What about antiseptics? Tests for consolidation

Antiseptic(or antiseptics) are agents that are used for antimicrobial effects on the skin and mucous membranes. Unlike antiseptics, disinfectants agents (or disinfectants) are used to destroy microorganisms at various objects external environment (surgical instruments, dishes, walls of the operating room, disinfection of water, bed linen, clothing, etc., etc.). Thus, the fundamental difference between antiseptics and disinfection lies in the answer to the question “what are we treating?”

Taking into account the above definitions, it becomes clear that the same substance can well be used both as an antiseptic and as a disinfectant (you can treat your hands with a solution of ethyl alcohol, or you can dip a scalpel in it).

Antiseptics can be preventive(hand treatment, treatment of fresh wounds to prevent infection, skin treatment before surgery, etc.) and therapeutic(processing already infected wounds and mucous membranes).

We have repeatedly emphasized the fact that the local use of chemotherapeutic agents often does not allow the creation of a high concentration of an antimicrobial substance, which is a determining factor in the mechanism of formation of antibiotic resistance. Confirmation of this can be observed at every step: the same famous solution of furatsilin, which is currently practically ineffective against most actual bacteria.

The fundamental feature of a good modern antiseptic is that, firstly, it has a very wide range microbicidal action (antiviral, antifungal, and antibacterial) and, secondly, it is used specifically as an antiseptic (disinfectant), but in no other way (not used systemically).

It's obvious that skin more resistant to the damaging effects of chemicals (of course, in comparison with oral and parenteral administration), which makes it possible to create sufficiently high concentrations of a chemotherapeutic agent with minimal risk development of microbial resistance. All this creates the prerequisites not only for effective prevention, but also for effective treatment, which often makes it possible to do without, for example, the use of antibiotics.

The number of drugs used for antiseptics and disinfection is huge, but we will allow ourselves only a brief overview of the main and most commonly used drugs, focusing on medicines, the need for which arises during therapeutic and prophylactic use at home.

All antiseptics and disinfectants can be divided into three main groups :

inorganic substances- acids, alkalis, peroxides, individual chemical elements(bromine, iodine, copper, mercury, silver, chlorine, zinc) and their derivatives (again inorganic);
organic substances- aldehydes, derivatives of alcohols and phenols, acids and alkalis, nitrofurans, quinolines, dyes and much more. The main thing is synthetic substances of organic nature;
bioorganic substances- drugs natural origin, i.e. obtained from actually existing biological objects(plant or animal raw materials, fungi, lichens).

Halogens and their derivatives

They are mainly represented by preparations based on chlorine and iodine.
To begin with, about chlorine…
Widely known (due to efficiency and low cost) chloramine , which in solutions of different concentrations can be used both as an antiseptic and as a disinfectant.

pantocide . It is produced in tablets and can be used for water disinfection (1 tablet per 0.5-0.75 l).
chlorhexidine . Presented in a huge number dosage forms: solutions (water and alcohol) in a wide variety of concentrations, aerosols, ointments, gels (including special dental ones), creams, emulsions, etc. In combination with other substances, it is included in some tablets used for resorption in the oral cavity for stomatitis, pharyngitis, etc. Chlorhexidine can be used for rinsing the mouth, injecting into the bladder, treating wounds and intact skin. Well tolerated in most cases age restrictions No. It is not recommended to use together with iodine preparations - skin irritation often occurs;

biclotymol . It is mainly used for diseases of the oral cavity. Available in the form of a spray and lozenges. Contraindicated for children under 6 years of age.

Widely known as an antiseptic 5 % alcohol solution iodine . Use is advisable for treating the edges of the wound (but not the wound surface!), As well as small cuts, injections (when the wound surface is practically absent).

The use of iodine solutions should be treated with caution due to two circumstances. Firstly, molecular iodine from the surface of the skin is able to be partially absorbed, reach the systemic bloodstream and create concentrations that inhibit the function of thyroid gland. Secondly, a 5% iodine solution quite often causes skin irritation, and the younger the child, the higher the risk of irritation.

Taking into account the two described circumstances, a standard 5% iodine solution is not recommended for use in children under 5 years of age. Some guidelines allow its limited use in children aged 1-5 years in diluted form (2-3% solution). Nevertheless, everyone is unanimous in the aspect that children of the first year of life cannot use a 5% iodine solution in any form.

At the same time, there are numerous iodine-containing antiseptics and disinfectants that are superior in their properties to the standard 5% solution - more effective and safe. These drugs, for the most part, if they irritate the skin, do so moderately; they are more intense and lasting. antiseptic effect. Nevertheless systemic effects iodine are possible, so caution should be exercised and instructions strictly followed.

In particular, when using tools such as Iodinol And iodonate (solutions) molecular iodine is also formed, which can be absorbed into the blood.

Preparations that are a combination of iodine with a special substance - polyvinylpyrrolidone - are actively used.

Iodine bound to polyvinylpyrrolidone , loses its irritant effect on the skin and mucous membranes, and in addition is slowly released, which determines long action medicines. The drugs are available in solutions, ointments, vaginal suppositories, aerosols.

Povidone-Iodine

Povidone-Iodine

Aquazan, solution

Betadine, solution, ointment, liquid soap, vaginal suppositories

Betadine, solution, vaginal suppositories

Brownodin B. Brown, solution, ointment

Vokadin, solution, ointment, vaginal tablets

Yod-Ka, solution

Iodixol, spray

Iodobak, solution

Iodovidone solution

Iodoxide, vaginal suppositories

Iodosept, vaginal suppositories

Iodoflex, solution

Octasept, solution, aerosol

Povidin-LH, vaginal suppositories

Povidone-Iodine, solution, ointment, foamy solution

Povisept, solution, cream

Polyiodine, solution

Early stop, ointment

A conversation about iodine preparations would be incomplete without mentioning solution Lugol .

In just a little while, Lugol's solution will turn 200 years old - the French doctor Jean Lugol proposed it in 1829 for the treatment of tuberculosis! The composition of Lugol's solution includes iodine (1 part), potassium iodide (2 parts) and water (17 parts). Lugol's solution in glycerin is also available.

Lugol's solution is still actively used (by some doctors in countries with developing healthcare) to treat the mucous membranes of the oropharynx for tonsillitis and pharyngitis. Modern medicine considers such treatment unjustified (especially in children), primarily because the therapeutic effectiveness is questionable, and a significant and potentially dangerous intake of iodine into systemic blood flow- on the contrary, there is no doubt.

And the last, to complete the conversation about iodine preparations. The irritating effect of iodine on the skin is often used to implement the so-called. distracting procedures. The latter, in most cases, is the process of applying drawings to the skin using a 5% iodine solution - most often drawing iodine nets (on the back with acute respiratory infections, on the buttocks after injections, etc.). The mentioned method of “treatment”, firstly, has nothing to do with civilized medicine, secondly, it obviously carries a risk associated with excessive intake of iodine into the body, and thirdly, it is an effective example of calming psychotherapy for this purpose. who, in fact, is engaged in drawing.

