What about antiseptics? Pinning Tests

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

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

antiseptic can be preventive(treatment of hands, treatment of fresh wounds so that infection does not join, treatment of the skin 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 creating a high concentration of antimicrobial substance, which is a defining moment in the mechanism of formation of antibiotic resistance. Confirmation of this can be observed at every step: the same famous furacilin solution, which is currently practically ineffective against most of the actual bacteria.

The fundamental feature of a good modern antiseptic is that, firstly, it has a very a wide range microbicidal action (and antiviral, and antifungal, and antibacterial) and, secondly, it is used precisely as an antiseptic (disinfectant), but nothing else (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 allows you 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 allows, for example, to do without the use of antibiotics.

The number of drugs used for antiseptics and disinfection is huge, but we will only allow ourselves a brief overview of the main and most commonly used drugs, focusing on medicines, the need for which arises during treatment and preventive 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 real-life 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 start 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 . Introduced in 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 in 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 skin surface is able to be partially absorbed, reach the systemic circulation and create concentrations that depress the function thyroid gland. Secondly, 5% iodine solution often causes skin irritation, and the younger the child, the higher the risk of irritation.

Given the two circumstances described, the 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 a diluted form (2-3% solution). Nevertheless, everyone is unanimous in the aspect that children of the first year of life should not 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 safer. These drugs, for the most part, if they irritate the skin, then moderately, show a more intense and prolonged antiseptic action. Nonetheless system effects iodine are possible, so care should be taken 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.

Actively used drugs, which are a combination of iodine with a special substance - polyvinylpyrrolidone.

Iodine bound to polyvinylpyrrolidone , loses its irritating effect on the skin and mucous membranes, and besides it is slowly released, which determines long-term 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

Brownodine B.Brown, solution, ointment

Vocadin, solution, ointment, vaginal tablets

Yod-Ka solution

Yodiksol, spray

Yodobak, solution

Iodovidone solution

Yodoxide, vaginal suppositories

Yodosept, vaginal suppositories

Yodoflex, solution

Octasept, solution, aerosol

Povidin-LH, vaginal suppositories

povidone-iodine, solution, ointment, foamy solution

Povisept, solution, cream

Polyiodin, solution

ranostop, ointment

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

Just a little more, and Lugol's solution will be 200 years old - the French doctor Jean Lugol proposed it in 1829 for the treatment of tuberculosis! Lugol's solution contains 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 developing countries) to treat the mucous membranes of the oropharynx with tonsillitis and pharyngitis. Modern medicine considers such treatment unjustified (especially in children), primarily because the therapeutic efficacy is in doubt, and a significant and potentially dangerous intake of iodine in systemic circulation 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, are the process of applying drawings to the skin using a 5% iodine solution - most often they draw 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 the risk associated with excessive intake of iodine in the body, and, thirdly, is an effective example of calming psychotherapy for 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 the pseudoscientific literature of recent times, a lot of advice has appeared on the non-standard (to put it mildly) use of hydrogen peroxide - it is taken orally and even administered intravenously in order to rejuvenate the body and total recovery. The authors of the recommendations very convincingly (for those who do not have a medical education) describe the advantages similar methods, but they scientific justification does not exist. It is not our task to debunk myths, but I would like to convincingly ask parents: do not use hydrogen peroxide in an unconventional way at least in relation to children (especially since they will certainly do without rejuvenation).

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

We explain: 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 for 15 ml of water).

Potassium permanganate . Represents crystals of red-violet color (sometimes powder). Let's well dissolve in water. Pharmacological guidelines recommend the use of potassium permanganate for washing wounds, rinsing the mouth, douching. Concentrated solutions (2-5%) 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 being 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's translate for those who are not particularly strong in mathematics: a 0.01% solution is 1 g per 10 liters of water, 0.1% - respectively, 10 g per 10 liters!

Thus, by adding a “gramule” of potassium permanganate to the water and achieving its (water) pale pink color, parents do not disinfect anything, but only put a tick on their own conscience - our baby, they say, is now in no danger.

Bornaya acid . Produced in the form of a powder, solutions of different concentrations, ointments. Included in some combined 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 media (drip into the ear canal or moisten turundas).

Currently application boric acid limited in many countries, as numerous side effects associated with toxic influence drug, vomiting, diarrhea, rash, headache, convulsions, kidney damage. All this 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. The drug is in any case contraindicated in pregnancy, lactation and children of the first year of life.

