We give a brief description of the individual chemical classes of antiseptics and disinfectants.

1. Alcohols. Aliphatic alcohols, denaturing protein, have an antimicrobial effect to varying degrees.

Ethyl alcohol (wine alcohol)is a fermentation product of sugars. The State Pharmacopoeia provides for alcohol of the following concentrations: absolute alcohol contains at least 99.8 vol. %\u003e ethyl alcohol, ethyl alcohol 95% contains 95-96 vol. % ethyl alcohol, ethyl alcohol 90% - 92.7 parts of ethyl alcohol 95% and 7.3 parts of water, ethyl alcohol 70%), respectively 67.5 and 32.5 parts, ethyl alcohol 40% - 36 and 64 parts.

It is widely used in surgical practice for the treatment of the operating field, wounds, surgeon's hands (70%), for alcohol compresses (40%), disinfection of instruments, suture material. 70% alcohol has an antiseptic effect, and 96%) also tanning.

2. Halides... Chloramine -0.1-5% aqueous solution, contains active chlorine (25-29%), has an antiseptic effect. When interacting with tissues, active chlorine and oxygen are released, which determine the bactericidal properties of the drug. A solution of sodium hypochlorite is used, its 5% solution contains 0.1 g of active chlorine in 1 dm 3 and can be used for irrigation, cleaning and disinfection of contaminated wounds.

Iodine- an effective bactericidal substance. A solution containing iodine in a ratio of 1: 20,000 causes the death of bacteria within 1 minute, and spores within 15 minutes, while the toxic effect on tissue is insignificant. Alcohol tincture of iodine contains 2% iodine and 2.4% sodium iodide, is the most effective antiseptic for treating the skin before surgery, venipuncture.

Iodinol- 1% solution. Antiseptic substance for external use. Used for washing wounds, rinsing the throat.

Iodonateand iodopyrone- organic compounds of iodine. A 1% solution is used. It is widely used as an antiseptic for the skin, especially during the preoperative preparation of the operating field.

Lugol's solution- contains iodine and potassium iodide, water and alcohol solutions can be used. The drug is of combined action. As a disinfectant it is used to sterilize catgut, as a chemotherapeutic agent - to treat thyroid diseases.

3. Heavy metals... Mercury oxycyanide- disinfectant. At concentrations of 1: 10,000, 1: 50,000, they are used for sterilizing optical instruments. Ammonium mercury ointment contains 5% of the active insoluble mercury compound and is used for treating skin and healing wounds as a disinfectant.

Silver nitrate- a solution of inorganic silver salts, has a pronounced bactericidal effect. 0.1-2% solution is used to wash the conjunctiva, mucous membranes; 2-5-10% solution - for lotions; 5-20% solutions have a pronounced cauterizing effect and are used to treat excess granulations.

Protargol, collargol (colloidal silver) -have pronounced bactericidal properties. Protein silver containing 20% \u200b\u200bsilver is used as a topical antiseptic for treating mucous membranes. They have astringent and anti-inflammatory effects. They are used for lubricating mucous membranes, washing the bladder for cystitis, urethritis, for washing purulent wounds, for sepsis, lymphangitis and erysipelas.

Zinc oxide- an antiseptic for external use, is part of many powders and pastes. Has an anti-inflammatory effect, prevents the development of macerations.

Copper sulfate -has pronounced antimicrobial properties.

4. Aldehydes... Formalin- 40% formaldehyde solution in water. Disinfectant. 0.5-5% solution is used to disinfect gloves, drains, instruments; 2-4% solution - for disinfection of patient care items. Dry formaldehyde is used for sterilizing optical instruments in gas sterilizers. 1-10% formalin solution causes the death of microorganisms and their spores within 1-6 hours.

Lysol- strong disinfectant. A 2% solution is used for disinfection of care items, premises, soaking contaminated instruments. Currently, it is practically not used.

5. Phenols. Carbolic acid- has a pronounced disinfecting effect. It is used as part of a triple solution. To obtain an antimicrobial effect, at least a concentration of 1-2% is required, while at a concentration of 5% it already significantly irritates tissues.

Triple solution -contains 20 g of formalin, 10 g of carbolic acid, 30 g of soda and up to 1 liter of water. Strong disinfectant. Used for processing tools, care items, cold sterilization of cutting tools.

6. Dyes. Brilliant green- has a pronounced antimicrobial effect, especially against fungi and gram-positive bacteria (Pseudomonas aeruginosa, Staphylococcus aureus), an antiseptic for external use. 1-2% alcohol (or water) solution is used to treat superficial wounds, abrasions, oral mucosa, pustular skin lesions.