Oxidizing agents, acids, aldehydes and alcohols

Oxidizing agents are capable of releasing atomic oxygen, which in turn has a detrimental effect on microorganisms. Two oxidizing agents are widely known and actively used (although no one thinks that these are oxidizing agents) - hydrogen peroxide and potassium permanganate (popularly potassium permanganate).

Peroxide hydrogen is produced mainly in the form of a 3% solution. It is used as an antiseptic for the treatment of skin and mucous membranes. It is also used as a hemostatic agent. Modern recommendations consider it appropriate to treat the edges of the wound, but do not provide for the contact of hydrogen peroxide with the wound surface: the antiseptic effect is beyond doubt, but it has also been proven that such treatment adversely affects the healing time. Regarding the timing of stopping bleeding: with intense bleeding, hydrogen peroxide is ineffective, with moderate bleeding, pressure on the wound is enough to stop it.

In recent pseudoscientific literature, a lot of advice has appeared on the non-standard (to put it mildly) use of hydrogen peroxide - it is used orally and even administered intravenously for the purpose of rejuvenating the body and total recovery. The authors of the recommendations very convincingly (for those without medical education) describe the advantages similar methods, but their scientific justification does not exist. It is not our task to debunk myths, but we would like to earnestly ask parents not to use hydrogen peroxide in an unconventional way at least in relation to children (especially since they will certainly do without rejuvenation).

Hydroperite is a compound of hydrogen peroxide and urea. It is produced in tablets, which are dissolved in water before use - the resulting solution is identical in its properties to hydrogen peroxide. Many parents are convinced that a tablet of hydroperite per glass of water is the “correct” solution of hydrogen peroxide.

Let us clarify: a solution corresponding to 3% peroxide is 1 tablet of 0.5 g per 5 ml of water! There are also tablets of 0.75 and 1.5 g (it is clear that 1.5 g is per 15 ml of water).

Potassium permanganate . It appears as red-violet crystals (sometimes powder). Let's dissolve well in water. Pharmacological guidelines recommend the use of potassium permanganate for washing wounds, rinsing the mouth, and douching. Concentrated solutions (2-5%) are used to lubricate ulcerative surfaces.

Most parents believe that the main goal home use potassium permanganate - disinfection of water prepared for bathing a baby. In fact, this is far from the case. Minimum concentration potassium permanganate, which has antiseptic activity, is a 0.01% solution. At the same time, the standard recommended disinfectant concentrations are 0.1% and higher.

Let us translate for those who are not particularly good at mathematics: a 0.01% solution is 1 g per 10 liters of water, 0.1% is, respectively, 10 g per 10 liters!

Thus, by adding a “gramule” of potassium permanganate to the water and making it (the water) pale pink in color, parents are not disinfecting anything, but are just putting a tick on their own conscience - our baby, they say, is now in no danger.

Bornaya acid . Available in the form of powder, solutions of different concentrations, ointments. Included in some combination products for external use (together with zinc, petroleum jelly, etc.).

2 % water solution used for conjunctivitis, alcohol solutions of different concentrations are prescribed for otitis (drop into the ear canal or moisten turundas).

Currently application boric acid limited in many countries due to numerous side effects associated with toxic influence drug, vomiting, diarrhea, rash, headache, convulsions, kidney damage. All this more often occurs with an overdose (treatment of large areas of skin, for example) or long-term use. However, the risk is always present, which is why most doctors consider boric acid to be an outdated and unsafe drug. In any case, the drug is contraindicated during pregnancy, breastfeeding and children in the first year of life.

Formaldehyde (a common synonym is formalin). Widely used in medical institutions, it is part of some combined disinfectants. It has nothing to do with outpatient pediatrics.

Ethyl alcohol . As an antiseptic, it is most advisable to use a 70% solution. Can be used to treat hands, skin (around the wound, before injections). Even from the surface of intact skin enters the systemic circulation. Inhalation of alcohol vapors is accompanied by similar effect. Exactly in children alcohol poisoning especially dangerous due to severe respiratory depression.

Use as irritant(compresses, rubbing, lotions, etc.) and to combat elevated temperature body (wiping the skin) in children is risky and is currently not recommended (more often strictly prohibited) by health authorities in most civilized countries.

Metal salts and dyes

Protargol (silver proteinate). Used in the form of a 1-5% solution as an antiseptic: lubrication of mucous membranes respiratory tract, washing Bladder and urethra, eye drops.

Currently pharmacological reference books consider protargol outdated tool with very moderate efficiency, completely incomparable with that of modern antibacterial agents. Nevertheless, in some regions protargol is still widely used by doctors who believe in its effectiveness. The frequency of use is largely explained by the psychotherapeutic effect - the very phrase “silver treatment” has a healing effect.

Collargol (colloidal silver). In solutions of different concentrations (0.2-5%) it is used for the same indications and with the same moderate results as protargol.

zinc sulfate . In the form of a 0.25% solution, it is sometimes used as an antiseptic for conjunctivitis (eye drops). However, it is more often used in tablets to treat certain diseases associated with zinc deficiency in the body.

Zinc oxide . It is actively used in the treatment of many skin diseases. It is used both independently and in combination with other drugs. Included in powders, ointments, pastes, liniments.

Diamond green (popular name- brilliant green). A widely known and equally actively used ineffective antiseptic. The breadth of application, however, is limited to the territory of the former Soviet Union. Available in the form of alcohol solutions (1 and 2%), as well as in the form of pencils.

Methylene blue . Available in both alcohol and aqueous solutions. Alcohol solutions (1-3%) are used to treat the skin for antiseptic purposes, and cavities (for example, the bladder) are washed with water solutions. The effectiveness of application as an external agent is equivalent to that of brilliant green.

Methylene blue is used not only as an antiseptic. Its solutions are very effective against certain poisonings: hydrogen sulfide, carbon monoxide, cyanides (injected intravenously during treatment).

Magenta . Dye, aqueous solutions of bright red color. It is not used independently, but is part of some combined antiseptics, in particular fucorcin (a combination of fuchsin, boric acid, phenol, acetone, resorcinol and ethanol). Indications for the use of fucorcin are fungal and pustular diseases skin, abrasions, cracks, etc.

The fucorcin solution (thanks to fuchsin) also has a bright red color. Thus, parents are given the opportunity to widely use a wide variety of ineffective, but completely safe dyes, which means, in accordance with their artistic taste, they can paint their children green, blue and red.

Bioorganic substances

Chlorophyllipt . The drug, which has antibacterial activity, is a mixture of chlorophylls obtained from eucalyptus leaves. In some situations, it is capable of exhibiting bactericidal activity against antibiotic-resistant bacteria. For local application use oil and alcohol solutions of varying concentrations.

During use, quite severe allergic reactions are possible.

Sodium usinate . Contains usnic acid, which is isolated from a special type of lichen. Has moderate antibacterial activity. Available in the form of an alcohol solution, as well as solutions in castor oil and fir balsam. The latter is of some pediatric interest - many note its effectiveness in treating cracked nipples in nursing mothers.

