phenol in small doses has bacteriostatic, in large - bactericidal action. It causes deep denaturation of the microbial cell cytoplasm protein. It acts mainly on vegetative forms of bacteria, mushrooms and little - on disputes. When interacting with proteins, it does not form a solid connection and can react with several protein molecules, i.e. The presence of proteins does not reduce the antiseptic activity of phenol, therefore it is rationally used to process the patient's discharge. Used in the form of 1-3% solutions for laundry disinfection, care objects, tools. Has a pronounced annoying, topically essential action; At a concentration of 2% and above - an ignition action. Perhaps poisoning when suction through the skin.
Birch tar Contains phenol and its derivatives. It has antiseptic, insecticidal, keratoplastic and keratolithic effect. Apply to the treatment of a number of skin diseases and scabies.
Dyes: Methylene blue, diamond green, ethanidine lactate. Influence mainly on the gram-positive flora, the enzyme properties of microorganisms are disturbed.
Diamond green - The most active dye is used in the form of 1-2% of aqueous or alcohol solutions for lubricating the skin with pyodermia and the edges of the age when blefarite.
Methylene blue - As an antiseptic is inferior to other dyes. Used in cystitis, urethritis - 0.02%, ulcerative stomatitis - 0.5-1% aqueous solution, with pyodermia, burns - 1-3% alcohol solution. Used to study kidney functional abilities. Interested in toxicological terms - has powerful redox properties, the role of the acceptor and donator H + can play, is used as antidotes in the poisoning of cyanide and nitrites (intravenously 1% aqueous solution).
Stacridine(Rivangol) is used in solutions 0.05-0.1% for the treatment of wounds, washing cavities for purulent processes. 3% ointment apply for the treatment of skin diseases.
Nitrofurans.
As an antiseptics use furacilinEffective with respect to gram-positive and gram-negative bacteria. An aqueous solution of furacin is 0.02% used for rinsing of the mouth and throat during stomatitis, angina, for washing the purulent wounds.
Stepanova Olga Ivanovna
Assistant Department of Pharmacology of the Pharmaceutical Faculty of the First MGMU. THEM. Sechenova, K. Farm.n.
Belyatskaya Anastasia Vladimirovna
Associate Professor of the Department of Pharmaceutical Technology of the Pharmaceutical Faculty of the First MGMU. THEM. Sechenova, K. Farm.n.
Now any person is difficult to imagine the "DaantySeptic" period, when even the most minor to the modern view of infections was dying a huge number of patients. N.I. Pirogov noted that most of the wounded die not so much from the damage themselves, as from the "hospital infection."
Modern (scientific) history of antiseptics is associated with the names of the Vienna Okuscher I. Zemnelway and the English Surgeon J. Listera. It should also be mentioned that many other doctors also used their chemicals at the same time or even earlier, many other doctors were used to prevent the prophylaxis and treatments. To them, with a full basis, it is necessary to include the Russian surgeon N.I. Pirogov, which in 1847-1856 widespread solution of chlorine lime, ethanol, nitrate of silver.
So, let us recall what antiseptic is, and how it differs from similar terms - "disinfection" and "chemotherapeutic drugs".
Antiseptic (lat. Anti - against, septicus - rotting) - a system of measures aimed at the destruction of microorganisms in a wound, a pathological focus of the body, organs and tissues, as well as in the body of the patient as a whole, while using mechanical and physical impact methods, active chemical Substances and biological factors. Unlike disinfection, which is a procedure that processes the proceedings contaminated by microbes and the environment in order to destroy them to such an extent so that they cannot cause infection when using this item. As a rule, in disinfection, most of the microbes die (including all pathogen), however, disputes and some resistant viruses can remain in viable state.
There is a considerable number of antiseptic classifications today. The most popular of them are presented below.
According to the mechanism of action, antiseptics are classified into mechanical, physical, biological and chemical.
To methods of mechanical impact on microbes that have fallen into the wound include: removal from wounds of infected foreign bodies; excision of infected, damaged or non-viable tissues at the time of primary surgical processing of the wound; Opening of jets; the use of the mechanical properties of hydrogen peroxide (foam formation) for washing the wound; Vacuum processing of wounds. To the relatively new methods of antiseptic effect on the wound, mainly mechanical action, can be attributed to the processing of the wound with a pulsating jet of an antiseptic, at which necrotic black tissues, pus and minor foreign bodies are easily removed. This method was proposed in the mid-80s. Academician M.I. Cousin and prof. B.M. Costume. Its widespread introduction is constant, mainly lacking, unfortunately, corresponding to the equipment.
Drainage of the wounds, the use of ultraviolet irradiation (UFO); Low-frequency ultrasound; laser scalpel; Plasma scalpel; electrophoresis of antibiotics; UHF relate to physical exposure.
The use of antibiotics; immune drugs; Extracorporeal detoxification on xenoores; The use of proteolytic enzymes is a biological impact on pathogens.
According to the method of application, the antiseptic is distinguished - the general and local. The latter, in turn, is divided into superficial and deep. With a common antiseptic, a chemical or biological factor is introduced into the inner media of the body (intravenously, intramuscularly, endolymphatic, etc.), having an impact on the body as a whole. This type of antiseptics is also called chemotherapy. Local antiseptic implies the local action of antiseptic factors. With a surface antiseptics, an effect on the surface of the wound or on the cover of the body is performed (the surface treatment of the wound with a laser beam, washing the wound with antiseptic solution, etc.). With a deep antiseptic, factors act in tissues or cavities affected by the infectious process (the introduction of antibiotics and chemical antiseptics in the tissue and cavity of the body by punitives, electrophoresis, phonophoresis, etc.). The same events are sometimes called local chemotherapy.
Antiseptic means are most often produced in the following dosage forms: tablets, plasters, films, powders, solutions, drops, sprays, etc.
To date, most antiseptic funds can be found in the range of almost any pharmacy.
Drugs used with sore throat
With sore throat with a wide demand among patients, funds are used from groups halogenCombined under the trade name (TN) "Strepsils", produced in the form of pills for resorption (sometimes they are mistakenly called lollipops or pastels) and spray for local use of dosage.
Strepsils (2,4-dichlorobenzyl alcohol + amylmetelationol + excipients); Strepsls with vitamin C (2,4-dichlorobenzyl alcohol + amylmetelationol + ascorbic acid (vitamin C) + excipients); Strepsils Plus (2,4-dichlorobenzyl alcohol + amylmeteatol + lidocaine hydrochloride + excipients); Strepsils with menthol and eucalyptus (2,4-dichlorobenzyl alcohol + amylmetecresol + levomentol + eucalyptus oil + excipients); Strepsils intensive (Flurgiprofen + auxiliary substances) .
The preparation is connected by truly effective antimicrobial agents. The active ingredient amylmetecresol destroys the shell itself of the microbes, and the second substance - dichlorobenzyl alcohol - causes dehydration, i.e. Dehydration of microorganism.