Methylene blue -antiseptic agent against Escherichia coli, pyogenic microbes. 1-3% alcohol (or aqueous) solution is used to treat superficial wounds, abrasions, oral mucosa, skin, 0.02% aqueous solution - for washing wounds.

7. Acids.Boric acid -2.5% solution only inhibits the growth and reproduction of all types of bacteria. 2-4% solution is used for washing wounds, ulcers, rinsing the mouth.

Salicylic acid -antiseptic. It is used as a fungicide on leather. It has a keratolytic effect. It is used in the form of crystals (for tissue lysis), is a part of powders, ointments.

8. Alkalis. Ammonia alcohol- an antiseptic agent for external use. Previously, 0.5% aqueous ammonia was used to treat the hands of surgeons (Spasokukotsky-Kochergin method).

9. Oxidants.Hydrogen peroxide solution -contains 27.5-31% hydrogen peroxide, antimicrobial effect is due to oxidizing properties. 3% solution - the main preparation for washing purulent wounds during dressings, rinsing, lotions, does not penetrate into the tissue. It is used for bleeding from mucous membranes and decaying cancerous tumors, etc. It is included in the composition of Pervomur and is an effective disinfectant ( 6% solution).

Potassium permanganate -belongs to strong oxidants, has a deodorant and astringent effect. In the presence of organic substances, especially the products of decay and fermentation, it splits off atomic oxygen with the formation of manganese oxides, which is the reason for the antiseptic effect. It is used in the form of 0.02-0.1-0.5% solutions for washing wounds.

10. Detergents (surfactants).Chlorhexidine bigluconate- an antiseptic agent that acts on gram-positive microbes and Escherichia coli. 0.5% alcohol solution is used to treat the hands of the surgeon and the operating field. 0.1-0.2% aqueous solution - one of the main drugs for washing wounds and mucous membranes, treating purulent wounds. It is part of solutions for the treatment of hands and the surgical field (plivasept, AHD-special). Antiseptic soap with the addition of chlorhexidine is used to treat the hands of the surgeon and the operating field. The systematic use of chlorhexidine-containing soap leads to the accumulation of this substance on the skin and to the accumulation of antimicrobial action.

Zerigel- an antiseptic agent for external use. It is used for treatment (film-forming antiseptic) of the hands and the operating field.

Degmin, degmicide -antiseptic agents for external use. Used to treat hands and the surgical field.

11. Derivatives of nitrofuran... Furacilin -an antimicrobial agent that acts on various gram-positive and gram-negative microbes. An aqueous 0.02% solution (1: 5000) is used to treat purulent wounds, ulcers, bedsores, burns. An alcoholic (1: 1500) rinse solution can be used, as well as an ointment containing 0.2% of the active substance. Does not interfere with the wound healing process.

Lifusol- contains furacilin, linetol, resins, acetone (aerosol). Antiseptic agent for external use. It is applied in the form of a film. It is used to protect postoperative wounds and drainage holes from exogenous infection and to treat superficial wounds.

Furadonin, furagin, furazolidone- have a wide antimicrobial spectrum of action. In addition to urinary tract infections, they are used in the treatment of intestinal infections (dysentery, typhoid fever).

12. Derivatives of 8-hydroxyquinoline... Nitroxoline (5-NOK) -a chemotherapeutic agent, "uroantiseptic". It is used to treat urinary tract infections.

Enteroseptol, Intestopan- chemotherapeutic agents used for intestinal infections.

13. Quinoxaline derivatives... Dioxidine- an antiseptic agent for external use. 0.1-1% aqueous solution is used for washing purulent wounds, mucous membranes, especially when antibiotics and other antiseptics are ineffective. With sepsis and severe infections, intravenous drip can also be administered.

14. Derivatives of nitroimidazole. Metronidazole (metragil, flagil, trichopolum) -a broad-spectrum chemotherapeutic agent. Effective against protozoa, bacteroids and a number of anaerobes.

15. Tar, tar... Tar birch- product of dry distillation of pine trunks and branches or pure selected birch bark. It is a mixture of aromatic hydrocarbons: benzene, toluene, phenol, creoles, resins and other substances. It is used in the form of 10-30% ointments, pastes, liniment, it is part of Vishnevsky's balsamic ointment (tar - 3 parts, xeroform - 3 parts, castor oil - 100 parts), used to treat wounds, ulcers, bedsores, burns, frostbites. When applied topically, it has a disinfectant effect, improves blood circulation and stimulates tissue regeneration.