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

Ethyl alcohol . As an antiseptic, the most appropriate is the use of 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 (rubbing the skin) in children is risky and is currently not recommended (more often strictly prohibited) by the health authorities of most civilized countries.

Metal salts and dyes

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

Currently pharmacological guides consider protargol obsolete tool with a 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 due to the psychotherapeutic effect - the very phrase "treatment with silver" has a healing effect.

Collargol (colloidal silver). In solutions of different concentrations (0.2-5%), it is used according to the same indications and with the same moderate result 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 commonly used in tablets to treat certain conditions 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 (vernacular name- 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%) for antiseptic purposes treat the skin, water - wash the cavity (for example, the bladder). The effectiveness of the application as an external agent is equivalent to that of brilliant green.

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

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 - fungal and pustular diseases skin, abrasions, cracks, etc.

A solution of fucorcin (due to magenta) also has a bright red color. In this way, parents are given the opportunity to widely use the most diverse, ineffective, but completely safe dyes, which means that, in accordance with their artistic taste, they can paint children in 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 able to exhibit bactericidal activity against antibiotic-resistant bacteria. For local application use oil and alcohol solutions of various concentrations.

In the process of use, quite severe allergic reactions are possible.

Sodium usninate . Contains usnic acid, which is isolated from a special type of lichen. It 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 particular pediatric interest - many note its effectiveness in the treatment of nipple cracks in nursing mothers.

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

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

Has antibacterial activity. They are used to treat festering wounds, burns, ulcers, fistulas, etc.: they are washed, wet wipes are applied. Often used in the form of nasal drops - mainly with a protracted runny nose of an infectious nature.

flowers nails . A common synonym is calendula flowers. An infusion of flowers is used as an antiseptic for inflammatory diseases of the oral cavity. There is also a tincture of calendula in 70% ethanol. 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. It is 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 washing the bladder, etc.

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

Miramistin . A full-fledged antiseptic - is active against viruses, bacteria, fungi, protozoa.

The main indication for use is the prevention of suppuration and the treatment of purulent wounds. It is used for otitis media, 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 explanation available is something like this: "ichthyol is obtained from tars 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 precepts of grandmothers who believe in its miraculous effectiveness, it is used as 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 circulation even when treating wounds, which determines its uniquely low toxicity. It does not make sense to describe the indications for use - it can be used in almost all situations where an antiseptic effect is necessary (an exception is that it is not recommended to drip into the ear and rinse the bladder). Rational as a means primary processing wounds (shots, abrasions, cuts) at home.

Produced in solution, in bottles with various nozzles (for spraying, for insertion into the vagina).

It can be used in children of any age, during pregnancy and lactation. In the latter case, if nipple treatment 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 antiseptic, but with preservative properties).

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

Benzalkonium chloride is a component of many topical preparations intended for the treatment of wounds, resorption in the oral cavity, etc.

Benzalkonium chloride

benzalkonium chloride

Benatex, vaginal gel, vaginal suppositories, vaginal tablets

Virotek Intim, solution

Virotek Clinic, solution

Dettol spray

Catamine AB, solution

Katapola solution

Catacel, paste for external use

Countertex, vaginal suppositories

Layna bio, liquid

Lizanin, solution

Maxi Dez, solution

Micro 10+, solution

Rokkal, solution

septustin, solution

Spermatex, vaginal suppositories

Farmaginex, 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 as 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 the pathogen in the external environment, are used to disinfect rooms, patient clothes, care items, secretions, medical instruments.

Antiseptics- are used to destroy the pathogen on the surface of the human body (skin, mucous membranes, wound surfaces).

Features of antiseptics and disinfectants:

the mechanism of action is mainly related to protein coagulation

nature of action bactericidal

wide antimicrobial spectrum, no selectivity for certain microflora

habituation of the microflora does not occur

toxicity is high, so the main application is local (rarely with resorptive purposes)

a) Chlorine preparations

In aqueous solutions, they form hypochlorous acid (HClO), which decomposes in an acidic and neutral environment to form atomic oxygen and chlorine. Oxygen oxidizes and coagulates the proteins of the microbial cell, 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 hypochlorite 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, with an increase in pH, 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 a powerful bactericidal activity, it coagulates proteins, providing a powerful regenerating 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, scratches.