Indications for use: Treatment of infectious inflammatory diseases of the oral cavity and pharynx (facilitates pain and softens irritation in the throat). Thus, there is aiming effect on suppressing the life of microbes. Side effects: rarely - allergic reactions.
Hexetidine ( Stopangin) - a pyrimidine derivative - an antiseptic for topical use in LOR-Practice, has a wide-distance antimicrobial, as well as antifungal activity, an analgesic effect when applied to a mucous membrane; In addition, it has an enveloping effect. Antimicrobial effect is associated with the suppression of oxidative reactions of metabolism of bacteria (TIAMIN antagonist). Release form: Spray for local use and solution for local applications (transparent, light red color. Composition: spray hexetidine - a mixture of essential oils (anise oil, eucalyptus, essential from the flowers of orange wood, Sassafrase, peppermints; menthol, methylsalicylate). The hexetidine solution is a mixture of essential oils: anise oil, eucalyptus, salted, peppermint, nails; menthol, methylsalicylate. Indications for use: infectious and inflammatory diseases of the oral cavity and larynx (tonsillitis, angina, pharyngitis, stomatitis, thorough ulcers of the mouth, Glossite , periodontitis, bleeding gums), fungal diseases of the oral cavity and larynx, mouth injury and larynx), oral hygiene to eliminate unpleasant odor.
Contraindications: Atrophic pharyngitis, children's age up to 6 years, I trimester of pregnancy, individual intolerance of the components of the drug. Important! Side Effects: The burning of the mucous membrane (quickly passes spontaneously), allergic reactions, with random swallowing the drug may occur nausea (passes spontaneously).
Hexetidine ( Hexoral) Aerosol is available. Stopangin and hexoral have a general active substance and quite a lot of total in the composition, therefore the scope of their action is identical. But the hexoral, in contrast to Stopangin, can be used to pregnant women and in the first trimester of pregnancy, and in other cases the decision remains behind the doctor.
Chlorhexidine (chlorhexidine) - An antiseptic of a versatile action, which today can be purchased not only in the form of a solution, but also cream, gel, patch. The drug kills microbes, bacteria, some viruses, effective for purulent processes. Additional plus chlorhexidine solution - a democratic price. The bacteriostatic effect of solutions is manifested at a concentration to 0.01%; The bactericidal effect is manifested at a concentration level of more than 0.01% (at a temperature of 22ºС and its effect on the affected area of \u200b\u200bthe skin for 1 minute or more); Fungicidal action is manifested at a concentration of a solution of 0.05% (at a temperature of 22 ° C and the exposure to the solution on the affected area of \u200b\u200bthe skin for 10 minutes); Viruticide action (overwhelming lipophilic viruses) is manifested at a concentration level in the range of 0.01-1% (the suppression of the bacterial dispute is possible only when using a warm solution). A 0.2% solution of the drug can be used to prevent sexually transmitted infections (in particular ureaplasmosis, chlamydia, trichomoniasis, syphilis, gorgers and genital herpes). To carry out disinfecting processing and sanitation with a solution is followed no later than 2 hours after the end of the intercourse. 0.5% The solution of the drug can be used to process the wounds, cracks of the skin, burns, open mucous membranes and infected failures in order to disinfect them. Indications for the use of chlorhexidine: disinfection of wounds on the skin and even mucous mehers; Course treatment of fungal diseases; Prevention of sexually transmitted diseases; Currency treatment of stomatitis, periodontitis and gingivitis.
If a solution to the wound is sufficient to process the cut, then to solve the problem of the diseases mentioned above, the procedure and frequency of actions establishes the attending physician. When using chlorhexidine, individual allergic reactions, dry skin, itching, dermatitis are possible. The most common side effect is dermatitis. However, the complaints against the antiseptic are extremely rare in medical practice.
Apply chlorhexidine with extreme caution follows women during periods of pregnancy and lactation, people with individual intolerance to the drug, as well as children to adolescence.
Allantoin + Pisidone iodine ( Yox) - Aerosol with antiseptic and anti-inflammatory effect is produced both in the form of spray and the solution for local applications. Indications: Infectious and inflammatory diseases of the oral cavity and pharynx (sore throat, tonsillites, tonsil pharyngitis, glossites, stomatitis). It is used to process the oral cavity and pharynx in surgical interventions on the respiratory tract and the oral cavity, as well as in the postoperative period; For the treatment of infections of the oral cavity and throat occurring during chemotherapy, as well as in streptococcal angins as an additional remedy for antibiotic treatment. The mechanism of action lies in direct influence on proteins of microorganisms. Important! Possible side effects - iodiism (increased iodine content in the body) and rarely allergic reactions; Contraindicated in pregnancy and breastfeeding, children under 6 years old, as well as hypertension, heart failure and increased sensitivity to Yes.
Gramicidine C + cetylpyridine chloride ( Gramicidine neo) - a combined drug for the treatment of infectious inflammatory diseases of the throat and oral cavity, produced in the form of tablets for resorption belongs to biological antisepticum microbial origin. The composition of the LA includes an antibiotic for the local application of gramicidine C and an antiseptic means - cetylpyridine chloride. The mechanism of action is associated with an increase in the permeability of the cytoplasmic membrane of the microbial cell, which disrupts its stability and causes cell death. Gramsicidine C has a pronounced antimicrobial effect on causative agents of infectious diseases of the oral cavity and pharynx. Side Effects: Allergic reactions due to individual sensitivity. Important! Contraindications: Increased sensitivity to components included in the preparation; Children's age up to 4 years; Pregnancy (I trimester).
Antiseptic Cetylpyridia chloride It is part of other combined drugs: Cetylpyridia chloride + benzocaine ( Septolet Plus) produced in pastels; Cetylpyridia chloride + lidocaine hydrocholide ( Calgel), a dental gel is produced, used in teething and cetylpyridine chloride + lidocaine hydrocholic ( Teraflu Lahr Menthol.), lozenges.
AcetylaminonitropropoxyBenzene ( Fallimint) - The nitroacetanilide derivative is produced in the form of a dragee, when resorption creates a feeling of coolness in the oral cavity and larynx, has an antitochematic, antiseptic, analgesic and weak topics. It does not have a drying effect on the mucous membranes, it does not cause feelings of numbness in the mouth. Indications: tonsillitis, pharyngitis, laryngitis, gingivitis, stomatitis, reflex cough, preparation for instrumental studies of the oral cavity and zea, removal of blinds and fitting of dentures. Contraindications: Hypersensitivity to the components of the drug, pregnancy, lactation period, children's age up to 5 years, shortage of sugar or isomaltosis, fructose intolerance, glucose-galactose macabsorption.