Currently, preparations based on birch tar are used much less frequently.

16. Quinolones (nalidixic acid, pipemidic acid, oxolinic acid).The mechanism of their action is associated with the ability to inhibit the synthesis of bacterial DNA by inhibiting the activity of enzymes of the microbial cell.

Fluoroquinolones (ciprofloxacin, ofloxacin, norfloxacinand others) - are active against gram-positive microbes, highly active against enterobacteria, mycobacterium tuberculosis. They are used mainly for infections of the intestines, abdominal cavity and small pelvis, skin and soft tissues, sepsis.

17. Sulfonamides (sulfadiazine, sulfadimezine, sulfadimethoxin, sulfamonomethoxin, sulfamethoxazole, sulfalene). They disrupt the synthesis of folic acid by a microbial cell and act bacteriostatically on gram-positive and gram-negative bacteria, chlamydia, toxoplasma. Combined preparations of sulfonamides with trimethoprim (bactrim, biseptol, septrin, sulfaton) are widely used in clinical practice to treat bacterial infections of various localizations.

18. Antifungal agents. There are drugs of the polyene series: nystatin, levorin, amphotericin B; imidazole series: clotrimazole, miconazole, bifonazole; triazole series: fluconazole, itraconazole; and others: griseofulvin, flucytosine, nitrofungin, decamine.

They act on yeast-like fungi of the genus Candida, dermatophytosis. They are used to prevent complications and treat fungal diseases (simultaneously with broad-spectrum antibiotics).

19. Plant antiseptics.Phytoncides, chlorophyllipt, ektericid, baliz, calendula - are mainly used as antiseptic agents for external use for washing superficial wounds, mucous membranes, skin treatment. They have anti-inflammatory effects.

Bacteriophages(bacterium + Greek phagos - devouring, syn.: phage, bacterial virus) - a virus capable of infecting a microbial cell, reproducing in it, forming numerous offspring and causing lysis of a bacterial cell. Antistaphylococcal, antistreptococcal and anti-coli bacteriophages are used mainly for washing and treating purulent wounds and cavities after identification of the pathogen.

Antitoxins- specific antibodies formed in the human and animal body under the influence of toxins, microbes, plant and animal poisons, which have the ability to neutralize toxic properties. Antitoxins play a protective role in toxinemic infections (tetanus, diphtheria, gas gangrene, some staphylococcal and streptococcal diseases).

Immunoglobulin preparations- γ-globulins - purified γ-globulin fraction of human serogenic proteins, containing in concentrated form antibodies against measles, influenza, poliomyelitis virus, tetanus γ-globulin, as well as increased concentrations of antibodies against certain infectious agents or toxins secreted by them.

Antistaphylococcal hyperimmune plasma- has a pronounced specificity due to the high content of antibodies to antigens with which donors were immunized. It is highly effective in the prevention and treatment of purulent septic diseases caused by staphylococcus. Antipseudomonal hyperimmune plasma is also used.

Proteolytic enzymes(trypsin, chimotpsin, chymoxin, terrilitin, iruksol) - when applied locally, they cause lysis of necrotic tissues and fibrin in the wound, dilute purulent exudate, and have an anti-inflammatory effect.

Biological antiseptics also includes methods for increasing the non-specific and specific resistance of the organism.

Non-specific resistance and non-specific immunity can be influenced in the following ways:

Ultraviolet and laser irradiation of blood (phagocytosis, complement system, oxygen transport are activated);

The use of a suspension of cells and spleen xenoperfusate, perfusion through the whole or fragmented spleen (pigs), while counting on the action of lymphocytes and cytokines contained in the spleen tissue;

Transfusion of blood and its components;

The use of a complex of vitamins, antioxidants, biostimulants;

The use of thymalin, T-activin, prodigiosan, levamisole (stimulate phagocytosis, regulate the ratio of T- and B-lymphocytes, increase the bactericidal activity of the blood), interferons, interleukins, roncoleukin, roferon, etc. (have a pronounced activating targeted effect on immunity).

Antibiotics- substances that are products of the vital activity of microorganisms (natural antibiotics), suppressing the growth and development of certain groups of other microorganisms. Chemical derivatives of natural antibiotics (semi-synthetic antibiotics) are also isolated.

