Antiseptics And Disinfectants

Antiseptics – antimicrobials of a non-selective action, used primarily for the disinfection of skin and mucous membranes.

Disinfectants – antiseptic drugs used for disinfection of external objects: rooms, health products, medical instruments.

Classification of antiseptics:

1. Halogen-containing compounds;

2. Aromatic series compounds;

3. Aliphatic series compounds;

4. Dyes;

5. Oxidizers;

6. Nitrofuran derivatives;

7. Acids and bases;

8. The metal salts;

9. Detergents.

( A ) Halogen-containing compounds include drugs of chlorine and iodine.

( 1 ) Chlorhexidine (Chlorhexidinum)

Pharmacodynamics. It has a bactericidal effect on gram-positive and gram-negative bacteria. It’s effective against the pathogens of sexually transmitted diseases: treponemes, gonococci, trichomonas, chlamydia, ureaplasma. The insensitive to chlorhexidine are Pseudomonas aeruginosa and Proteus. No effect on bacterial spores and viruses, mycobacterium tuberculosis, fungi. It produces atomic chlorine, which has strong oxidizing properties and destroys the molecules of organic substances.

It is used in the form of 0.5% or 1% alcohol water solution for treating the surgical field and the surgeon's hands. In case of wound infections, burns one uses water solution of 0.05%; mouthwash for gingivitis, stomatitis - 0.02% solution. 0.1% water solution can be used for general disinfection of rooms, sanitary equipment, etc.

Undesirable side reactions. Possible dryness and itching of the skin, dermatitis, staining of teeth, accumulation of dental tartar and the taste disturbance, allergic reactions.

Contraindications. The tendency to allergic reactions and dermatitis. Undesirable is simultaneous use of iodine preparations (possible dermatitis).

( 2 ) Chloramine B (Chloraminum B) contains 25-29% of active chlorine.

Pharmacodynamics. It has antiseptic, deodorant and spermatacid properties.

Used for the treatment of infected wounds (wash, soaking tampons and tissues 1.5-2% solution, hand disinfection (0.25-0.5% solution), non-metallic tools. For decontamination of care and discharge products in case of infections of the intestinal group, respiratory infections – 1-3% solutions are used, at TB - 5% solution.

The dosage form is powder.

( 3 ) 5% iodine alcohol solution (SolutioIodispirituosa 5%) – 5% iodine tincture. It contains 5 g of iodine, potassium iodide, 2 g of water and 95% alcohol in equal proportions up to 100 ml.

Pharmacodynamics. Molecular iodine, which has antiseptic properties, coagulates proteins to form iodamines and cause the death of germs. It acts on bacteria, pathogenic fungi, viruses, protozoa.

It is used topically as an antiseptic, irritating and distracting agent for inflammatory and other diseases of the skin and mucous membranes. As a distracting drug it is used for myositis, neuralgia. 5% solution is used as an antiseptic for skin of the surgical field and the surgeon's hands, in the treatment of abrasions, scratches.

Dosage forms. 5%, 1%, 2%, 3% alcohol solutions of iodine.

( 4 ) Povidone-iodine (Povidoneiodine, betaine) - 10% of a complex of iodine with polyvinylpyrrolidone (PVP). It has antibacterial, antifungal, antiviral and antiprotozoal activity associated with the release of free iodine. Used for the treatment of a surgeon’s hands and surgical field. In the form of 0.5-1% solutions it is used for the treatment of wounds and burns. Mouthwash form is used for stomatitis or after dental procedures – 1 teaspoon of a 1% solution into half a glass of water. In the form of ointments it is applied in case of skin diseases. Do not allow the solution get into the eye.

( 5 ) Iodinol (Iolinolum) – a water solution containing 0.1% iodine, 0.3% potassium iodide and 0.9% polyvinyl alcohol. Apply externally for chronic tonsillitis, peridontitis, purulent otitis, trophic ulcers.