Means under inflammatory diseases of the oral mucosa and after dental interventions
Rotokanproduced in the form of a solution in orange glass bottles belongs to alcohol groupegostav includes water-alcohol extract from a mixture of medicinal vegetable raw materials - chamomile flowers, calendula flowers (marigolds) and yarrow herbs in a 2: 1: 1 ratio. Pharmacological action - anti-inflammatory. The drug enhances the reparative regeneration processes, has hemostatic and antispasmodic properties, has a positive effect on the trophic of the stomach mucosa. Rotokan is small-toxic, does not have allergenic, teratogenic and mutagenic properties. It is used in inflammatory diseases of the mucous membrane of the oral cavity and periodontics of various etiologies, such as aphthous stomatitis, periodontitis, ulcer-necrotic gingivo-stomatitis. Important! The use of LP is contraindicated in patients with increased sensitivity to plants contained in it, side effects are possible - allergic reactions.
Miramistin + benzyldimethyl ammonium chloride monohydrate ( Miramistin) belong to the team of detergents,available in formation for local applications 0.01%. Indications: Treatment and prevention of infectious and inflammatory diseases of the oral cavity - stomatitis, gingivitis, periodontitis, periodontitis. It is also used for hygienic processing of removable prostheses. Side Effects: In some cases, a sense of light burning may occur at the point of use, which passes independently after 15-20 seconds and does not require the abolition of the drug; Allergic reactions. Contraindications: Individual LP intolerance.
Benzalconium chloride + mint pepper leaves oil + thymol + eucalyptus of rutoid leaves oil + levomentol ( Septol Pastilika). Is a combination of an antiseptic agent from a group of quaternary ammonium compounds ( benzalconium chloride) and active natural substances ( menthol, Mint's essential oil, Eucalyptus essential oil, Timol). Benzalconium chloride It has a bactericidal effect on gram-positive and gram-negative bacteria, as well as a fungicidal effect on Candida Albicans and some lipophilic viruses. Menthol and peppermint essential oil have moderate painkillers and deodorizing effects. Pastili facilitate throat pain when swallowing, as well as a sense of allocation. Timol has an antiseptic effect that enhances the effectiveness of the drug. Eucalyptus essential oil reduces mucus secretion in the upper respiratory tract and makes breathing. The drug does not contain sugar, which allows you to take it with sick diabetes. Indications: pharyngitis, laryngitis, tonsillitis, gingivitis, stomatitis. Important! There are contraindications: child age up to 4 years, lactase enzyme deficiency, isomaltase, galactosemia, increased sensitivity to the drug component. Side Effects: Allergic reactions, nausea, diarrhea.
Tools used in burns
Decantenol ( Bapten Plus Cream, 5% in aluminum tubes) in skin cells quickly turns into pantothenic acid, which plays an important role in both the formation and in the healing of damaged skin. Quickly absorbed. When applied to the surface of the wound protects against infection, contributing to healing. Easily applied and washed off. The composition of the cream "Bepanten Plus" is as follows: in 1 g of cream contains 50 mg decpeantenol, 5 mg chlorhexidine dihydrochloride. The composition includes additional substances: alcohol Cetilovy, DL Pantolactone, alcohol Stearylovy, paraffin liquid, paraffin white soft, lanolin, polyoxyl 40, stearate, water. Important! Increased sensitivity to the components of the drug, and the side effect is an allergic reaction (urticaria, itching).
Funds used in open wounds
Hydrogen peroxide (hydrogen peroxide solution,flakes of 40 and 25 ml) From the group "Oxidifiers" is suitable even for infants. For example, it is recommended to handle a poucher wound a newborn. The main advantage of hydrogen peroxide in comparison with the green and iodine - the solution can be applied to the open wound. At the same time, the hydrogen peroxide is not "pinlet". Having finished the surface of a fresh wound solution with a solution of hydrogen peroxide, you can see how the antiseptic foams. At this point there is a disinfecting process: atomic oxygen is released, which eliminates the wound from microbes, pus and dead tissues. The antiseptic effect of hydrogen peroxide is not sterilizing, with its use, only a temporary decrease in the number of microorganisms occurs. Indications for use: for washes and rinsing during stomatitis, angina, gynecological diseases. Small surface wounds, small capillary bleeding from surface wounds, nasal bleeding.
Nitrofural ( Furacilin) - Nitrofuran derivative. Indications for use: purulent wounds, breakdowns, burns II-III Art. and mn. Dr. (See Instructions for use).
Important!Side effects: Dermatitis arise in some cases. Sometimes when taking inside, dyspeptic phenomena (loss of appetite, nausea, vomiting), dizziness, allergic rash are observed. Long-term use of LP may cause neuritis. With long-term (months) local application, the hair and depigmentation of the skin (leukoderma) is noted in areas subjected to direct action of the drug. Contraindications: Increased individual sensitivity to nitrofuran derivative. Inside are prescribed with caution in disruption of kidney functions. Release Forms: Powder, Tablets for Ingestion (Rarely); Tablets combined for outdoor use, 0.02% Furaticillin solution (1: 5000) for outdoor use, 0.2% Furacin ointment (1: 500); Furacilin paste for hands and face from the effects of various irritating chemicals.
The low solubility of furaticiline in water (1: 5000) limits the use of this to the well-known drug due to inconvenience, primarily associated with the preparation of the solution - a long dissolution of factory tablets or boiling water powder. Currently, on the basis of the Department of Pharmacology and Pharmaceutical Technology of the Pharmaceutical Faculty of GBOU VPO of the First MIMU. THEM. Sechenov of the Ministry of Health of Russia developed a rapidly soluble dosage form of furaciline - effervescent pills.
Antiseptic tools for local preventive use for every day
Hand Gel Antiseptic Sanitelle ( Sanitel) In the packages of one-time use are easy to use, 99.9% of the most common bacteria, fungi and viruses are destroyed for 15 seconds. The gel includes: ethyl alcohol 66.2%, deionized water, glycerin, propylene glycol, aloe vera extract, vitamin E, functional additives. Contraindications: Individual intolerance to the drug.
All of the above antiseptics are released without recipes and in a pharmacy are located in a free sale, however, if there are wounds, non-clear pathogenesis ulcers, should be consulted. The abuse of drugs also has a number of dangers associated with their side effects and individual characteristics of a person.
Very great. And x are used in the treatment of infected wounds, lesions of skin microorganisms and mucous membranes, for water treatment and food, for disinfection of medical instruments, linen, etc.
Antiseptics and disinfectants must have a wide range of action against microorganisms, simplest and fungi, characterized by a small latent period of action, high activity, including in the presence of biological substrates. It is important that the drugs are chemically resistant and accessible from the point of view of their production and cost.
For example, before surgery, biopsy, injections, punctures, blood circulation and bladder catheterization. Active ingredients: Iodine Polyvidone, iodine. This article is only a pharmacy. Regarding the risks and side effects, read the batch sheet and consult your doctor or pharmacist.
Christian Mayre and JSC. Marcus brazen from the hygiene and medical microbiology section recognized by the German fond of Rudolph Shink. Every two years, Rudolph's Foundation Schuke in Hamburg awards a hygienic prize of scientists who have achieved special problem solutions in the field of hygiene, microbiology and preventive medicine.