Iodinol applied externally in chronic tosillitis, purulent otitis media, trophic ulcers.

Biguanides.

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

Oxidizers:

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, the cleansing effect is mainly expressed due to foaming. It is used to treat contaminated and purulent wounds, to rinse the mouth with stomatitis, tonsillitis. It has a hemostatic effect (due to the activation of thromboplastin and mechanical blockage 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 is more active than 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, washing the urethra. It oxidizes alkaloids and some toxins, therefore it is used for gastric lavage in case 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 action is astringent and bacteriostatic, if it is loose, the action 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 small concentrations infectious diseases eyes (trachoma, conjunctivitis), and in higher ones - in the treatment of skin ulcers, erosions, cracks, as well as to remove excess granulations, warts.

Protargol, collargol- organic preparations of silver.

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

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

Mercury oxide yellow- less toxic, used as an antiseptic for conjunctivitis, 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, dehydrate tissues (dry necrosis - coagulation).

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

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

Ammonia solution(ammonia) has antiseptic and detergent properties. Used to wash hands 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, has a powerful antimicrobial effect. It has a tanning effect, takes away water from the surface layers of fabrics. It is used for the treatment of hands, disinfection of instruments, with excessive sweating (0.5 - 1% solution), for the preservation of tissues, histological preparations, formalin vapor - for disinfection of clothing.

Ethanol 70-95% denatures proteins and has a bactericidal effect. At a concentration of 70%, it is used to treat the surgeon's hands and the patient's skin. At this concentration, ethyl alcohol has a deeper antiseptic effect on the skin (penetrates into the ducts of the sebaceous and sweat glands). In concentrations of 90-95%, it is 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 the 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) - 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, 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 the patient's secretions. It is used in the form of 1-3% solutions for disinfection of linen, care items, tools. It has a pronounced irritating, local anesthetic effect; at a concentration of 2% and above - cauterizing effect. Possible poisoning by absorption through the skin.

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

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

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

methylene blue- as an antiseptic inferior to other dyes. It is used for cystitis, urethritis - 0.02%, ulcerative stomatitis - 0.5-1% aqueous solution, for pyoderma, burns - 1-3% alcohol solution. It is used to study the functional abilities of the kidneys. It is interesting in toxicological terms - it has powerful redox properties, can play the role of an acceptor and donor of H +, is used as an antidote for cyanide and nitrite poisoning (intravenously 1% aqueous solution).

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

Nitrofurans.

Used as an antiseptic furatsilin effective against Gram-positive and Gram-negative bacteria. An aqueous solution of furacilin 0.02% is used for rinsing the mouth and throat with stomatitis, tonsillitis, for washing purulent wounds.

Medicines with antimicrobial activity are divided into 2 groups:

1 - do not have 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 are capable of inhibiting the growth, development or death of microorganisms in the patient's environment or on the surface of his body.

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

Disinfectants - 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, into 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. many substances in low concentrations are used as antiseptics, and in higher concentrations for disinfection.

Requirements for antiseptics and disinfectants.

Should have a wide spectrum of action;

Should have a small latent period of action;

Must have high activity;

Must be chemically resistant;

Availability and low cost;

No local irritating or allergenic effect on tissues;

Minimal absorption from the place of their application;

Low toxicity.

Classification by chemical structure.

1. Inorganic compounds:

· halogens and halogenated compounds

Chloramine B;

Chlorhexine bigluconate;

Alcoholic 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 lact.

· 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, an increase in concentration also increases antimicrobial activity, but ethyl alcohol is an exception - an increase in alcohol concentration to 70% increases antimicrobial activity, but a further increase in concentration in the presence of proteins, on the contrary, reduces activity - this is due to the rapid coagulation of proteins, the formation of a protective film that prevents penetration alcohol into the deep layers of the skin, where microorganisms can be found.

An increase in exposure time increases antimicrobial activity - so 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, sublimate - by 3 times. The presence of proteins reduces the activity of drugs in this group. So, human serum inhibits the activity of phenol by 10%, and sublimate by 90%, because. the process of drug binding to proteins.