Lysozyme . One of critical components immune protection. Enzyme. Derived from protein chicken eggs. Wipes moistened with lysozyme solution are used in the treatment of purulent wounds, burns, frostbite. Also used in the form eye drops.

Ectericide . Transparent yellow oily liquid with a specific odor fish oil(from it, in fact, the ectericide is obtained).

Has antibacterial activity. Used to treat festering wounds, burns, ulcers, fistulas, etc.: wash, apply wet wipes. It is often used in the form of nasal drops - mainly for prolonged runny nose of an infectious nature.

Flowers marigold . A common synonym is calendula flowers. An infusion of flowers is used as an antiseptic for inflammatory diseases of the oral cavity. Calendula tincture in 70% ethanol is also available. Indications, precautions and meaning of use are the same as for 70% ethyl alcohol.

Other antiseptics and disinfectants

Decamethoxin . It has antibacterial and antifungal activity. Available in the form of ear and eye drops, as well as in the form of tablets intended for the preparation of solutions. Used for the treatment of otitis and conjunctivitis, for rinsing with bacterial and fungal infections of the oral cavity, for lotions for skin diseases, for rinsing the bladder, etc.

Decamethoxin is well tolerated, contraindications for use (except hypersensitivity) No.

Miramistin . A complete antiseptic - it is active against viruses, bacteria, fungi, and protozoa.

The main indication for use is the prevention of suppuration and treatment of purulent wounds. Used for otitis, conjunctivitis, sinusitis, and a wide variety of inflammatory processes in the oral cavity.

Available in solutions (usually 0.01%) and in the form of 0.5% ointment.

Ichthyol . It is almost impossible to explain what ichthyol is and where it comes from - the simplest available explanation looks something like this: “ichthyol is obtained from resins formed during the gasification and semi-coking of oil shale.” Ichthyol is a thick black liquid with a very specific smell. It has very little antiseptic properties. According to the behests of grandmothers who believe in its miraculous effectiveness, it is used in the form of an ointment for treatment various diseases skin. Civilized medicine is not used.

Octenidine (octenidine hydrochloride). A modern antiseptic with a wide spectrum of action. It does not penetrate into the systemic bloodstream even when treating wounds, which determines its uniquely low toxicity. It makes no sense to describe the indications for use - it can be used in almost all situations where an antiseptic effect is necessary (with the exception of dripping into the ear and rinsing the bladder). Rational as a means primary processing wounds (shots, abrasions, cuts) at home.

Available in solution, in bottles with various attachments (for spraying, for insertion into the vagina).

Can be used in children of any age, during pregnancy and breastfeeding. In the latter case, if treatment of the nipples is necessary, care must be taken to ensure that the drug does not get into the child’s mouth.

In finished dosage forms, octenidine is usually combined with phenoxyethanol(also an antiseptic, but with preservative properties).

Quaternary ammonium compounds. A group of widely used antiseptic and disinfectants. The most famous - benzalkonium chloride , which besides antimicrobial action It also has spermicidal activity (i.e. the ability to kill sperm), and therefore is used as contraceptive local action.

Benzalkonium chloride is included in many topical medications intended for wound treatment, absorption in the oral cavity, etc.

Benzalkonium chloride

Benzalkonium chloride

Benatex, vaginal gel, vaginal suppositories, vaginal tablets

Virotek Intim, solution

Virotek Clinic, solution

Dettol spray

Katamin AB, solution

Katapola solution

Katatcel, paste for external use

Contratex, vaginal suppositories

Line-bio, liquid

Lizanin, solution

Maxi-Dez, solution

Micro 10+, solution

Rokkal, solution

Septustine, solution

Spermatex, vaginal suppositories

Pharmaginex, vaginal suppositories

Pharmatex, vaginal cream, vaginal suppositories, tampons for intravaginal administration

Erotex, vaginal suppositories

Another famous drug this group - cetrimide . Its combination with benzalkonium chloride is available in the form of a cream, indications for use are diaper rash, diaper dermatitis, burns.

(This publication is a fragment of the book by E. O. Komarovsky adapted to the format of the article

ANTISEPTIC AND DISINFECTANTS

Disinfectants– designed to destroy pathogens in the external environment, used to disinfect premises, patient clothing, care items, secretions, and medical instruments.

Antiseptics– used to destroy pathogens on the surface of the human body (skin, mucous membranes, wound surfaces).

Features of antiseptics and disinfectants:

the mechanism of action is mainly associated with protein coagulation

nature of action is bactericidal

antimicrobial spectrum is wide, there is no selectivity for certain microflora

microflora does not become addictive

toxicity is high, so the main use is local (rarely for resorptive purposes)

a) Chlorine preparations

In aqueous solutions they form hypochlorous acid (HClO), which decomposes in acidic and neutral environments to form atomic oxygen and chlorine. Oxygen oxidizes and coagulates microbial cell proteins, and chlorine replaces H + in the amino group, forming a chlorinated protein, which leads to disruption of the formation of H-bonds between polypeptide chains and disruption of the secondary structure of the protein. In an alkaline environment, hypochlorous acid dissociates to form a hypochloride ion (ClO –), which also has the properties of an oxidizing agent, but its antimicrobial activity is lower than that of atomic O and Cl. Therefore, as the pH increases, the effect of chlorine-containing antiseptics decreases. 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 - treatment of hands, infected wounds

2-3% - processing of care items, patient secretions

5% - treatment of secretions of a tuberculosis patient

b) Iodine preparations

Elemental iodine has powerful bactericidal activity; it coagulates proteins, providing a powerful restorative effect.

Pharmacological effects of iodine:

antiseptic

antisyphilitic

antifungal

expectorant

anti-sclerotic (improves lipid metabolism)

antithyroid

absorbable

Alcohol solution of iodine used in the treatment of abrasions and scratches.

Iodinol used externally for chronic tosillitis, purulent otitis, trophic ulcers.

Biguanides.

Chlorhexidine acts on bacteria, fungi of the genus Candida, Trichomonas. Does not work on disputes. Used in solutions for treating the surgeon’s hands and the surgical field - 0.5% alcohol solution; with gingivitis, stomatitis, wound infections, gynecological practice- 0.05% aqueous solution; for washing the bladder - 0.02% aqueous solution.

Oxidizing agents:

Hydrogen peroxide- upon contact with tissues, it 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, the drug is not very active; its cleansing effect is mainly expressed due to foaming. Used for treating contaminated and purulent wounds, for rinsing the mouth for stomatitis, sore throats. It has a hemostatic effect (due to the activation of thromboplastin and mechanical clogging of small vessels; it is dangerous to wash the cavities (uterus, bladder) due to the possibility of embolism). Preparations: diluted hydrogen peroxide solution (3%), perhydrol (concentrated solution).