Important requirements for antiseptics are the absence of a local negative (for example, irritating) action on the tissue, the minimum absorption from the place of application, the absence of allergizing influence and low toxicity.
Disinfectants should not damage the processed items (change the color, cause corrosion of metals, etc.). It is desirable that they have an unpleasant odor.
This is the conclusion of the Innsbruck Working Group led by the Professor of Culture, which succeeded in the university. Section of hygiene and medical microbiology. Honey is one of the oldest products known to humanity, there are records of its consumption by the Greek Mathematics Pythagore in 585 BC. Brazil is the 9th largest food exporter in the world.
Honey is also one of the most studied phytotherapeutic substances in the world and the product, extremely rich drug properties. Its most famous functions are anti-inflammatory, immunomodulatory and musolitic effect - it dissolves the mucus in the respiratory tract, helping in sputum.
The common criterion for assessing the activity of antiseptics is the so-called phenolic coefficient (The ratio of the concentrations of phenol and the test antiseptic, in which substances have the same antimicrobial effect).
The mechanism of action of different antiseptics and disinfectants of the neodynaks and can be associated with protein denaturation, impaired plasma membrane permeability, braking important for the life of microorganisms of enzymes.
In addition to the fact that you are a delicious meal, it has antiseptic properties, heals and also burst. Its minerals are easily assimilated and contribute to the maintenance of a skeleton - with calcium - and blood regeneration - iron, "the native says Maximo Asinelli.
Check out some interesting facts about honey. During the production of honey, the bee is added an enzyme called glucose oxidase, ensuring that a small amount of hydrogen peroxide is constantly formed in the Sugar in food. Thus, honey acts as a kind of disinfectant that prevents inflammation and conducive to restoration of a new fabric in place.
Classification of antiseptics and disinfectants (by chemical structure)
1. Detergents
Corgel, Roccal and others.
2. Nitrofuran derivatives Furacilin (Furazolidon)
3. Phenol group and his derivatives Phenol pure resorcin tar birch
4. Dyes Diamond Green Methylene Blue Stacridida lactat
Those who have lazy guts can bet on this food to help the body. Honey contains soluble fibers that increase the involuntary intestinal motion, functioning as a regulator of this organ and contributing to digestion. Fifty years ago, women often cared for beauty with homemade products. Honey with strong moisturizing and healing properties was among the favorites. Today, he is still a great ally of beauty, whether in domestic masks or as the main element of cosmetics.
5. Halogen-containing connections Chlorhexidine chlorine B solution of iodine alcohol et al.
6. Metal compounds
Mercury dichloride mercury oxide yellow silver copper nitrate sulfate
Zinc zinc oxide sulfate
7. Oxidifiers
Potassium hydrogen peroxide solution permanganate
8. Aldehydes and alcohols Formaldehyde solution ethyl alcohol
According to Professor of Cosmetology, Mauricio Puoo, honey has a great ability to fight dryness of the upper layer of the skin and has a long action. Hydration is so intense that improves the appearance of wrinkles, and the enzymes contained in it make it a powerful antioxidant, which helps to reduce collagen degradation in the skin, "he says. Honey, which can be found in the markets and in pharmacies, is easy to buy and great for creating a home mask once a week.
Here is the main recipe: after the skin is exhausting a slightly with soap, apply a layer of pure honey to face and let it act within an hour. After this period, remove the product. Contraindicated for children under the age of one year. In search of a more natural way to sweeten the juices and mother teas choose honey, without suspecting that the product consumption is contraindicated for babies that have not yet reached one year. The recommendation comes from the National Agency for Sanitary Supervision. Mysa Helena de Agiar Toloni, a researcher of the Federal University of Sao Paulo with almost 300 parents, discovered that 73% of them offered honey to their children at this stage.
9. Acids and alkali Acid Boric Solution Amia
Detergents , or cationic soaps, have detergent and antiseptic properties. They affect many bacteria and mushrooms. One of these drugs is a cerigel. It contains a cationic detergent - a monochrotic ammonium salt of cetylpyridinium-chloride, as well as polyvinyl butyral and ethyl alcohol. This group includes rocca with severe surface activity. It is a monochdic ammonium salt. Apply detergents for handling the hands of the surgeon, sterilization of tools, instruments. In conventional concentrations of tissue irritation, they do not cause.
The danger lies in microorganisms that may be present in food. "Until the first year of life, the child's immune system is not sufficiently mature," says the nutritionist. She also warned that, among other things, sweet tastes at this age will lead a child to the development of incorrect eating habits, which can lead to obesity and diabetes.
No need to sweeten the children's food. It is recommended to avoid sugar to a maximum, since its introduction to the diet of small may foresee the refusal of breast milk, the development of caries and other diseases, such as hypertension, "he says. Pregnant women and babies should also avoid using psychoactive substances, as the pathogens can move from the mother to the child through the umbilical cord or breastfeeding.
Detergents can not be combined with anionic soaps, because at the same time their antimicrobial activity falls. The effect of detergents is also reduced in the presence of organic substances.
An important group of antiseptics are nitrofuran derivatives . These include furacilin (nitrofural, nitrofrazon). Nitrofurans have a wide range of action. They destructive effect on gram-positive and gram-negative bacteria, the simplest.
Against hospital and skin infections. A specific kind of honey, which is called Manuk, produced in New Zealand, contains a substance toxic to bacteria, which makes it effective in combating hospital and skin infections. The study was conducted by Professor and researcher Di Carter from the Faculty of Natural Sciences in Sydney University in Australia. The idea is that this diversity can replace antibacterial products during sterilization, treating cuts, insect bite and other skin problems.
Although it is more natural, honey is also harmful to diabetic health as ordinary sugar. It contains a large amount of carbohydrates, about 12 g for each tablespoon. "This is the same amount of fruit, but in fruit absorption takes place slower because of the fibers," says Deniz Duelt Isice, an endocrinologist from Sirio-Libane's hospital. "The replacement of sugar on honey has doubtful benefits, both are long-chain carbohydrates, quickly absorb," he says.
Furaticyline is used mainly externally for processing wounds, leather, mucous membranes, for washing serous and articular sheels. Furacyline is transferred, as a rule, well. Sometimes he causes sensitization, dermatitis.
Phenol group
And its derivatives includes many well-known antiseptics of aromatic series. These include oxybenzenes ( phenol pure)and dioxibenzenes ( resorcinand etc.). Phenol acts mainly on vegetative forms of bacteria and mushrooms. Phenol solutions are used for disinfection of tools, household items.
It should be borne in mind that toxic phenol with high lipophilicity is easily absorbed from the skin and mucous membranes and raises poisoning !!!
Resorcinthe antiseptic action is inferior to Phenol. In small concentrations, the resorcin has a keratoplastic property, in large - annoying and keratolytic. Use it with some skin diseases (for example, with eczema, seborrhea, etc.), with conjunctivitis.