Detergents (soaps)- the mechanism of antimicrobial action is associated with their ability to reduce surface tension at the interface between the water and fat phases. As a result, the structure and permeability of the shell of microorganisms, as well as osmotic balance, nitrogen and phosphorus metabolism are disturbed, oxidative enzymes are blocked and proteolytic enzymes are activated, lysis and death of the bacterial cell occurs. Wide application in medical practice as an antiseptic ls have cationic detergents - tserigel, rokal. Zerigel 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 affect only gram-positive microorganisms (green soap, soap alcohol). Of the amphoteric detergents, ampholane 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, lifusol. The mechanism of action is associated with the reduction of the nitro group to the amino group. As hydrogen acceptors, nitrofurans compete with 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 structures of DNA (rupture of helices), which leads to inhibition of growth, reproduction and death of microbes.

Phenol group– the antimicrobial activity of phenol is the standard for determining the activity of other antimicrobial agents. Dilution (1:400 - 1:800) acts bacteriostatically - it violates the permeability of the microbial cell membrane, blocks the activity of dehydrogenases. At a concentration of 1% -5%, it acts bactericidal, tk. causes denaturation of the protein of the cytoplasm of microorganisms have a wide spectrum of action, but does not affect spores and viruses.

Halogen compounds- represented by preparations containing chlorine and iodine. Mechanism bactericidal action chlorine is associated with its interaction with the proteins of the cytoplasm of microorganisms. In the protein molecule, chlorine replaces the hydrogen atom, which is bonded to the nitrogen atom, which leads to a disruption in the formation of hydrogen bonds, as a result of which the secondary structure of the protein is disrupted. 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 containing free iodine, as well as partially organic iodine compounds, are used as active antiseptic agents. The mechanism of antimicrobial action is protein denaturation as a result of the interaction of iodine with nitro groups of protein molecules. A fungicidal effect is noted, it 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 ulceration, frostbite, paraproctitis, gynecological diseases.

Metal compounds- their mechanism of action with the blocking of sulfhydryl, carboxyl and amino groups of enzymes and proteins of microorganisms. Metal ions, which are formed during the dissociation of salts, interacting with these functionally active groups of biosubstrates, cause their denaturation. The resulting albuminates can be dense and loose. In the first case, a film is formed, the tissue is compacted and reduced inflammatory process. This is typical of an astringent action. With a 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 also increases in the same sequence. As antiseptics, metal salts on the right side of the series are of the greatest interest.

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

1) H 2 O 2 \u003d 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 much lower than that of atomic oxygen, so H 2 O 2 is used mainly for mechanical wound cleansing, because foam and bubbles form. They are 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 microbial proteins. Go through cell walls 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.

Brilliant green - effectively suppresses the causative agent of diphtheria, in the presence of organic compounds phenolic acids, the activity is reduced. Used to treat purulent wounds, with skin lesions, blepharitis.

Ethacritide 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 action. It is an acceptor and donor of hydrogen proton. It converts hemoglobin to methemoglobin, which actively combines with cyanides, and therefore is used as a first aid for poisoning with cyanide compounds.

Phytoncides and essential oils(mint essential oil, calendula tincture, chlorophyllipt) - used to irrigate the throat and nasopharynx. Menthol is irritant.

Antiseptics considered to be 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 the 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 distinguish clearly between the two types of preparations, since most of these substances in smaller dosages have antiseptic properties, and in increased quantities become disinfectants. Thus, having determined the object to be processed, one can understand how antiseptic and disinfectant substances differ.

Antiseptic preparations are preventive actions - for disinfection of damaged (injured) areas of the skin, hands, sterilization of the skin before surgical intervention etc., and therapeutic, when the agent is used already on the fact of the presence of wounds affected by infection.

Means of both types are characterized by a considerable number of side effects for humans, so they are used mainly for external and local processing.

There are three key groups of antiseptics and disinfectants:

inorganic means, these include: peroxides, alkalis, acids, individual chemical substances(chlorine, zinc, bromine, silver, iodine), as well as their inorganic type compounds;
organic means- phenolic and alcohol derivatives, alkalis, acids, aldehydes, etc. All these are synthetic substances of organic origin;
bioorganic agents, these include preparations from natural natural resources animal and vegetable 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 represented by tablets, used for water disinfection (1 tablet per 0.5-0.75 l).
. Produced in the form of solutions in alcohol and water with different dosage active component, ointments, pastes, gels, emulsions, etc. Also, chlorhexidine is contained in the composition of drugs in the form of lozenges for inflammation oral cavity(pharyngitis, stomatitis, etc.).
Biclotymol. Its use involves the treatment of diseases of the oral cavity. Not allowed for children under 6 years of age.