The main groups of antibiotics:

1. B-Lactam antibiotics:

1.1. Natural penicillins;

Semi-synthetic penicillins:

Penicillins resistant to penicillinase;

Aminopenicillins;

Carboxypenicillins;

Ureidopenicillins;

B-lactamase inhibitors;

1.2. Cephalosporins:

1st generation;

2nd generation;

III generation;

IV generation.

2. Antibiotics of other groups:

Carbapenems;

Aminoglycosides;

Tetracyclines;

Macrolides;

Lincosamides;

Glycopeptides;

Chloramphenicol;

Rifampicin;

Polymyxins.

Penicillins -all drugs of this group act bactericidal, their mechanism of action is the ability to penetrate the cell membrane of microbes and bind to "penicillin-binding proteins", as a result, the structure of the cell wall of the microbe is disrupted.

Natural penicillins.These include:

Benzylpenicillin (penicillin C);

Procainepenicillin (novocaine salt of penicillin O);

Benzatinpenicillin (Bicillin);

Phenoxymethylpenicillin (penicillin V).

These antibiotics are active against group A, B, C streptococci, pneumococci, gram-negative microorganisms (gonococci, meningococci), as well as some anaerobes (clostridia, fusobacteria) and are inactive against enterococci. Most strains of staphylococci (85-95%) produce B-lactamases and are resistant to the action of natural penicillins.

Penicillins resistant to penicillinase:

Methicillin;

Oxacillin;

Cloxacillin;

Flucloxacillin;

Dicloxacillin.

The spectrum of antimicrobial action of these drugs is similar to the spectrum of action of natural penicillins, but they are inferior to them in antimicrobial activity. The advantage of these drugs is their stability against staphylococcal B-lactamases, and therefore they are considered the drugs of choice in the treatment of staphylococcal infection.

Aminopenicillins:

Ampicillin;

Amoxicillin;

Bacampicillin;

Pivampicillin.

They are characterized by a wide spectrum of antimicrobial action. They are highly active against some gram-negative bacteria, mainly of the intestinal group (Escherichia coli, Proteus, Salmonella, Shigella, Haemophilus influenzae). Bacampicillin and pivampicillin are ampicillin esters, which, after absorption in the intestine, are de-esterified and converted into ampicillin, are absorbed better than ampicillin, and create high blood concentrations after taking the same doses.

Aptispseudomonal penicillins:

Carboxypenicillins (carbenicillin, ticarcillin);

Ureidopenicillins (piperacillin, azlocillin, mezlocillin). This group has a wide spectrum of action on gram-positive cocci, gram-negative bacilli, anaerobes.

Preparations containing penicillins and B-lactamase inhibitors:

Ampicillin and sulbactam - unazine;

Amoxicillin and clavulanic acid - amoxiclav, augmentin;

Ticarcillin and clavulanic acid - tymentin;

Piperacillin and tazobactam - tazocin.

These drugs are fixed combinations of broad-spectrum penicillins with B-lactamase inhibitors. They have the property of irreversibly inactivating a wide range of B-lactamases - enzymes produced by many microorganisms (staphylococci, enterococci, Escherichia coli), bind enzymes and protect the broad spectrum penicillins contained in their composition from the action of B-lactamases. As a result, microorganisms resistant to them become sensitive to the combination of these drugs.

Cephalosporins of I, II, III and IV generations.They rank first among antibacterial agents in terms of frequency of use in inpatients. They have a wide spectrum of antimicrobial action, which covers almost all microorganisms, with the exception of enterococci. They have a bactericidal effect, have a low frequency of resistance, are well tolerated by patients and rarely cause side effects.

Their classification is based on the spectrum of antimicrobial activity. In clinical practice, the most commonly used cephalosporins of the I, II and III generations. In recent years, two drugs have appeared, which, on the basis of antimicrobial properties, have been attributed to IV generation cephalosporins.

Generation I cephalosporins - cephaloridin, cephalothin, cefapirin, cefradine, cefazolin, cephalexin.

II generation cephalosporins - cefamandol, cefuroxime, cefoxitin, cefmetazole, cefotenan. They have a wider spectrum of action than drugs of the 1st generation.

Third generation cephalosporins - cefotaxime, cefodizime, cefoperazone, ceftibuten, cefixime, latamoxef, etc. Some drugs are active against Pseudomonas aeruginosa.

Cefodizim -the only cephalosporin antibiotic with an immunostimulating effect.

They are widely used for the treatment of nosocomial infections.