The goal, as well as the pioneage museum in this action - to collect honey and sell it or donate to his employees. The Museum of the Grand Palace Production is about 50 kilograms. In addition to the propaganda of pollination and subsequent diversification of the local flora, French experts found honey from the roofs of Paris tastier and with fewer impurities. The reason would be in the absence of pesticides in the colors of cities other than colors of fields.
If you have no acquaintance with medical terms, or you first in the pharmacy should take a drug with this property, you can be a little rocky before an antiseptic word. Of course, it seems that it seems very difficult, but not worrying about what you think: this is a word obtained from the Greek language, or rather, from the Union of two terms in this language, which are antiseptics, which means against and rotten. Briefly, the antiseptic drug when it is accepted, destroys bacteria that is responsible for pathology, or prevents the decisions or decomposition of the affected person.
Part segty birch Phenol and its derivatives, resins and other connections are included. Get the drug with dry distillation of birch crust. Melt Birch possesses antimicrobial, keratoplastic, keratolithic and irritating effects. Apply it in the treatment of a number skin diseases and scabies.
Melt Birch is one of the components of the balsamic liniment by A.V. Vishnevsky (ointment of Vishnevsky), used in the treatment of wounds, as well as ointments of Vilkinson, appointed during scabies and fungal lesions of the skin.
There are also some drugs that, in addition to the destruction of bacteria and microbes, are able to prevent them from reforming or preventing their growth. The antiseptic drug, in addition to the destruction and prevention of proliferation of bacteria in the affected organs, is able to counteract or effectively slow down the effect of smaller and more harmful organisms, such as viruses and other microorganisms. An antiseptic property, in addition to bacteria and antiviral drugs, can be found, for example, for many disinfectants that are used by parents for the treatment of children's injuries, when they are badly damaged, or parts of the body - knees and elbows. This is only in the pharmaceutical area: some cleaning products commonly used by housewives are in fact antiseptic, so they are able to sterilize the surface and kill all the bacteria found on them, thereby avoiding the spread of many diseases is dangerous.
To the dyes group There are a number of compounds of various chemical buildings. Tryphenylmethan derivative is most widely used. diamond green. Sometimes use a derivative of phenothiazine methylene blue and derivative acridine stacridine lactat.
Especially sensitive to dyes gram-positive coils.
Antiseptics, drugs in which we find
There are many drugs with antiseptic properties on the market, and it is very difficult to compile an exhaustive list, as each year they come out again in the pharmacy. However, among them you can find five groups that are most often used and which are most common, such as alcohols, biguenides, halogenated compositions, peroxides and boric acids. Alcohols, which are also widely used in surgery concern skin disinfection without injury and mainly consist of ethyl alcohol. Biguanides are also used to treat the integrity of the skin, but are more effective in combating certain types of bacteria and mushrooms and are not particularly toxic.
Diamond green It is highly active and relatively high-speed antiseptic. IN the presence of proteins is reduced efficiency. Applied outfit, mainly with purulent lesions of the skin (pyoderms).
Methylene blue (methylthion chloride, methylene blue) is inferior in the activity of diamond green. Apply it outwardly, as an antiseptic, inwards in the infections of urinary tract, as well as intravenously with cyanide poisoning. Efficiency in the latter case is explained by the fact that methylene blue (in large doses) translates hemoglobin to methemoglobin, which comes into contact with cyanides, forming non-toxic cyanmethemoglobin.
Instead, halogenated compositions that are also found in many products used for hygiene, although they have a low degree of toxicity, less effective than other antiseptics. Peroxides, being very effective in the treatment of skin diseases, especially in the case of escort and injury, is the fear of children and adults, because they always cause light pain.
The antiseptic preparation can affect the human body in different ways. In general, looking at most of the products that we find in the pharmacy, and many of which can be purchased without a recipe, the antiseptic acts on the cell membrane and microscopic organisms sensitive to this chemical agent.
Stacridida lactat (rvanol) Painted in yellow. His activity is high enough, but the action develops slowly. Apply it externally and for washing the infected cavities (pleura, peritoneum), bladder, uterus.
Halogen-containing antiseptics
represented by drugs containing chlorine and iodine. The most active antiseptics containing elementary halogens or liberating them. One of the drugs, cleaving chlorine, is chloramine B, Possessing antiseptic and deodorizing properties. It is used to disinfect the discharge of patients (for example, in the abdominal title, cholera, tuberculosis, etc.), items, non-metallic tools, as well as for handling hands and infected wound surfaces.
Effective chlorine-containing antiseptics include a biguanide derivative chlorhexidine(Hibanita). It provides antibacterial and fungicidal action. It is applied for processing of the hands of the surgeon, operational field, wounds, bladder, as well as for sterilization of tools. When processing the hands of the surgeon, dry skin, dermatitis are possible.
However, more specifically, the antiseptic can change the structure of the cells of microorganisms, leading them to death or preventing growth, or destroying the permeability of their cell membranes. In the case of ethyl alcohol and other disinfectants, denaturation of proteins can occur inside the microorganism, that is, the loss of the initial characteristics and functioning of the molecule, which leads to the neutralization of the pathogen and its death.
Treatment of children in children, adolescents and adults
Surface disinfection of the skin in front of small performances. Heavy caries treatment. Treatment of tumor removal. In dentures, it is advisable to use a solution of iodisol for immersion of fingerprint, immersing it into a diluted solution of iodioisole.
In addition, the drugs containing elementary iodine refers solution of Lugola (consists of 1 part of iodine, 2 parts of potassium iodide and 17 parts of water) used to lubricate the mucous membrane of the pharynx and larynx during inflammatory processes.
Significant number of antiseptics represented compounds (salts) of metals.
Use without medical care to children, adolescents and adults
Disinfection of hands; treatment of small skin damage; haze; Treatment of inflammation of the oral mucosa; Treatment after insect bites. Jodizol is a highly efficient disinfectant. This is a 3% solution of a compound connection with a wide range of applications. It has a wide range of effects for proliferating forms of microorganisms, that is, bacteria, mushrooms and viruses. The iodine associated in the complex is released at a concentration sufficient for disinfection, but does not damage the skin or mucous membranes.
Mechanismantimicrobial metal salts actions low concentrations are associated with blocking sulfhydryl groups of microorganisms enzymes. In large concentrations, depending on the nature of the metal and the acid residue, the concentration of salt, the degree of dissociation and solubility can occur different local effects: binding, irritating, migrating (necrotic).
Local action of metals salts associated with denaturation of proteins. The albumintes may be dense and loose. In the first case, a film is formed on the surface of the fabric, the fabric is compacted, inflammation decreases, this picture is typical for the binder. With a deeper penetration of the substance, irritation of cells and nerve endings occurs. The extreme manifestation is the migrating effect of metals salts. The latter is more pronounced than albums soluble.
According to the solubility of the formed albuminats in water and biological fluids, the metals can be positioned in the following row: ry, ... A1, Zn, Cu, Ag, ... Hg.
The lead's salts have the most pronounced astringent action (formed dense albuminates), mercury salts are migrating. At the same time in this row from lead to mercury, antimicrobial activity increases.