( B ) Aliphatic compounds

( 1 ) Ethanol (Spiritusaethylicus) at concentrations of 70-95% denatures proteins and has a bactericidal effect. 70% solution is used to treat the surgical field and the surgeon's hands. For emergency treatment of hands one sometimes uses 90% ethanol. Its effect is more superficial, because it causes no bactericidal effect, only astringent action - due to the temporary closing ducts of the sweat and sebaceous glands. 90% - 95% solutions are used for the disinfection of instruments, rubber catheters, etc.

( 2 ) Formaldehyde solution (SolutioFormaldehydi)

Pharmacodynamics. It acts on bacteria, fungi, viruses.

Application. It is used as a disinfectant and deodorizing cleanser for washing hands, feet skin treatment in case of excessive sweating (0.5-1% solution, 3.7% gel), disinfection of instruments (0.5% solution), douching/syringing (1: 2000-1 : 3000).

Dosage form – for external use; 3.7% gel (Formagel).

( C ) Oxidizers

      ( 1 ) Diluted hydrogen peroxide solution (SolutioHydrogeniiperoxydi)

Pharmacodynamics. When in contact with the tissues under the influence of the catalase enzyme it decomposes with the release of molecular oxygen, which is a less active antiseptic compared to atomic oxygen. When applied to contaminated surface of wounds hydrogen peroxide foams due to the intensive oxygen release. The formed foam removes the particles of foreign bodies, dead tissue, blood clots, pus from the surface of the skin and wounds and cleans the wound. As a hemostatic agent it is used for bleeding wounds and capillary bleeding.

Application. It is used in the form of a solution for rinsing and lubrication in case of inflammatory diseases of the mucous membranes (stomatitis, sore throat), for the treatment of purulent wounds, etc. In dermatological practice – as a depigmenting agent.

Dosage form. 3% topical solution in vials; 1.5% alcohol solution for external use.

( 2 ) Hydroperite (Hydroperitum) is a complex compound of hydrogen peroxide with urea. Contains 35% of hydrogen peroxide.

Application. One tablet of 1.5 g is identical to 15 ml (1 tablespoon) of 3% hydrogen peroxide solution. To get a solution similar to 1% solution we take 2 tablets and dissolve them in 100 ml of water. 1% solution is used for washing. Mouth and throat rinsing – one 1.5 g tablet is mixed with a glass of water (0.25% solution).

Dosage form. In tablets, 0.5; 0.75; 1.5 g.

( 3 ) Potassium permanganate (Kaliipermanganas) has a strong oxidizing properties.

Pharmacodynamics. It has an antimicrobial action due to the release of atomic oxygen.

Application. In the form of 0.02-0.1% solutions the drug is used for mouth and throat rinsing as an antiseptic and deodorant agent, as well as for syringing, urethral lavage. For washing wounds – 0,1-0,5% solutions. The higher concentrations (2-5%) it exerts cauterizing and astringent actions that can be used to treat ulcers, and burns. 0.02% potassium permanganate solution is used for gastric lavage as an antidote for poisoning with alkaloids (morphine, quinine, nicotine).

Dosage form. A powder for an external use solution.

( 4 ) Brilliant green (Viridenitens).

Pharmacodynamics. As an antiseptic it is used in the form of 1% and 2% alcohol and water solution for lubrication in pyoderma, erysipelas, burns, folliculitis, blepharitis, candidiasis of the skin and mucous membranes.

Dosage form. Topical solution.

( 5 ) Ethacridine (Aethacridinum, rivanola)

Pharmacodynamics. It exerts an antimicrobial effect against infections caused by cocci, particularly streptococci.

Application. Used as an external preventive and therapeutic antiseptic. For the processing and treatment of infected and fresh wounds one uses 0.05%, 0.1%, 0.2% water solutions. In dermatological practice they use 2.5% powder, 3% ointment, 5.10% paste.

Dosage form. 0.1% alcohol solution for outdoor use; 3% ointment.