Potassium permanganate– as an antiseptic it exhibits greater activity compared to hydrogen peroxide, because when it decomposes, atomic oxygen is released. It also has deodorizing properties. Solutions of the drug

(0.01-0.1%) is used for washing wounds, rinsing the mouth and throat, for douching, and washing the urethra. Oxidizes alkaloids and some toxins, therefore it is used for gastric lavage in cases of alkaloid poisoning and food poisoning. Due to manganese oxide, it has an astringent and cauterizing effect, which is used to treat ulcers and burns (2-5% solution).

Metal compounds: these are general cellular poisons, they bind thiol groups (SH groups) of enzymes and form albuminates with proteins. If the albuminate is dense, the effect is astringent and bacteriostatic, if it is loose, the effect is cauterizing and bactericidal.

According to the degree of solubility of albuminates, metals are arranged as follows:

Schmideberg series

AlPb ZnCuAgHg

Solubility

Antimicrobial action

Silver nitrate– low concentrations (up to 2%) have an antimicrobial effect, in higher concentrations (5-10%) it acts as a cauterizing agent. Used in low concentrations for infectious diseases eyes (trachoma, conjunctivitis), and in higher cases - in the treatment of skin ulcers, erosions, cracks, as well as for the removal of excess granulations and warts.

Protargol, collargol– organic silver preparations.

zinc sulfate And copper sulfate as an antiseptic and astringents used in solutions of 0.1-0.25% for conjunctivitis, laryngitis, urethritis.

Mercury dichloride(sublimate) in solutions of 1:1000 is used to disinfect linen and patient care items. Highly toxic.

Mercury oxide yellow– less toxic, used as an antiseptic for conjunctivitis and blepharitis.

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 (form gels in the surface layers). Strong acids deeply denature proteins, have a cauterizing effect, and dehydrate tissues (dry necrosis - coagulation).

Weak alkalis soften the epidermis, dissolve mucus, and reduce its viscosity. Strong alkalis cause tissue necrosis with liquefaction (liquefaction necrosis) and penetrate deeply into tissues (deep burns).

Boric acid in the form of a 2% solution it is used in ophthalmic practice, 3% - for dermatitis, pyoderma.

Ammonia solution(ammonia) has antiseptic and cleaning properties. Used for hand washing medical personnel, for processing premises.

Aldehydes and alcohols:

Formaldehyde– used in the form of a 40% solution (formalin). Acts on bacteria, fungi, viruses. Coagulates proteins and has a powerful antimicrobial effect. It has a tanning effect and removes water from the surface layers of tissues. Used for hand treatment, disinfection of instruments, for excessive sweating (0.5 - 1% solution), for preserving tissues, histological preparations, formaldehyde vapor - for disinfecting clothing.

Ethanol 70-95% denatures proteins and has a bactericidal effect. A concentration of 70% is used to treat the surgeon’s hands and the patient’s skin. In this concentration, ethyl alcohol has a deeper antiseptic effect on the skin (penetrates the ducts of the sebaceous and sweat glands). In concentrations of 90-95% they are used for disinfection - disinfection of surgical instruments.

Detergents: These are cationic soaps, substances with high surface activity. They accumulate on the cell membrane of a microorganism, change surface tension, increase permeability, which leads to swelling and death of the microorganism.

Cetylpyridinium chloride in the preparation "Zerigel" used for hand treatment.

Aromatic antiseptics:

Phenol(carbolic acid) is the oldest antiseptic, a standard for assessing the antiseptic activity of other drugs (phenol coefficient).

Phenol in small doses has a bacteriostatic effect, in large doses it has a bactericidal effect. It causes deep denaturation of the cytoplasmic protein of the microbial cell. It acts mainly on vegetative forms of bacteria and fungi and little on spores. When interacting with proteins, it does not form a strong bond and can react with several protein molecules, i.e. the presence of proteins does not reduce the antiseptic activity of phenol, so it is rational to use it to treat patient secretions. Used in the form of 1-3% solutions for disinfecting linen, care items, and instruments. Has a pronounced irritating, local anesthetic effect; in a concentration of 2% and higher – cauterizing effect. Possible poisoning if absorbed through the skin.

Birch tar contains phenol and its derivatives. It has antiseptic, insecticidal, keratoplastic and keratolytic effects. Used to treat a number of skin diseases and scabies.

Dyes: methylene blue, brilliant green, ethacridine lactate. They affect mainly gram-positive flora and disrupt the enzymatic properties of microorganisms.

Diamond Green- the most active dye, used in the form of 1-2% aqueous or alcohol solutions to lubricate the skin with pyoderma and the edges of the eyelids with blepharitis.

Methylene blue– as an antiseptic inferior to other dyes. Used for cystitis, urethritis - 0.02%, ulcerative stomatitis - 0.5-1% aqueous solution, for pyoderma, burns - 1-3% alcohol solution. Used to study the functional abilities of the kidneys. It is interesting from a toxicological point of view - it has powerful redox properties, can play the role of an acceptor and donor of H +, and is used as an antidote for poisoning with cyanides and nitrites (intravenous 1% aqueous solution).

Ethacridine(rivanol) is used in solutions of 0.05-0.1% for the treatment of wounds, washing cavities during purulent processes. To treat skin diseases, 3% ointment is used.

Nitrofurans.

Used as an antiseptic furatsilin, effective against gram-positive and gram-negative bacteria. An aqueous solution of furatsilin 0.02% is used to rinse the mouth and throat for stomatitis, sore throats, and for washing purulent wounds.

Medicines with antimicrobial effects are divided into 2 groups:

1 – not having selective antimicrobial action, they have a detrimental effect on most microorganisms (antiseptics and disinfectants).

2 – antimicrobial drugs electoral action(chemotherapeutic agents).

Antiseptics and disinfectants are a group of drugs that can inhibit the growth, development or cause the death of microorganisms in the patient’s environment or on the surface of his body.

Antiseptics -(anti- against; septicas – putrefactive). This is a group of medicines that are used to eliminate pathogenic microbes in the wound (skin, mucous membranes) in the gastrointestinal tract and urinary tract. They have a bacteriostatic or bactericidal effect depending on the concentration.

Disinfectant medicines – serve for disinfection of medical instruments, utensils, premises, equipment, etc. Disinfection – This is a set of measures aimed at preventing infection from entering the wound, the body as a whole, or to prevent the spread of infection.

It is not always possible to draw a sharp line between antiseptics and disinfectants, because Many substances in low concentrations are used as antiseptics, and in higher concentrations – for disinfection.

Requirements for antiseptics and disinfectants.

Must have a wide spectrum of action;

Must have a short latent period of action;

Must have high activity;

Must be chemically resistant;

Availability and low cost;

No local irritant or allergenic effect on fabrics;

Minimal absorption from the site of application;

Low toxicity.

Classification by chemical structure.

1. Inorganic compounds:

· halogens and halogen-containing compounds

Chloramine B;

Chlorhexine bigluconate;

Alcohol iodine solution;

Yoddicirin.

· Oxidizers

Potassium permanganate;

Hydrogen peroxide.

· Acids and alkalis

Boric acid;

Ammonia solution.

· Heavy metal salts

Zinc sulfate;

Copper sulfate;

Silver nitrate.