As antiseptics, metal salts located on the right side of the series are greatest interest, especially mercury and silver.
Of mercury salts The role of antiseptics use the following drugs:
a) well soluble in water mercury dichloride (SUMMA) - HGCL 2;
b) insoluble in water mercury amidochloride (mercury sediment white) and mercury oxide yellow (mercury sediment yellow).
Well soluble and dissociating mercury dichloride It has high antimicrobial activity. Preparation applied for handling the skin of hands, dishes, premises, etc.For disinfection of metal objects, it is not suitable, as it causes corrosion of metals. IN presence of proteins The activity of mercury dichloride fallsTherefore, to disinfect the discharge of patients containing protein components, the drug does not apply. It has a pronounced irritant effect, in connection with which only episodically can be used to handle the skin of the hands. Should also be considered that mercury dichloride is very toxic. The complicating point is the ability of the substance to penetrate the skin and mucous membranes.
Mercury oxide yellow Most often used with infectious eye lesions(with conjunctivitis, keratitis). Mercury amidochloride is usually prescribed under the skin diseases such as piederma.
Acute poisoning mercury compoundsAs a rule, is associated with random or deliberate intake of mercury of dichloride. It is manifested by pain in the abdomen, vomiting, diarrhea (the result of the ignition effect on the mucous membrane of the digestive tract), as well as changes from the CNS (excitation, replacing with oppression) and the cardiovascular system (acute heart failure, collapse). After 2-4 days, symptoms are increasing, associated with necrotic changes from the kidneys ("Summer kidney") and a digestive tract (stomatitis, ulcerative colitis). Such localization of lesions is explained by the fact that the main way of removing mercury compounds is through the kidneys, as well as the colon and salivary glands.
Treatment of acute mercury poisoning dichloride It is primarily in the prevention of absorption of the drug. To this end, the stomach is washed, the antidota solution of mercury unitiol compounds is introduced into it (contains sulfhydryl groups that bind mercury). Sometimes an activated carbon is introduced, small volumes of binding solutions, milk, egg protein. The stomach washing should be carried out with great care, since mercury dichloride damages the mucous membrane of the esophagus and the stomach. Then the laxatives are prescribed, as well as siphon enemas with a solution of unitiola. To inactivate the toxic drug, unitiol is administered intravenously. With the light and moderate severity of poisoning, forced diuresis is effective. In pronounced poisoning, especially in violation of the kidney function, it is necessary to resort to hemodialysis and peritoneal dialysis, conducted on the background of intravenous administration of unitiol and the Tetacin calcium (SANA 2 EDTA).
In the case of chronic poisoning with mercury preparations (the so-called mercuryiaism ) The mucous membrane of the oral cavity (stomatitis) is affected, as well as the CNS, blood formation, etc. Most often it is the result of professional poisoning associated with work with mercury drugs. In this regard, the first and main event is to eliminate the source of poisoning. As antidotes use unitiol, as well as Tetacin calcium, sodium thiosulfate. In addition, measures to accelerate the removal of the substance from the body are also carried out symptomatic therapy.
From silver preparations Used silver nitrate (Lapis; AGNO 3), popartharol (silver Proteinat) and collargol.(silver colloidal). They have antimicrobial, binding and anti-inflammatory effects. They are used in ophthalmology (In case of conjunctivitis, Blennorea), for irrigation of the Russian Academy of Sciences, washing the urethra and bladder. In addition, silver nitrate in high concentrations and in chopsticks is used externally as an igniting means in erosions, ulcers, excess granulation, as well as during the trach.
As antiseptics and binders in ophthalmology also apply copper sulfat (copper sulphate; CUSO 4 ∙ 5H 2 O), zinc Sulfat. (ZNSO 4). When trachy use special eye pencils containing copper sulfate, potassium nitrate, alum and camphor. Saltular salts (copper sulfate and zinc sulfate) can be used to dry the urethra and bladder.
To the group of oxidizing agents relate hydrogen peroxide (H 2 O 2) and potassium permanganate (potassiummaganta); KMNO 4). They possess antiseptic and deodorizing effects. The principle of action of both drugs is in the release of oxygen.
When applied to the tissue in the presence of proteins, hydrogen peroxide under the influence of catalases is splitted with the release of molecular oxygen.
H 2 O 2 → 2N + O 2.
However, oxidative and, consequently, the antimicrobial activity of molecular oxygen is insignificant. More important is in this case mechanical cleansing of wounds, ulcers, cavities, which is associated with the release of oxygen bubbles and the formation of foam. Hydrogen peroxide also has deodorizing properties. There is a drug briefly. In addition, hydrogen peroxide contributes to stopping bleeding.
Potassium permanganate in the presence of organic substances clears atomic oxygen.
2KMNO 4 + H 2 O → 2 + 2MNO 2 + ZO.
Antiseptic action of atomic oxygen expressed in a greater stepyeni than molecular. It provides antimicrobial and deodorizing effects, and the resulting manganese oxide (MNO 2) - astringent. IN Big concentrations of potassium permanganate has annoying and migrating action.
Applythe drug in solutions for rinsing, sinking, irrigation of the wounds, processing of burn surfaces, washing the stomach in the case of morphine poisoning, phosphorus, etc.
Some connections also include antiseptics from the group of aldehydes and alcohols. One of the representatives of aldehydes is a solution formaldehyde (formalin; Contains 36.5-37.5% of formaldehyde - nsno). He possesses strong antimicrobial and deodorizing properties. It is used as disinfectantas well as for skin treatment with sweating. Under the influence of the formaldehyde solution, the epidermis is sealing (due to the denaturation of proteins), as a result of which the sweating decreases. The drug is pronounced annoying action.
To the same group can be attributed hexamethylenetereminine (Urotropin). It is sometimes used as an antiseptic with urinary tract infection. The bacteriostatic effect of hexamethylenetetramine is associated with its splitting in an acidic medium and formaldehyde formation (if necessary, ammonium chloride can be used in the acid side of the urine reaction to the acidic side). Assign hexamethylenetereminine inside and intravenously. In the stomach, it is partially destroyed. Of side effects should be kept in mind the possibility of an annoying effect on the kidneys, which is the basis for its cancellation.
Pronounced antimicrobial properties has ethanol. It is used for disinfection of tools, surgeon hand processing, operational field. The antimicrobial activity of ethyl alcohol increases with an increase in its concentration. However for leather disinfection is better to use 70% ethyl alcohol, which penetrates into deeper layers of epidermis than 95%.
As antiseptics can be used row acids and alkalis. So, for washing the mucous membranes and rinsing of the oral cavity is sometimes prescribed solution of acid BORN (H 3 in 3). It can also be applied across the masses and powders. However, the antimicrobial activity of acid borne is low.
To antisepticam the alkalis group includes a solution of ammonia (ammonia alcohol; NH 4 Oh; Contains 9.5-10.5% ammonia). Its 0.5% solution used to handle the surgeon's hands.In addition, it can be used inhalation for reflex stimulation center of breathing.