IV generation cephalosporins - cefpirome, cefepime - have a broader spectrum of action than III generation cephalosporins. Their high clinical efficacy has been established in the treatment of various nosocomial infections.

Carbapenems.Carbapenems (imipenem, meropenem) and combined carbapenem thienam (imipenem + sodium cilastatin) are characterized by the widest spectrum of antibacterial activity. They are used to treat severe infections, mainly hospital ones, especially with an unknown causative agent of the disease. The wide spectrum and high bactericidal activity allow using these drugs as monotherapy, even in the treatment of life-threatening infections.

Aminoglycosides.All of them act only on extracellular microorganisms. There are three generations of aminoglycosides, but only aminoglycosides of the II generation (gentamicin) and III (sisomycin, amikacin, tobramycin, netilmicin) are used.

Tetracyclines.They inhibit protein synthesis in a microbial cell, have high activity against gram-positive and gram-negative microorganisms (aerobic and anaerobic), chlamydia, rickettsia, cholera vibrio, spirochetes, actinomycetes. The most active drugs are doxycycline and minocycline.

Doxycycline circulates in the body for a long time and is well absorbed (95%) when taken orally.

Macrolides(erythromycin, clarithromycin, spiramycin, azithromycin, midecamycin). The spectrum of their action is similar to that of natural penicillins. Depending on the type of microorganism and the concentration of the antibiotic, macrolides act bactericidal or bacteriostatic. They are the drugs of choice in the treatment of croupous pneumonia, atypical pneumonia, streptococcal infections (tonsillitis, erysipelas, pharyngitis, scarlet fever).

Lincosamides(lincomycin, clindamycin). The mechanism of action of lincosamides is to suppress the protein synthesis of bacteria. They are active against anaerobes, staphylococci and streptococci. They are the drugs of choice in the treatment of infections caused by anaerobic microorganisms (infection of the abdominal cavity and small pelvis, endometritis, lung abscesses and other localization). As an alternative, they are used for staphylococcal infections.

Glycopeptides(vancomycin, teicoplanin). Disrupt the synthesis of the cell wall of bacteria, have a bactericidal effect. Active against streptococci, pneumococci, enterococci, corynebacteria.

Chloramphenicol.Broad-spectrum antibiotic. It is active against gram-positive cocci (staphylococci, streptococci, pneumococci, enterococci), some gram-negative bacteria (colibacillus, hemophilus influenzae), anaerobes, rickettsia.

Rifampicin.The mechanism of action is associated with the suppression of RNA synthesis in the microbial cell. It is active against mycobacterium tuberculosis, gonococci, meningococci.

Polymyxins[polymyxin B, polymyxin E (calistin)]. The mechanism of action is associated with damage to the cytoplasmic membrane of the microbial cell. They are used only in cases of severe gram-negative infection (Pseudomonas aeruginosa, Klebsiella, Enterobacter) with resistance to all other antibacterial agents.

This can be explained by their extreme importance. They are especially irreplaceable in families with small children, because abrasions, scratches and small wounds are an indispensable attribute of every person's childhood. What drugs belong to the group of antiseptics and what is their mechanism of action?

Antiseptic medicines: how they work

Antiseptics are a kind of drugs from the group of antibiotics, that is, their main task is to fight pathogenic bacteria. A really effective drug from the group of antiseptics is able to perfectly cope with various microorganisms, but with a few exceptions, they are used topically, that is, by applying to the surface of the skin.

A number of antiseptics deprive bacteria of the ability to multiply, however, most of these drugs make changes in various cellular structures of microbes, which leads to their rapid death.

Antiseptics are not harmless medicines. If used incorrectly, they can burn the wound and even cause painful shock. Therefore, each of these drugs has its own indications.

Antiseptic drugs are represented by a very wide list. Among them there are very popular among the population (iodine, brilliant green, ethyl alcohol), and those that are known only to medical workers (formaldehyde, mercury solutions, etc.) Which drugs from this group are most often used in everyday life, and what are the main indications for them application?

• Iodine-based medicines (Iodinol, alcoholic iodine solution, iodoform, Lugol's solution).

They are used to treat skin diseases in which the process of suppuration is expressed, for the treatment of bedsores, trophic ulcers. Alcohol solution of iodine is an effective medicine for treating the edges of the operating field, but you need to know that if it gets into a deep wound, it can cause tissue necrosis, which means it will take much longer to heal. Iodine-based medicines are used to treat purulent tonsillitis (it is applied topically to the tonsils with small cotton swabs), purulent otitis media (instilled directly into the external auditory canal).