Organic compounds.

· Aromatic compounds:

· Phenol group

Birch tar;

· Nitrofuran derivatives

Furacillin

· Dyes

Brilliant Green;

Ethacridine lactate.

· Aliphatic compounds:

· Aldehydes

Formaldehyde

· Alcohols

Ethanol

· Detergents (surfactants)

Zerigel.

Pharmacodynamics.

Antiseptics and disinfectants can have both bacteriostatic and bactericidal effects. The activity of the drug depends on many factors:

From the sensitivity of the pathogen;

From the concentration of the drug;

From exposure time;

From the presence of proteins in the medium.

As a rule, increasing the concentration also increases the antimicrobial activity, but the exception is ethyl alcohol - increasing the alcohol concentration to 70% increases the antimicrobial activity, but a further increase in the concentration in the presence of proteins, on the contrary, reduces the activity - this is explained by the rapid coagulation of proteins, the formation of a protective film that prevents penetration alcohol into the deep layers of the skin where microorganisms may be located.

Increasing the exposure time increases the antimicrobial activity - for example, sublimate (mercury dichloride) is 40 times more active at an exposure of 30 minutes than at 2.5 minutes.

An increase in temperature by 10 0 C leads to an increase in the activity of phenol by 7 times, mercuric chloride by 3 times. The presence of proteins reduces the activity of drugs of this group. Thus, human serum inhibits the activity of phenol by 10%, and mercuric chloride by 90%, because the process of binding drugs to proteins occurs.

Detergents (soaps)– the mechanism of antimicrobial action is associated with their ability to reduce surface tension at the boundary of the water and fat phases. As a result of this, the structure and permeability of the membrane of microorganisms is disrupted, as well as osmotic balance, nitrogen and phosphorus metabolism, oxidative enzymes are blocked and proteolytic enzymes are activated, lysis and death of the bacterial cell occurs. Wide Application V medical practice as an antiseptic ls have cationic detergents - Cerigel, Rocal. Cerigel consists of cetylperidinium chloride, polyvinyl butyral and ethyl alcohol. When applied to the skin, Cerigel forms a film. The antimicrobial activity of the drug is used to treat the hands of medical personnel before surgical operations. Cationic detergents are quite effective against vegetative forms of microorganisms, both gram-positive and gram-negative. Anionic detergents only affect gram-positive microorganisms (green soap, soap alcohol). Among the amphoteric detergents, ampholan is used.

Nitrofuran derivatives– they have a wide spectrum of action; gram-negative and gram-positive strains, as well as protozoa, are sensitive. Preparations – furatsilin, furaplast, lifuzol. The mechanism of action is associated with the reduction of the nitro group to the amino group. As hydrogen acceptors, nitrofurans compete with the hydrogen acceptors of the microbial cell. As a result, active metabolites are formed that inhibit the activity of enzymes and disrupt the functioning of the respiratory electron transport chain of the microbial cell. Also noted irreversible damage DNA structure (breaking of helices), which leads to inhibition of growth, reproduction and death of microbes.

Phenol group– the antimicrobial activity of phenol is a standard for determining the activity of other antimicrobial agents. Dilution (1:400 – 1:800) has a bacteriostatic effect - it disrupts the permeability of the microbial cell membrane and blocks the activity of dehydrogenases. At a concentration of 1%-5% it is bactericidal, because causes denaturation of the cytoplasmic protein of microorganisms; they have a wide spectrum of action, but do not affect spores and viruses.

Halogen-containing compounds– represented by preparations containing chlorine and iodine. Mechanism bactericidal action chlorine is associated with its interaction with proteins of the cytoplasm of microorganisms. In a protein molecule, chlorine replaces a hydrogen atom, which is bonded to a nitrogen atom, which leads to disruption of the formation of hydrogen bonds, resulting in disruption of the secondary structure of the protein. In addition, when chlorine interacts with water, atomic oxygen is released, which oxidizes the vital enzymes of microorganisms.

Cl 2 + H 2 O \u003d HCl + HClO \u003d (HCl; O)

Iodine preparations that contain free iodine, as well as partially organic iodine compounds, are used as active antiseptics. The mechanism of antimicrobial action is protein denaturation as a result of the interaction of iodine with the nitro groups of protein molecules. It has a fungicidal effect, has a local irritating effect and a distracting effect. Preparations: alcohol solution of iodine, ioddicerin, iodovidone. Depending on the dosage form used for burns, wounds, skin ulcerations, frostbite, paraproctitis, and gynecological diseases.

Metal compounds– their mechanism of action involves blocking sulfhydryl, carboxyl and amino groups of enzymes and proteins of microorganisms. Metal ions that are formed during the dissociation of salts, interacting with these functionally active groups of biosubstrates, cause their denaturation. The resulting albuminates can be dense or loose. In the first case, a film forms, the tissue becomes denser and shrinks. inflammatory process. This is typical of astringent action. With deeper penetration of the substance into the tissue, cell irritation occurs and nerve endings, and the extreme manifestation is the cauterizing effect of metal salts. According to the solubility of albuminates in biological environments metals can be located in next row: Pb, ... Al, Zn, Cu, Ag, ... Hg. Antimicrobial activity increases in the same sequence. As antiseptics, the metal salts on the right side of the row are of greatest interest.

Oxidizers– hydrogen peroxide and potassium permanganate have an antiseptic and deodorizing effect. The principle of action of both drugs is to release oxygen.

1) H 2 O 2 = 2H + O 2 (molecular oxygen is formed);

2) 2KMnO 4 + H 2 O = 2KOH + 2MnO 2 + 3O 2 (atomic oxygen is formed).

The antimicrobial activity of molecular oxygen is significantly lower than that of atomic oxygen, therefore H 2 O 2 is used mainly for mechanical cleansing of wounds, because foam and bubbles form. Used to treat mucous membranes and burn surfaces.

KMnO 4, along with antimicrobial activity, has a deodorizing and astringent effect due to the formation of manganese oxide. The drug is used for rinsing, douching, irrigation of wounds, treatment of burn surfaces, gastric lavage.

Aldehydes and alcohols– represented by ethyl alcohol and formaldehyde. Both drugs cause protein denaturation, tissue dehydration, tissue thickening, narrowing of the sweat and excretory ducts. sebaceous glands, which complicates the penetration of ethanol into the deeper layers of the skin and prevents the death of microbes there. For antimicrobial action, 70% ethyl alcohol is used, and for leather tanning - 90%.

Formaldehyde is used to treat the skin with sweating as a disinfectant.

Acids and alkalis– cause denaturation of microorganism proteins. Go through cell membranes in an undissociated form, and their dissociation takes place inside the microbial cell, where they cause the denaturation of protein components.

Dyes – act mainly on pyogenic gram-positive cocci and fungi (Candida). Dye cations displace the hydrogen proton from biologically active compounds of microorganisms and form difficult-to-dissociate complexes with carboxyl groups of amino acids, excluding them from metabolic processes.