Control Questions (Feedback)
1. What is the difference between antiseptics from disinfectants?
2. What is a phenolic coefficient?
3. What do you understand under the spectrum of antimicrobial action?
4. What is the difference between the bacteriostatic effect of bactericidal?
5. Classification of antiseptic and disinfectants.
6. The main mechanisms of action of antimicrobial means.
7., defining antimicrobial activity.
8. Comparative assessment of antiseptic tools from various groups.
9. Poisoning, aid measures, the principles of antidote therapy.
Until the XIX century, most surgical operations ended with the fatal outcome of the patient from infections entered by health workers. Fortunately, such an achievement of medicine, like antiseptic, reduced the percentage of deaths from septicopemia to a minimum. Modern surgery successfully applies various types of antiseptics that we will tell about in this article.
What is antiseptic and what is it needed for?
Ancient lekari, who unconsciously applied natural components with anti-inflammatory properties guessed the relationship of pathogenic microbes with purulent inflammation of the Russian Academy of Sciences. Nevertheless, a truly struggle with surgical infections began in the second half of the XIX century, when English Medica J. Lister published an article in which he described his method for treating an open fracture with a 5% carbolic acid solution. Since then, a new era has begun in surgery, where all new types of antiseptics appeared with the development of medicine.
Antiseptic in modern terminology means a set of measures and manipulations, the purpose of which is the destruction of microorganisms, as well as their disputes and toxins in tissues and macroorganisms. Along with this, the term "aseptics" is of great importance in surgery, which means a set of measures to prevent the development of pathogenic microbes in the wounds. Aseptics methods also include sterilization of surgical instruments and accessories. As well as the opening of anesthesia and blood groups, discontinuished surgery in the XIX century views of asepsis and antiseptics became one of the fundamental medical achievements of the time. It was from that period that the surgeons began to actively practice those who were still risky (practically with a 100% fatal outcome) operations on the chest and the abdominal cavity.
The main types of antiseptics in modern medicine
Aseptic, of course, is of great importance in surgery and often does not require additional events, however, as practice has shown, a complete refusal of antiseptic manipulations is impossible. Types of antiseptics in medicine can be conditionally divided by the nature of the methods used and according to the method of application. In the first case, the number of antiseptics includes:
- Mechanical antiseptic.
- Physical.
- Chemical.
- Biological.
- Mixed.
By the method of use, chemical and antiseptics are divided into:
- Local in the form of processing some separate body part. Local antiseptics can be surface and deep. Surface implies toilet wounds and damage (washing with solutions, coating, ointments, compresses), and a deep antiseptic is an introduction to the body of chemical and biological anti-infectious drugs through injections.
- In general, implying infusion saturation of the body through blood and lymph with antiseptic drugs (injection of droppers).
Mechanical antiseptic
The mechanical antiseptic is carried out using surgical instruments and includes:
Physical antiseptic
The physical antiseptic includes a set of measures to prevent the reproduction of pathogenic microbes and absorbing their livelihoods of patient tissues. Physical types of antiseptics of the Russian Academy of Sciences include the following means:
Chemical antiseptic
The chemical antiseptics includes measures to destroy pathogenic microbes in the patient's wound or body with the help of chemicals, among which you can allocate:
Biological antiseptic
Biological antiseptic includes means of biological origin, which can affect both directly on microorganisms and indirectly. Biological antiseptices include:
Mixed antiseptic
Combined antiseptics uses techniques and means of all types of antiseptic in the aggregate. As combined funds are used:
- Inorganic antiseptic means.
- Synthetic analogues of biological agents.
- Synthetically produced organic substances.
Types of antiseptics for wood and other building materials
Various bacteria can cause rotation and decomposition processes not only in human and animal organisms, but also in building materials, such as a tree. To protect wooden products in the interior and exterior from damage to insects and house mushrooms, various types of wood antiseptics are applied in construction. They can be.
Citation:Cherkashin M.A. Local antiseptics in surgical practice // RMW. 2007. №22. P. 1648-1650
Prevention and treatment of surgical infections is currently one of the most complex tasks. The wide prevalence and availability of antimicrobial chemotherapy facilities contributes to the growth of resistant forms of micro-organizes. An increasingly significant role is acquired by nosocomial infections. Sometimes there is a dramatic situation - after, it would seem, a small intervention is developing quite severe and unpleasant wound complications requiring often the operational benefit. In 30% of surgical patients in the postoperative period, infectious complications of various localization are developing (the area of \u200b\u200bthe operational incision, the respiratory organs, the urinary system organs). The problem of reinfeating wound surfaces by hospital strains from medical personnel, bed linen, suture and dressing material in the departments of intensive therapy, in groups of patients with disabilities of movement (after brainwood disorders) is presented. Among other things, the period of inpatient treatment is extended, which reduces the patient's workability and the quality of his life, not to mention the pharmacoeconomic indicators. So, according to E.A. Oganesyan et al. (2003), A.A. Be-Lozer et al. (2003), the time of stay of patients in the hospital increases by 15-18 days.
One of the important aspects of solving this problem is the impact on the causative agent. The leading role in this undoubtedly belongs to the means of antimicrobial chemotherapy.
Rational antibacterial therapy is the cornerstone in the treatment of any infectious process. Especially if we are talking about in-hospitality pathogens.
But you should not forget about the second part of the medical strategy. Local treatment also plays an important role.
Preparations for external use include local antiseptics and local antibiotics forms.
Currently, the domestic health care is used a huge amount of funds intended for antiseptics. At the same time, it is no secret that many drugs are morally outdated due to the fact that:
pathogenic microorganisms have developed mechanisms of resistance;
During the long years of use, allergic reactions have been formed in medical staff;
There is an inconvenience on the part of logistics - severe, volumetric and fragile containers;
Many drugs need cooking "on demand", because There are no long-stored dosage forms.
For example, many antiseptic drugs intended for processing the operating field, the hands of the surgeon, the skin before injections, the introduction of vascular catheters, elbow folds before the vessel puncture, do not always provide reliable sterility. Studies of recent years show that hospital strains of microorganisms are resistant to traditional antiseptices (furaciline, aqueous solution of chlorhexidine, permanganate potassium solution). In the Furacilina solution PS. Aeruginosa is maintained in an amount of 106 CFU / ml.
Chemical antiseptics are most widely in the treatment of wound infections.