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

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

Products containing alcohols, aldehydes, acids and oxidizers

Oxidizers have a detrimental effect on pathogens by releasing atomic oxygen. The most popular are two of them: and potassium permanganate.

Release hydrogen peroxide carried out in the form of a solution of 3%. Acts as an antiseptic for mucous membranes and skin. The drug is able to stop bleeding.
Hydroperit. It is a mixture of urea and hydrogen peroxide. It is 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, a solution of a strong concentration of 2-5% is needed.
Boric acid. Available as a solution, powder or ointment. It is used in the production of medicinal preparations for external use. For inflammation of the eyes and ear canal(conjunctivitis, otitis media) 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, diarrhoea, kidney failure).

formalin or formaldehyde. Acts as an integral component of some disinfectants, common in the provision of medical care in healthcare facilities.
Ethanol. Applied in the form of a 7% solution with antiseptic properties, for the disinfection of wounds and areas before injections. Penetrates into the circulatory system even from a healthy skin surface.

Substances dyes and metal salts

Protargol. It is a solution of 1-5% concentration, which has antiseptic properties. It is effective in eliminating inflammation of the urinary tract and treating the mucous membrane of the respiratory cavity. For the treatment of eye infections, protargol is used in the form of drops.
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. Appears as transparent crystals, colorless and odorless. It is most often used in the form of tablets when it is necessary to replenish zinc reserves in the body. A solution of 0.25% 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 in a single form.
Brilliant green or brilliant green. A very popular solution, however, its antiseptic effect is not so significant.
Methylthionium chloride or Methylene blue. The solution is made with the addition of water or alcohol. With an aqueous solution, the urinary canals are washed with cystitis, urethritis. An alcohol-based agent is indicated for use for the purpose of antiseptic treatment of the skin. Methylene blue is similar in effect to brilliant green.
Magenta. Known as a means of 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, and specifically in fucorcin, a preparation based on compounds of fuchsin, ethanol, acetone, boric acid, resorcinol and phenol. The scope of fucorcin is the disinfection of the affected skin surface with fungal and pustular inflammations, scratches, cuts, etc.

VIDEO

Substances of bioorganic origin

Chlorophyllipt. A preparation obtained by combining eucalyptus chlorophylls. Manifests antibacterial effect in relation to staphylococcal infection, which is not amenable to antibiotics. Solutions of chlorophyllipt have an oil and alcohol base, suitable for external and local use.
Usninate sodium. Produced from the specific substance usnic acid, which is extracted from lichens a certain kind. The degree of antibacterial activity of the drug can be defined as moderate. There are three types of solutions based on this remedy: with the addition of alcohol, castor oil or fir balm.
Lysozyme. It is an enzyme isolated from chicken egg white. It plays a key role in the mechanisms of formation of stable immunity. With the help of lysozyme applied to a napkin, purulent skin lesions, as well as burnt and frostbite areas of the body, are treated. In some cases, lysozyme in solution is used for instillation of the eyes.
Ectericide. A clear substance derived from fish oil, which accounts for its distinct fishy odor. It has yellow and oily runny consistency. It is an antibacterial agent. With its help, purulent formations on the surface of the skin are treated, as well as burnt or frostbite areas of the body, ulcerative lesions, fistulas, etc., at the end, a napkin moistened with the preparation is applied. In the case of advanced infectious rhinitis, the ectericide is used in the form of drops for the upper respiratory tract.
Inflorescences of calendula (marigolds). They are dried flowers of a bright yellow color of a medicinal plant known in folk medicine. Alcoholic and aqueous infusions are prepared from them, which have bactericidal properties, which, depending on the method of preparation, are suitable for external or internal use. The action of calendula can be compared with the effect of taking strong antibiotic, especially for staphylococcal and streptococcal pathogens. The antiseptic properties of calendula appear when rinsing to relieve inflammation of the oral cavity. Douching tincture of calendula for gynecological infections is popular.