Diamond Green – effectively suppresses the causative agent of diphtheria, in the presence organic compounds phenolic acids, activity decreases. Used to treat purulent wounds, skin lesions, and blepharitis.

Etacritide lactate – effective in streptococcal infections, in the presence of organic compounds, the phenol coefficient does not decrease. Used for washing cavities, in the form of tampons, in eye drops, for skin diseases.

Methylene blue – has antimicrobial and antifungal effect. It is an acceptor and donor of the hydrogen proton. Converts hemoglobin into methemoglobin, which actively combines with cyanides, and therefore is used as a first aid remedy for poisoning with cyanide compounds.

Phytoncides and essential oils(mint essential oil, calendula tincture, chlorophyllipt) – used to irrigate the throat and nasopharynx. Menthol has an irritating effect.

Antiseptics It is generally accepted to consider substances used to protect the skin and mucous membranes of the body from the adverse effects of pathogenic microorganisms. The fundamental difference between disinfectants is that they eliminate microbes directly on surrounding objects (medical instruments, operating room surfaces, walls and floors of rooms, disinfection of water, clothing, bedding, patient care items, etc.).

Antiseptics and disinfectants

It is sometimes difficult to identify clear differences between the two types of drugs, since most of these substances have antiseptic properties in smaller dosages, and in increased quantities become disinfectants. Thus, having determined the object to be processed, you can understand how antiseptics and disinfectants differ.

Antiseptic drugs are: preventive actions – for disinfection of damaged (wounded) areas of skin, hands, sterilization of skin before surgical intervention etc., and therapeutic, when the product is used after the presence of wounds affected by infection.

Both types of products are characterized by a considerable number of side effects for humans, so they are used mainly for external and local treatment.

There are three key groups of antiseptics and disinfectants:

inorganic products, these include: peroxides, alkalis, acids, individual chemical substances(chlorine, zinc, bromine, silver, iodine), as well as their inorganic compounds;
organic products– phenolic and alcohol derivatives, alkalis, acids, aldehydes, etc. All these are synthetic substances of organic origin;
bioorganic products, these include preparations made from natural natural resources animal and plant origin, lichens and fungi.

Halogens and their compounds

As a rule, these are products based on iodine and chlorine.

Types of antiseptics containing chlorine:

Pantocide. The release form is presented in tablets, used for water disinfection (1 tablet per 0.5-0.75 l).
. Available in the form of solutions in alcohol and water with different dosage active component, ointments, pastes, gels, emulsions, etc. Chlorhexidine is also contained in medications in the form of lozenges for inflammation oral cavity(pharyngitis, stomatitis, etc.).
Biclotymol. Its use involves the treatment of diseases of the oral cavity. Prohibited for use by children under 6 years of age.

5% iodine solution in alcohol is popular as an antiseptic. It is used to disinfect wounds along the edges, treat minor cuts, scratches, pricks. The main condition is the absence of an extensive wound surface. It is not advisable to use this iodine solution for children under 5 years of age.

Widely used iodine compounds with polyvinylpyrrolidone. Such drugs do not irritate the skin and mucous membranes; they differ long period activity.
. It is still widespread in countries with advanced healthcare systems, where it is used to treat the oral cavity and pharynx for pharyngitis and tonsillitis. Some experts consider the use of the solution inappropriate because they are not confident in the proper effectiveness of the drug.

Products containing alcohols, aldehydes, acids and oxidizing agents

Oxidizing agents have a detrimental effect on pathogens through the release of atomic oxygen. The most popular are two of them: and potassium permanganate.

Release hydrogen peroxide carried out in the form of a 3% solution. Acts as an antiseptic for mucous membranes and skin. The drug is able to stop bleeding.
Hydroperite. It is a mixture of urea and hydrogen peroxide. Presented as tablets for dissolution in water, using which a solution with peroxide characteristics is obtained.
Potassium permanganate. It has the form of violet-red crystals or powder, has a high solubility in water. Recommended for the treatment of damaged skin areas, douching and rinsing. To wash ulcerative surfaces, you need a solution of strong concentration of 2-5%.
Boric acid. Available as a solution, powder or ointment. Used in the production of medications for external use. For eye inflammation and ear canal(conjunctivitis, otitis) use a solution of 2% concentration. Modern medicine is gradually abandoning boric acid, since the drug causes the manifestation of a number negative effects(nausea, headache, diarrhea, renal failure).

Formalin or formaldehyde. Acts as an integral component of some disinfectants, common in the provision of medical care in healthcare facilities.
Ethanol. Used in the form of a 7% solution, which has antiseptic properties, to disinfect wounds and areas before injections. Penetrates into the circulatory system even from a healthy skin surface.

Dyes and metal salts

Protargol. It is a solution of 1-5% concentration with antiseptic properties. Effective in eliminating inflammation of the urinary canals and treating the mucous membrane of the respiratory organs. Protargol in the form of drops is used to treat eye infections.
Collargol or colloidal silver. Medical drug, containing a significant proportion of silver in the composition, which has antiseptic properties. Used in the form of solutions with varying degrees concentration of the substance (from 0.2 to 5%).
Zinc sulfate. Looks like transparent crystals without color or odor. Most often used in tablet form when it is necessary to replenish zinc reserves in the body. A 0.25% solution based on zinc sulfate is used in the form of eye drops to eliminate conjunctivitis.
Zinc oxide. Indicated for use in the treatment of most skin diseases. It is used in combination with other substances, as well as alone.
Brilliant green or brilliant green. The solution is extremely popular, however, its antiseptic effect is not so significant.
Methylthionium chloride or Methylene blue. The solution is made with the addition of water or alcohol. The urinary canals are washed with an aqueous solution for cystitis and urethritis. The alcohol-based product is indicated for use for antiseptic skin treatment. Methylene blue is similar in effect to brilliant green.
Magenta. Known as a dye in the form of a solution of a scarlet hue. It is not used separately, but the substance is contained in certain combined type antiseptics, namely fucorcin, a preparation based on fuchsin, ethanol, acetone, boric acid, resorcinol and phenol compounds. The scope of application of fucorcin is the disinfection of the affected skin surface during fungal and pustular inflammations, scratches, cuts, etc.