Also, preparations based on iodine are used as such a traditional method of treating various diseases of muscles, joints and bones, such as "iodine mesh". Given its superficial effect, it is not necessary to expect that it will be absorbed deep into the tissues of muscles and joints, therefore, in this case, its role is rather distracting and annoying. When iodine enters the skin, it promotes vasodilation and increased blood flow to the site of injury. Thus, microcirculation improves in this tissue area, which contributes to the acceleration of recovery.

It is one of the most effective medicines for treating wounds of any size. Unlike iodine, its contact with the affected tissues does not cause burns and necrosis, so it can be safely taken with you on any trip. This drug is suitable for rinsing the mouth with angina and viral diseases. Chlorhexidine is widely used in hospitals, both for treating wounds and for disinfecting the hands of medical personnel and sterilizing instruments.

• Ethyl alcohol (70% and 40%).

It is also an excellent medicine from the group of antiseptics. Despite the desire of some people to consume it internally, topical application of this solution to the skin is much more useful, as it promotes the rapid destruction of various microorganisms. In addition, it is used in hospitals as a disinfectant for materials and tools. Alcohol sprays are an excellent preparation for antiseptic treatment of hands during an epidemic of viral infections in cases where there is no way to wash them with soap (at work, in transport, on a trip).

• Brilliant green (or, as it is usually called, brilliant green).

It is used to treat the edges of wounds, minor scratches or abrasions. This is a drug of choice for many people for application on rashes with chickenpox. Numerous studies have shown that treating a rash with brilliant green in this disease does not in any way affect its prognosis, that is, by and large, it can be lubricated with nothing at all. However, for parents and doctors, the absence of new skin elements untreated with brilliant green in the morning indicates the cessation of pouring and the transition of the disease to the last stage - healing and recovery, and this is a very important fact from the point of view of epidemiology.

• Potassium permanganate (potassium permanganate).

An effective medicine that is widely used to treat wounds and burns, rinse the mouth and throat. Unlike most other antiseptics, this drug is used for internal use (gastric lavage in case of poisoning, douching in urology and gynecology).

• Protargol.

This medication can also be taken orally and is suitable for treating various mucous membranes (respiratory and genitourinary tract, eyes, mouth and pharynx).

• Ammonia solution 10%.

For topical application to the skin, it is practically not used (except for insect bites). However, it can be extremely useful for those with increased emotional sensitivity, as it is the first choice medicine for fainting. In hospitals, this medicine is also used to treat the hands of a surgeon before surgery or dressings.

• Hydrogen peroxide (simple and concentrated solution).

It is an effective medicine for treating wounds, especially if they are dirty. Its ability to foam allows the wound to quickly clear of soil, sand, shavings or dust, and this helps to quickly remove them from its surface, which will have a positive effect on healing. In addition to the cutaneous method of application, hydrogen peroxide is used for washing the organs of the genitourinary system, for the treatment of purulent wounds in hospitals.

The question of which drugs from the antiseptic group should be kept in your home medicine cabinet is very important. Trauma is never planned, so these medications are almost always needed urgently. If the wound occurs at night, then there is a high probability that all nearby pharmacies will be closed. Therefore, it is better to take care of the availability of these drugs in advance. So, what medicines you need to always have on hand:

• Hydrogen peroxide,
• Iodine-based medicines,
• Potassium permanganate,
• Brilliant green
• Chlorhexidine.

Other antiseptic drugs are prescribed by doctors for certain diseases, so their long-term storage at home is undesirable. Be sure to monitor their expiration dates and storage conditions. Sometimes an initially effective drug can be completely useless if stored incorrectly.

ANTISEPTIC AND DISINFECTANTS

Disinfectants - are designed to destroy the pathogen in the external environment, are used to decontaminate rooms, patient clothing, 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 associated with protein coagulation

the nature of the action is bactericidal

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

habituation of microflora does not occur

toxicity is high, therefore the main application is local (rarely for resorptive purposes)

a) Chlorine preparations

In aqueous solutions, they form hypochlorous acid (HClO), which decomposes in an acidic and neutral medium to form atomic oxygen and chlorine. Oxygen oxidizes and coagulates proteins of a 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 a violation of the secondary structure of the protein. In an alkaline medium, hypochlorous acid dissociates to form a hypochlorous 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 deodorant effect. Contains 25-28% active chlorine. Does not irritate the skin. Used by:

0.5 - 1% solution - treatment of hands, infected wounds

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

5% - treatment of the discharge of a tuberculous patient

b) Iodine preparations

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

Pharmacological effects of iodine:

antiseptic

anti-syphilitic

antifungal

expectorant

anti-sclerotic (improves lipid metabolism)

antithyroid

absorbable

Iodine alcohol solution it is used in the treatment of abrasions, scratches.