Other antiseptics and disinfectants

Miramistin. surface active medicinal product based on ammonium compounds. It is characterized by 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 the class synthetic means external use, characterized by antiseptic and antifungal effect. The causative agents of staphylococcus and streptococcus are sensitive to it. The release form is soluble tablets, with which solutions are made, as well as drops for the eyes and ear canals. Decamethoxine is used for local rinsing with infectious inflammations oral cavity, as well as for the treatment of conjunctivitis and otitis media. Washing and lotions based on the drug are indicated for bladder infections, fungal and bacterial diseases skin.
Ichthyol. A substance in the form of a liquid industrial way from resins that are released during the process of semi-coking and gasification of oil shale. It is characterized by a thick texture, black color and a sharp peculiar smell. The antiseptic properties of ichthyol are extremely weak. It is used in production, which is used externally for skin lesions (burns, psoriasis, eczema).
Octenidine (octenidine hydrochloride). It is one of the most relevant medical developments today. This antiseptic drug characterized by a strong and long-term effect on pathogenic microorganisms, similar to action antibiotics. The scope of its application is quite wide. A feature of octenidine is its low toxicity, since when local use means 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 periods of childbearing 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 brightest representative. In addition to those already mentioned antiseptic properties the drug performs the active function of spermicide, in other words, deactivates male spermatozoa, which leads to its use in the field of contraception.
Cetrimide another member of the group. The compound of cetrimide with benzalkonium chloride is used in the manufacture of a cream against dermatitis, burns and diaper rash.

Halogensoderreaping	Aromaticswhom row	Aliphaticswhom row	Oxidizers	Dyes
Chloramine B Chlorhexidine bigluconate Sebidin Alcoholic iodine solution Iodinol Iodovidon	Phenol Ferezol Oracept Ichthyol Tar birch Liniment Vishnevsky	Formaldehyde Ethyl alcohol Inol Septocid Septocid-R	Hydrogen peroxide Potassium permanganate Hydroperit	Methylene blue Brilliant green Ethacridine lactate
Heavy metal salts	Nitrofurans	Detergents	acids	plantnye
Silver nitrate Protargol Collargol	Furacilin	Degmicid Rokkal Hibiscrab Tserigel Miramistin	Boric acid Salicylic acid	Chlorophyllipt Calendula tincture Eucalyptus tincture Rotokan

These drugs do not have a selective 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 the treatment of water and food, the disinfection of 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. It is part of Konkov's ointment.

acids

Many acids have an antimicrobial effect by hydrolyzing the protoplasmic proteins of microorganisms. However, most of them cannot be used as antiseptics due to their pronounced irritating effect. Therefore, only some of them, which have a weak irritating effect on tissues, 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 for irrigation of wounds and purulent cavities, rinsing the mouth, rinsing the eyes, in the form of 5-10% ointment and powders for inflammatory diseases skin.

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

Salicylic acid It has an antimicrobial, distracting, irritating and keratolytic effect. Applicable for 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 LS: Lassar paste, Teymurov paste, corn 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. Outwardly, furatsilin is used in the form of solutions 1: 5000 for the treatment of purulent wounds, ulcers, burns, bedsores; for washing body cavities in case of purulent-inflammatory processes in them; for rinsing the mouth and throat with stomatitis, sore throat; with conjunctivitis in the form of eye drops and many other diseases. Inside is sometimes prescribed for bacillary dysentery. Included in the drug "Furaplast" for the treatment of abrasions, scratches, cuts and other soft injuries skin.

Detergents

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

Degmicid, Rokkal, Hibiscrab, Zerigel are used to treat the surgeon's hands, the operating field, to disinfect surgical instruments, etc.

Miramistin (septomyrin) 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 at low concentrations is associated with the blocking of sulfhydryl groups of microbial enzymes.

Salts of heavy metals also have a local effect on tissues: 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 tissue is compacted, a film is formed - astringent action. With deeper penetration of the substance, irritation of cells and nerve endings occurs. If protein folding covers big number cells and causes their death (necrosis), an irreversible cauterizing effect is manifested.

The strength of antimicrobial and local action increases with an increase in the concentration of drugs, the 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). AT small concentrations(1-2%) has an astringent and anti-inflammatory effect, and in high concentrations (5% or more) - cauterizing. It is used for the treatment of skin ulcers, erosions, cracks, in ophthalmology for conjunctivitis, blennorrhea, for washing the urethra and bladder, as well as for cauterizing warts, excessive granulations.