The means of chemical antiseptics in our country are customary as follows:
I. Halogen group:
1. Chloramine B.
2. iodine alcohol solution 5-10%
3. Joda preparations: iodonate 1% rr, iodinol 1% rr, iodopiron 1% rr
II. Oxidifiers:
1. Rf of hydrogen peroxide
2. Pergel, contains about 30% hydrogen peroxide, is used to prepare a warmer
3. Permanganate potassium
III. Acids:
1. Boric acid
2. Muraiic acid
3. Salonic acid
IV. Aldehydes:
1. Formaldehyde
2. Lizophoform
3. Formalin
V. Phenol:
1. Carbolic acid
2. ichthyol
Vi. Alcohol
VII. Hypertensive solutions:
1. Hypertensive solution - 10% sodium chloride
2. 30% urea rr
3. 40% R-R glucose
VIII. Dyes:
1. Methylene blue 1-3% alcohol rr
2. Diamond green (green)
3. Rivangol
IX. Salts of heavy metals:
1. Nitrate of silver
2. Sulema (mercury dichloride)
3. Salter salts: collargol and protargol
H. Detergents:
1. Chlorhexidine Bigluconat
2. Cerigel
3. Roccal - 10% and 1% aqueous solution
Xi. Nitrofuran derivatives:
1. Furacillain - for processing wounds, tools, washing cavities
2. Furadonin, Furazolidon
3. Furagin
In practical surgery, traumatology, military field surgery, the drugs are played, which can be used directly in the wound. Based on this, quite strict requirements should be made to such antiseptics:
non-toxicity
hypoallergenicity
High bactericidal activity
Ease of use in any conditions (desired is the finished dosage form in a comfortable package).
Traditionally, antiseptics from a group of halide (alcohol solution of iodine), oxidizing agents (hydrogen peroxide), dyes (diamond green) are used to treat wound surfaces.
Currently, there are a number of drugs created on the basis of high technologies. Silver-based preparations are very promising, various wound coatings of long-term use, wet healing environments, etc.
One of the modern local antiseptic means is the Polyvinylpyrrolidone iodine (vocadin, etc.).
What is his advantages?
The actual polyvinylpyrrolidone is a biologically inert polymer molecule.
Polyvinylpyrrolidone binds halides with the formation of habeans with a strong disinfectant effect. The PVP complex with iodine was first obtained by Shelansky, which showed that the polyvinylpyrrolidone forms a reddish-brown complex with an aqueous solution with an odor with iodine. In the complex with polyvinylpyrrolidone, the iodine loses the property to burn tissue, but retains high bactericidal activity, which made it possible to expand the scope of iodine as an antiseptic agent. Thanks to the polymer molecule, the iodine penetrates deep into the wound into inflamed fabrics, under the Strap, etc.
The drug has a wide spectrum of antimicrobial effect: bactericidal, fungicidal, selective virutocidal, tuberculocidal, protocidal.
Contraindications to the use of polyvinylpyrrolidone iodine are:
Sensitivity to iodine
Hyperthyroidism
adenoma of the thyroid gland
dermatitis
renal failure
The drug can be used as for processing the surgeon's hands before operations (there is a form of vocal form in the form of soap), processing the operating field and for local treatment of RAS (1% solution for local applications and 5% ointment ointment) and infection prevents surgery or diagnostic procedures in the vagina (vaginal suppositories and tablets).
Polyvinylpyrrolidone iodine can be used in all phases of the wound process.
A huge problem of almost all hospitals (not only surgical, but also neurological, therapeutic) is straggings formed in patients with limited mobility. Traditional methods of preventing the formation of silent by treating problem areas (seats, blades, heels and other seats) The permanganate potassium solution can be considered as an ineffective method that contribute to the involvement of deep anatomical structures into the purulent process. The permanganate potassium solution is not active in relation to the main causative agents of the hospital infection. Forming dense Strap as a result of daily skin treatments by this antiseptic creates ideal greenhouse conditions for the development of deep phlegmon. At the same time, when using a solution or water-soluble ointment of polyvinylpyrrolidone-iodine, favorable conditions for the reproduction of microorganisms are not created, since thanks to PVP, the conductor of iodine, the drug penetrates well under the stamp.
The serious problem of modern health and in our country and in the world is the treatment of severe forms of venous insufficiency, accompanied by trophic disorders.
Currently, it is generally recognized that venous trophic ulcers are found in 2% of the adult population of industrialized countries.
In our country, the insufficient development of the system of publicly accessible phlebological assistance leads to the fact that often patients turn to a specialist with a long-term existing trophic ulcer. Many patients prefer to be treated for a long time with the use of different system and local means, which in no way improve their condition.
In general, this situation is that the patients most often appeal for qualified help for purulent inflammation.
The wound infection plays a large role in the stimulation of local autoimmune processes, thus turns on "negative feedback" and chronic inflammation there is a long time, creating, in turn, conditions for the persistence of infection.
A feature of the treatment of venous ulcers is the inability and meaninglessness of using most topical forms of antibiotics, because In an acidic medium, they are very quickly cleaving and do not provide a proper healing effect. In this regard, local antiseptics and antibiotics should be applied, working at small pH values. In the exudation phase, antiseptics are one of the important components of treatment, as it is necessary to achieve maximum purification of ulcers from necrotic tissues and suppress infection. It will be logical to use the PVP iodine solution (this allows rinse wound). In the reparation phase, one of the treatment goals is prevention of reinfection, and here it is also impossible to do without antiseptics. This phase is possible to use the ointment of the drug.
In the outpatient practice of polyclinic surgeons, the treatment of purulent-destructive processes in soft tissues of brushes and feet (panaria, paronychy, phlegmon) occupies a large place. The most important condition for successful treatment is the drainage of the focus, the evacuation of purulent discharge, systemic antibacterial therapy and, of course, local treatment, which is unthinkable without the use of antiseptics. In such cases, polyvinylpyrrolidone-iodine turns out to be indispensable, since the polymer molecule allows iodine to penetrate inflamed tissues.
Thus, the polyvinylpyrrolidone-iodine complex is highly efficient, safe and convenient to use the means of local antiseptics. Wine can be widely used in surgical practice for the treatment of various wounds, surgical infections, burns, layers, trophic ulcers. Iodofors must be included in the drug set when the stock of the reserves for the team of medicine disasters, military medical service.
Literature
1. Blaun L.A. Modern iodifors are effective preparations for the prevention and treatment of infectious complications. Consilium Medicum. 2005, Volume 7 No. 1.
2. Oganesyan E.A., Pavlov S.I., Petova V.A. Epidemiological supervision of nosocomial infections in the Kaluga region. In Sat .: Modern problems of epidemiology, diagnosis and prevention of nosocomial infections. St. Petersburg, 2003; from. 61-63.
3. Belozer A.A., Smirnov O.A., Petova V.A. Infectious monitoring of nosocolnic infections in the hospital of emergency medical care. Modern problems of epidemiology, diagnosis and prevention of nosocomial infections. St. Petersburg, 2003; from. 75-77.
4. Novikova N.F., Mordovtsev V.N., Penkov T.V. New opportunities for the treatment of trophic ulcers, wounds of leather and soft tissues, bedding and fistula. - Consilium Provisorum, 2001, T.1, N4. - P.30.
5. Phlebology. Guide for doctors under. ed. V.S. Sweelleva. M., Medicine. 2001.
6. Loda H. Catheter-associated infections in the IUIT. Materials of the international conference "Nosocomial infections in intensive care departments." 1998; from. 15-16.
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