Iodinol it is applied externally for chronic tosillitis, purulent otitis media, trophic ulcers.

Biguanides.

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

Oxidants:

Hydrogen peroxide - on contact with tissues, it decomposes in two ways:

1.H 2 O 2 peroxidase H 2 O + O (antimicrobial effect (oxidation))

2.H 2 O 2 catalase H 2 + O 2 (mechanical cleaning of wounds)

As an antiseptic, the drug is not very active, mainly the cleansing effect is expressed due to foaming. Used for the treatment of contaminated and purulent wounds, for rinsing the mouth with stomatitis, tonsillitis. It has a hemostatic effect (due to the activation of thromboplastin and mechanical clogging of small vessels; it is dangerous to wash the cavity (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 during its decomposition, atomic oxygen is released. It also has deodorant properties. Drug solutions

(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 poisoning with alkaloids and in foodborne diseases. Due to manganese oxide, it has an astringent and cauterizing effect, which is used to treat ulcers, 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:

Schmiedeberg 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. In small concentrations, they are used for infectious diseases of the eyes (trachoma, conjunctivitis), and at higher concentrations, for the treatment of skin ulcers, erosions, cracks, as well as for the removal of excess granulations, warts.

Protargol, collargol - organic silver preparations.

Zinc sulfate and copper sulfate as antiseptics and astringents are used in solutions of 0.1-0.25% for conjunctivitis, laryngitis, urethritis.

Mercury dichloride (mercuric chloride) in solutions 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 (they 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, and reduce its viscosity. Strong alkalis cause tissue necrosis with their liquefaction (colliquation necrosis), penetrate deeply into tissues (deep burns).

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

Ammonia solution (ammonia) has antiseptic and detergent properties. It is used for washing the hands of 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. Has a tanning effect, removes water from the surface layers of fabrics. It is used for treating hands, disinfecting instruments, with excessive sweating (0.5 - 1% solution), for preserving tissues, histological preparations, formalin vapor - for disinfecting clothes.

Ethanol 70-95% denatures proteins and has a bactericidal effect. At a concentration of 70%, it is used to treat the hands of the surgeon and the patient's skin. In this concentration, ethyl alcohol has a deeper antiseptic effect on the skin (it 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 the microorganism, change the surface tension, increase the permeability, which leads to swelling and death of the microorganism.

Cetylpyridinium chloride as part of the drug "Zerigel"used to handle hands.

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 protein of the cytoplasm of the microbial cell. 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, therefore it is rational to use it to process 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; in a concentration of 2% and above - a cauterizing effect. Poisoning by absorption through the skin is possible.

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, disrupt 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. Used to study the functional capacity 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 (intravenous 1% aqueous solution).

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

Nitrofurans.

Use as an antiseptic furacilineffective against gram-positive and gram-negative bacteria. An aqueous solution of furacilin 0.02% is used for rinsing the mouth and throat for stomatitis, tonsillitis, for washing purulent wounds.

For citation:Cherkashin M.A. Local antiseptics in surgical practice // BC. 2007. No. 22. S. 1648-1650

The prevention and treatment of surgical infections is currently one of the most difficult tasks. The widespread prevalence and availability of antimicrobial chemotherapy agents contributes to the growth of resistant forms of microorganisms. Nosocomial infections are taking on an increasingly important role. Sometimes a dramatic situation develops - after a seemingly small intervention, rather severe and unpleasant wound complications develop, which often require surgical treatment. In the postoperative period, 30% of surgical patients develop infectious complications of various localization (the area of \u200b\u200bthe surgical incision, respiratory organs, organs of the urinary system). The problem of reinfection of wound surfaces with hospital strains from the hands of medical personnel, bed linen, sutures and dressings in intensive care units, in groups of patients with limited mobility (after cerebrovascular accidents) seems to be important. Among other things, the period of inpatient treatment is lengthened, which reduces both the patient's ability to work and the quality of his life, not to mention the pharmacoeconomic indicators. So, according to E.A. Oganesyan et al. (2003), A.A. Belozer et al. (2003), the length of hospital stay for patients is increased by 15-18 days.