( D ) Detergents

( 1 ) Cerigel (Cerigelum).

Pharmacodynamics. It refers to the group of cationic detergents having a high surface activity. It has an antibacterial (disinfectant) effect.

Application. For the treatment of the hands of medical personnel during the preparation for surgical operations and other manipulations.

Dosage form. Alcohol solution for the external use.

( 2 ) Phenol (Phenolum). Carbolic acid (Acidumcarbolicum)

Pharmacodynamics. Phenol solutions have potent bactericidal activity against vegetative forms of microorganisms and have little effect on the spores.

Application. 3% and 5% solutions – for disinfecting hospital and household appliances, instruments, clothes, etc., and discharges.

Undesirable side reactions. Phenol exerts irritaring and cauterizing action on skin and mucous membrane. It is easily-absorbed through them and in large doses can cause toxic effects (dizziness, weakness, respiratory disorders, collapse). It is not used for extensive skin lesions and mucous membranes. It is easily adsorbed by food products.

( 3 ) Resorcin (Resorcinum).

Pharmacodynamics. Antibacterial and local anesthetic agent used for skin diseases (eczema, seborrhea, itching, fungal diseases) topically in the form of 2-5% water and alcohol solutions and 5-20% ointment.

Dosage form. 1% and 2% alcohol solution for external use.

( E ) Salts of heavy metals

( 1 ) Silver nitrate (Argentinitras, Lapis)

Pharmacodynamics. In small concentrations it has astringent and anti-inflammatory effects. It also possesses antibacterial properties.

Application. Topically in the form of water solutions, ointments, and lapis pencils for erosions, ulcers, excess granulations, cracks, acute conjunctivitis, etc. Topically to lubricate the skin and cauterize one uses 2-10% solution, 1.2% ointment; to lubricate the mucous membranes - 0.25-2% solution.

( 2 ) Protargol (Protargolum) contains 7,8-8,3% silver.

Application. It is prescribed as an antiseptic, astringent and anti-inflammatory agent for lubricating mucous membranes of the upper respiratory tract (1-5% solution), washing of the urinary tract, in the form of eye drops.

Dosage form. Powder.

( 3 ) Collargol (Collargolum) contains 70% silver.

Application. For washing purulent wounds 0.2-1% solutions; bladder lavage – 1-2% solution; in the form of eye drops – 2-5% solutions.

Dosage form. Powder.

( F ) Acids and bases

( 1 ) Boric acid (Acidumboricum).

Pharmacodynamics. It has an antiseptic activity (coagulates proteins of bacteria), as well as fungistatic action. When applied locally it possesses an antipedicular action.

Pharmacokinetics. It penetrates through the skin and mucous membranes, is slowly excreted and can accumulate in tissues and organs.

Application. Conjunctivitis – 2% water solution; dermatitis, pyoderma, weeping eczema – 3% water solution; in acute and chronic otitis – 0.5-2% alcohol solution.

( 2 ) Ammonia (Ammonia).

Pharmacodynamics. It has antiseptic and irritating properties. As an antiseptic one uses 10% ammonia solution (Sol.Ammoniicaustici 10% ammonia). It has antiseptic and detergent properties. It is used to wash the hands of medical staff before the surgery (25 ml to 5 liters of water).

( G ) Nitrofuran derivatives

( 1 ) Furaciline (Furacilinum, nitrofurazone)

Pharmacodynamics. It affects on gram-positive and gram-negative bacteria. It is prescribed mainly for external use for the treatment and prevention of inflammatory bacteria.

Application. 0.02% Furaciline water solution – mouth rinsing in case of stomatitis, sore throat, purulent otitis, for washing purulent wounds.

Dosage form. 0.1 g tablets for oral administration and 0.02 g tablets for the preparation of a solution for topical use; 0.02% water solution and 0.067% alcohol solution for external application; 0.2% ointment in a jar; paste for external use.