VIDEO

Substances of bioorganic origin

Chlorophyllipt. A drug obtained by combining eucalyptus chlorophylls. Shows antibacterial effect for staphylococcal infections that are not susceptible to antibiotics. Chlorophyllipt solutions have an oil and alcohol base and are suitable for external and local use.
Sodium usninate. Made from a specific substance, usnic acid, which is extracted from lichens certain type. The degree of antibacterial activity of the drug can be defined as moderate. There are three types of solutions based on this product: with the addition of alcohol, castor oil or fir balsam.
Lysozyme. It is an enzyme isolated from chicken egg white. Plays a key role in the mechanisms of formation of stable immunity. Using lysozyme applied to a napkin, purulent skin lesions, as well as burned and frostbitten areas of the body are treated. In some cases, lysozyme in solution is used for eye drops.
Ectericide. A transparent substance obtained from fish oil, which explains its distinct fishy odor. It has yellow and an oily liquid consistency. It is an antibacterial agent. It is used to treat purulent formations on the surface of the skin, as well as burned or frostbitten areas of the body, ulcerative lesions, fistulas, etc., at the end a napkin moistened with the drug is applied. In case of advanced infectious rhinitis, ectericide is used in the form of drops for the upper respiratory tract.
Calendula inflorescences (marigolds). They are dried bright yellow flowers of a medicinal plant known in folk medicine. Alcohol and water infusions with bactericidal properties are prepared from them, which, depending on the preparation method, are suitable for external or internal use. The effect of calendula can be compared with the effect of taking strong antibiotic, especially for staphylococcal and streptococcal pathogens. The antiseptic properties of calendula are manifested when rinsing to relieve inflammation of the oral cavity. Douching with calendula tincture for gynecological infections is popular.

Other antiseptics and disinfectants

Miramistin. Surface active medicinal product based on ammonium compounds. Characterized by an antiseptic effect on various pathogenic microorganisms(bacteria, fungi, viruses). They are used, as a rule, in the treatment and prevention of foci of suppuration, as well as in eye, ear, nasal infectious diseases and inflammation of the oral cavity.
Decamethoxin. Belongs to class synthetic products for external use, characterized by an antiseptic and antifungal effect. The pathogens of staphylococcus and streptococcus are sensitive to it. The release form is soluble tablets, which are used to make solutions, as well as drops for the eyes and ear canals. Decamethoxin is used as a local rinse for infectious inflammations oral cavity, as well as for the treatment of conjunctivitis and otitis media. Rinsing and lotions based on the drug are indicated for bladder infections, fungal and bacterial diseases skin.
Ichthyol. Substance in liquid form obtained industrially from resins that are released during the semi-coking and gasification of oil shale. It is characterized by a thick consistency, black color and a sharp, unique odor. The antiseptic properties of ichthyol are extremely weak. It is used in production, which is used externally for skin damage (burns, psoriasis, eczema).
Octenidine (octenidine hydrochloride). It is one of the most relevant medical developments to date. This antiseptic drug characterized by a strong and long-lasting effect on pathogenic microorganisms, similar to the action antibiotics. The scope of its application is quite wide. A feature of octenidine is its low toxicity, since local use even on damaged areas of the skin there is no risk of it entering the circulatory system. This makes it possible to use the drug for people of all age groups, including infants, as well as during pregnancy and lactation. Preparations based on octenidine are indicated for use for disinfection of hands in surgery, the skin of patients before injections, for the treatment of infections in gynecology, surgery, etc.
Quaternary ammonium compounds. One of the most popular groups of antiseptics and disinfectants. Benzalkonium chloride is its most striking representative. In addition to those already mentioned antiseptic properties the drug performs the active function of a spermicide, in other words, it deactivates male sperm, which determines its use in the field of contraception.
Cetrimide another representative of the group. The combination of cetrimide with benzalkonium chloride is used in the production of cream against dermatitis, burns and diaper rash.

Halogenatedreaping	Aromaticswho's next	Aliphaticheswho's next	Oxidizers	Dyes
Chloramine B Chlorhexidine bigluconate Sebidine Iodine solution alcohol Iodinol Iodovidone	Phenol Feresol Oracept Ichthyol Birch tar Vishnevsky liniment	Formaldehyde Ethyl alcohol Inol Septotsid Septotsid-R	Hydrogen peroxide Potassium permanganate Hydroperite	Methylene Blue Diamond Green Ethacridine Lactate
Heavy metal salts	Nitrofurans	Detergents	Acids	plantnew
Silver nitrate Protargol Collargol	Furacilin	Degmicide Rokkal Hibiscrub Tserigel Miramistin	Boric acid Salicylic acid	Chlorophyllipt Calendula tincture Eucalyptus tincture Rotokan

These drugs do not have selectivity of action; in appropriate concentrations they have a detrimental effect on most microorganisms. They are used in the treatment of infected wounds, lesions of the mucous membranes, for treating water and food, disinfecting medical instruments, linen, patient secretions, etc.

Ethacridine lactate in the form of solutions, powders, ointments, it is used in dermatology, ophthalmology, urology, surgery, gynecology for the treatment and treatment of purulent wounds, washing cavities, mucous membranes of the mouth, pharynx, nose. Included in Konkov's ointment.

Acids

Many acids have an antimicrobial effect by hydrolyzing the proteins of the protoplasm of microorganisms. However, most of them cannot be used as antiseptics due to their pronounced irritant effect. Therefore, only a few of them, which have a slight irritating effect on tissue, are used as antiseptics.

Boric acid has antimicrobial activity against gram-positive and gram-negative microorganisms, including Pseudomonas aeruginosa. 2-4% aqueous solutions are used to irrigate wounds and purulent cavities, rinsing the mouth, washing the eyes, in the form of 5-10% ointments and powders for inflammatory diseases skin.

A solution of boric acid alcohol 1-5% is used as an antiseptic in the form ear drops for otitis.

Salicylic acid has antimicrobial, distracting, irritating and keratolytic effects. Used when skin diseases and for the treatment of infected wounds in the form of powders (2-5%), ointments, pastes and alcohol solutions (1-10%). Included in the drug: Lassara paste, Teymurov paste, callus plaster, Persalan and etc.

Nitrofurans

Antiseptics related to nitrofuran derivatives are characterized by high antimicrobial activity and relatively low toxicity to humans.

Furacilin has a wide spectrum of action. Externally, furatsilin is used in the form of solutions of 1: 5000 for the treatment of purulent wounds, ulcers, burns, bedsores; for washing body cavities during purulent-inflammatory processes in them; for rinsing the mouth and throat for stomatitis, sore throat; for conjunctivitis in the form of eye drops and many other diseases. Orally is sometimes prescribed for bacillary dysentery. Included in the drug "Furaplast" for the treatment of abrasions, scratches, cuts and others soft injuries skin.

Detergents

Detergents (from Latin - detergeo - to wash, clean) are surfactants that can change the surface tension of water, thereby helping to cleanse the skin and various objects from fat, foreign particles, microorganisms, i.e. have cleaning properties. In addition, they change the permeability cell membranes microorganisms, disrupt the transport of substances through the microbial cell membrane.

Degmicide, Rokkal, Hibiscrub, Zerigel used for treating the surgeon’s hands, the surgical field, for disinfecting surgical instruments, etc.

Miramistin (septomirin) is an antiseptic of the group of cationic detergents. It is used in the form of a 0.01% solution for the treatment of wounds, burns, osteomyelitis, inflammatory diseases of the female genital organs, urethritis, prostatitis, chlamydia, fungal skin lesions.

Heavy metal salts

The mechanism of the antimicrobial action of metal salts in low concentrations is associated with blocking the sulfhydryl groups of microbial enzymes.