Protargol and collargol are non-dissociating silver compounds. They do not have a cauterizing effect on tissues. 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, there are 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 wash the stomach with water with activated carbon, the appointment of saline laxatives, to neutralize the poison, a 5% unithiol solution is injected into the muscle or under the skin.

Combined disinfectantsmultifunctional application

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

A number of drugs have antiseptic properties vegetable origin: Chlorophyllipt - from eucalyptus leaves; tincture of calendula, tincture of eucalyptus, "Rotokan", "Mirramil" - combined medicines containing an extract of chamomile, yarrow, calendula and many other medicines.

Drug name, synonyms, storage conditions	Release forms	Application methods
Chloraminum B	Powder	1-2% solutions for washing wounds, wetting napkins; 0.25-0.5% solutions for processing hands and non-metallic tools; 1-5% solutions for disinfection of care items and secretions
Chlorhexidini bigluconas (Hibiscrab, Plivasept)	Flac. four%. 5%, 20% solution - 300 ml, 500 ml	0.02-0.05% solutions for washing cavities, eyes, wounds; 0.5-1% solutions for the treatment of hands, tools, 0.1% solution for disinfection
Sebidinum, Drill	Official tab.	1 tab. every 2-4 hours until completely absorbed in the mouth
Sol. Iodi spirituosa (B)	Flac. 5% solution - 10 ml Amp. 5% - 1 ml	For processing the surgical field, the edges of wounds
Iodinolum(B)	Flac. 100 ml	For the treatment of wounds, ulcers, burns For washing the tonsils Drops in the ear, nose
Phenolum (Acidum carbolicum) (B)	Flac. 3% glycerin solution- 10 ml	Ear drops (10 drops 2-3 times a day in a warm form)
Ichthyolum	Ointment 10% and 20% - 15.0; 25.0 Candles 0.2	On the affected areas of the skin, 1 suppository in 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)	Flac. 10% solution 100 ml (official solution)	Outwardly 0.5-1% solution; 0.05-0.1% for douching
Sol. Hydrogenii peroxydi diluta	Official 3% solution in a vial	Externally for the treatment of skin, wounds, etc.
Sol. Hydrogenii peroxydi concentrata (Perhydrolum) (B)	Official solution 27.5-31% solution in a vial	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, ulcers
Viride nitens	Flac. 1% and 2% alcohol solution - 10 ml and 15 ml	On the affected areas of the skin and mucous membranes
Methylenum coeruleum	Powder	1-3% alcohol solutions externally; 0.02% water solution for washing the bladder
Aethacridini lactas (Rivanolum) (B)	Powder	0.05-0.2% aqueous solution for washes, douches, powders, ointments, pastes - externally
Acidum boricum	Powder Flac. 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	Topically applied to the skin
Furacilinum (B)	Powder Tab. 0.1	0.02% solutions for washing, rinsing
Degmicidum, Roccalum	Flac. 100 ml; 250 ml; 500 ml	For processing 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 washings; 1-5% solutions for lubricating mucous membranes
Miramistinum (Septomirinum)	Flac. 0.01% solution - 100 ml	For burns or wound surface 2-3 ml into the urethra 1-2 ml into the external auditory meatus
Chlorophylliptum	Flac. 1% alcohol solution - 100 ml Flac. 2% oil solution- 20 ml	Externally for washing, rinsing

test 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 antimicrobial action of oxidizing agents?

4. What antiseptics are dyes?

5. In what cases is furacilin solution used?

6. What antiseptic agents can be used to treat the surgeon's hands?

7. Name herbal antiseptics.

Pinning Tests

1. Iodine tincture has an effect:

a) Antimicrobial;

b) Antifungal;

c) cauterizing;

d) Enveloping;

e) Anesthetic.

2. Potassium permanganate:

a) It is an oxidizing agent

b) It has an astringent effect;

c) Activated by the action of catalase;

d) Splits off molecular oxygen;

e) Has a cauterizing effect.

3. Chlorhexidine:

a) Is a dye;

b) It is used as a 20% solution;

c) It is used in the form of a 0.5% solution;

d) Disinfects the operating field;

e) It is used for conjunctivitis.

4. Aliphatic antiseptics include:

a) Ethyl alcohol;

b) Formaldehyde solution;

c) Zinc sulfate;

d) Birch tar.

5. With microbial conjunctivitis, you can prescribe:

a) Chlorhexidine;

b) Zerigel;

c) Zinc sulfate;