Salts of heavy metals also have a local effect on tissue: astringent, irritating, cauterizing. It depends on the ability of metal ions to form albuminates when interacting with proteins. If coagulation of tissue proteins occurs in the most surface layers tissue, the fabric becomes compacted, a film is formed - astringent action. With deeper penetration of the substance, irritation of cells and nerve endings occurs. If protein folding involves big number cells and causes their death (necrosis), an irreversible cauterizing effect appears.

The strength of antimicrobial and local action increases with increasing concentration of the drug, duration of action and the degree of its dissociation. The strength of their antimicrobial action is significantly reduced in the presence of pus and blood, because they react with all proteins, regardless of nature.

LS silver. How is an antiseptic used? silver nitrate(lapis). IN small concentrations(1-2%) has an astringent and anti-inflammatory effect, and in high concentrations (5% or more) - cauterizing. It is used to treat skin ulcers, erosions, cracks, in ophthalmology for conjunctivitis, blenorrhea, for washing the urethra and bladder, as well as for cauterizing warts and excess granulations.

Protargol and collargol are non-dissociating silver compounds. They do not have a cauterizing effect on tissue. Their solutions are used for washing the urethra and bladder (1-3% solutions), for blenorrhea, blepharitis, conjunctivitis (1-3% solutions), for lubricating the mucous membrane of the upper respiratory tract, for rhinitis (1-5% solution).

At acute poisoning salts of heavy metals when the poison gets inside, they cause sharp pains in the abdomen, vomiting, diarrhea mixed with mucus and blood, headaches, metallic taste and burning sensation in the mouth. Help with poisoning is to rinse the stomach with water activated carbon When prescribing saline laxatives, a 5% solution of unithiol is injected into the muscle or under the skin to neutralize the poison.

Combined disinfectantsmultifunctional use

These products are produced on the basis of quaternary ammonium compounds, polyhexamethylene guanidine, aldehydes, organic acids, and alcohols. Polidez, Descocid, KDI, KDP, Hexadecone, Slavin have disinfectant, anti-corrosion, and deodorizing properties.

A number of drugs have antiseptic properties of plant origin: Chlorophyllipt - from eucalyptus leaves; tincture of calendula, eucalyptus tincture, “Rotokan”, “Mirramil” - combination medicines containing extracts of chamomile, yarrow, calendula and many other medicines.

Drug name, synonyms, storage conditions	Release forms	Methods of application
Chloraminum B	Powder	1-2% solutions for washing wounds, wetting napkins; 0.25-0.5% solutions for treating hands and non-metallic instruments; 1-5% solutions for disinfection of care items and secretions
Chlorhexidini bigluconas (Hibiscrab, Plivasept)	Flak. 4%. 5%, 20% solution - 300 ml, 500 ml	0.02-0.05% solutions for washing cavities, eyes, wounds; 0.5-1% solutions for treating hands and instruments, 0.1% solution for disinfection
Sebidinum, Drill	Official table	1 table each every 2-4 hours until completely dissolved in the mouth
Sol. Iodi spirituosa (B)	Flak. 5% solution - 10 ml Amp. 5% - 1 ml	For treating the surgical field and wound edges
Iodinolum(B)	Flak. 100 ml	For the treatment of wounds, ulcers, burns For washing the tonsils Drops in the ear, nose
Phenolum (Acidum carbolicum) (B)	Flak. 3% glycerin solution- 10 ml	Ear drops (10 drops 2-3 times a day, warm)
Ichthyolum	Ointment 10% and 20% - 15.0; 25.0 Candles 0.2	For affected areas of skin, 1 suppository into the rectum 1-2 times a day
Pix liquida Betulae	Ointment and liniment 10% -30.0	On the affected areas of the skin
Sol. Formaldehydi (Formalinum)	Flak. 10% solution 100 ml (official solution)	Externally 0.5-1% solution; 0.05-0.1% for douching
Sol. Hydrogenii peroxydidiluta	Official 3% solution in a bottle	Externally for treating skin, wounds, etc.
Sol. Hydrogenii peroxydi concentrata (Perhydrolum) (B)	Official solution 27.5-31% solution in a bottle	Mix with water 1:10. used for washing, rinsing
Kalii permanganas	Powder	0.1% - 0.5% solution for washing wounds, 0.01-0.05% solution for rinsing the mouth and washing cavities; in case of poisoning for gastric lavage; 2-5% solution for lubricating burns and ulcers
Viride nitens	Flak. 1% and 2% alcohol solution - 10 ml and 15 ml	On affected areas of skin and mucous membranes
Methylenum coeruleum	Powder	1-3% alcohol solutions externally; 0.02% water solution for rinsing the bladder
Aethacridini lactas (Rivanolum) (B)	Powder	0.05-0.2% aqueous solution for rinsing, douching, powder, ointment, paste - externally
Acidum boricum	Flac powder. 3% alcohol solution - 10 ml	Externally in powders, ointments Drops in the ear (3-5 drops 2-3 times a day)
Acidum salicylicum	Powder Flac. 1% alcohol solution - 40 ml	Externally for application to the skin
Furacilinum (B)	Powder Tab. 0.1	0.02% solutions for washing and rinsing
Degmicidum, Roccalum	Flak. 100 ml; 250 ml; 500 ml	For treating hands, care items, tools, etc.
Argenti nitras (A)	Powder	2-10% solutions for lubricating the skin and cauterization 1-2% eye ointments and solutions 0.25%-0.5% solutions for lubricating mucous membranes
Collargolum (B) Protargolum	Powder	1-3% solutions for rinsing; 1-5% solutions for lubricating mucous membranes
Miramistinum (Septomirinum)	Flak. 0.01% solution - 100 ml	For a burn or wound surface 2-3 ml into the urethra 1-2 ml into the external auditory canal
Chlorophylliptum	Flak. 1% alcohol solution - 100 ml Flak. 2% oil solution- 20 ml	Externally for washing, rinsing

Control questions

1. What is the mechanism of action of halogen-containing antiseptics based on?

2. What is an alcohol solution of iodine used for?

3. What is the mechanism of the antimicrobial action of oxidizing agents?

4. What antiseptics are dyes?

5. In what cases is furatsilin solution used?

6. What antiseptics can be used to treat the surgeon’s hands?

7. Name herbal antiseptics.

Tests for consolidation

1. Iodine tincture has an effect:

a) Antimicrobial;

b) Antifungal;

c) Cauterizing;

d) Enveloping;

d) Anesthetic.

2. Potassium permanganate:

a) Is an oxidizing agent

b) Has an astringent effect;

c) Activated by catalase;

d) Eliminates molecular oxygen;

e) Has a cauterizing effect.

3. Chlorhexidine:

a) Is a dye;

b) Used as a 20% solution;

c) Used as a 0.5% solution;

d) Disinfects the surgical field;

d) Used for conjunctivitis.

4. Aliphatic antiseptics include:

a) Ethyl alcohol;

b) Formaldehyde solution;

c) Zinc sulfate;

d) Birch tar.

5. For microbial conjunctivitis, you can prescribe:

a) Chlorhexidine;

b) Zerigel;

c) Zinc sulfate;