One of the important aspects of solving this problem is the impact on the pathogen. The leading role in this, undoubtedly, belongs to the means of antimicrobial chemotherapy.
Rational antibiotic therapy is the cornerstone in the treatment of any infectious process. Especially when it comes to nosocomial pathogens.
But don't forget about the second part of the treatment strategy. Local treatment also plays an important role.
Topical preparations include topical antiseptics and topical forms of antibiotics.
At present, a huge amount of antiseptic agents are used in domestic health care. At the same time, it is no secret to anyone that many drugs are obsolete due to the fact that:
pathogenic microorganisms have developed resistance mechanisms;
for many years of use, the medical staff developed allergic reactions;
there is an inconvenience from the side of logistics - heavy, bulky and fragile containers;
many drugs need to be prepared "on demand" because there are no long-term stored dosage forms.
For example, many antiseptic agents intended for the treatment of the operating field, the surgeon's hands, the skin before injections, the introduction of vascular catheters, the elbow bends before the puncture of the vessels, do not always provide reliable sterility. Recent studies show that hospital strains of microorganisms are resistant to traditional antiseptics (furacilin, chlorhexidine aqueous solution, potassium permanganate solution). In a solution of furacilin Ps. aeruginosa remains at 106 CFU / ml.
Chemical antiseptics are most widely used in the treatment of wound infections.
Chemical antiseptics in our country are usually classified as follows:
I. Group of halogens:
1. Chloramine B
2. Iodine alcohol solution 5-10%
3. Iodine preparations: iodonate 1% r – r, iodinol 1% r – r, iodopyrone 1% r – r
II. Oxidants:
1. Р – р hydrogen peroxide
2. Perhydrol, contains about 30% hydrogen peroxide, is used to prepare a solution of pervomur
3. Potassium permanganate
III. Acids:
1. Boric acid
2. Formic acid
3. Hydrochloric acid
IV. Aldehydes:
1. Formaldehyde
2. Lysoform
3. Formalin
V. Phenols:
1. Carbolic acid
2. Ichthyol
Vi. Alcohols
Vii. Hypertonic solutions:
1. Hypertonic solution - 10% solution of sodium chloride
2.30% solution of urea
3.40% rr glucose
VIII. Dyes:
1. Methylene blue 1-3% alcohol solution
2. Brilliant green (brilliant green)
3. Rivanol
IX. Heavy metal salts:
1. Silver nitrate
2. Sublimate (mercury dichloride)
3. Silver salts: collargol and protargol
H. Detergents:
1. Chlorhexidine bigluconate
2. Zerigel
3. Rokkal - 10% and 1% aqueous solution
XI. Derivatives of nitrofurans:
1. Furacillin - for treating wounds, instruments, washing cavities
2. Furadonin, furazolidone
3. Furagin
In practical surgery, traumatology, military field surgery, drugs that can be used directly in the wound play an important role. Based on this, rather strict requirements should be imposed on such antiseptics:
non-toxicity
hypoallergenic
high bactericidal activity
ease of use in any conditions (a finished dosage form in a convenient package is desirable).
Traditionally, antiseptics from the group of halogens (alcohol solution of iodine), oxidants (hydrogen peroxide), dyes (brilliant green) are used to treat wound surfaces.
At present, there are a number of high-tech drugs. Silver-based preparations, various wound dressings for long-term use, media for moist wound healing, etc. are very promising.
One of the modern local antiseptic agents is polyvinylpyrrolidone iodine (Vokadin and others).
What are its advantages?
Polyvinylpyrrolidone itself is a biologically inert polymer molecule.
Polyvinylpyrrolidone binds halides to form galexes, which have a strong disinfecting effect. The complex of PVP with iodine was first obtained by Shelansky, who showed that polyvinylpyrrolidone forms a reddish-brown, odorless complex with iodine in aqueous solution. In combination with polyvinylpyrrolidone, iodine loses its ability to burn tissue, but retains a high bactericidal activity, which made it possible to expand the scope of iodine as an antiseptic. Thanks to the polymer molecule, iodine penetrates deep into the wound into inflamed tissues, under the scab, etc.
The drug has a wide spectrum of antimicrobial action: bactericidal, fungicidal, selective virucidal, tuberculocidal, protocidal.
Contraindications to the use of polyvinylpyrrolidone-iodine are:
iodine sensitivity
hyperthyroidism
thyroid adenoma
dermatitis
renal failure
The drug can be used both for treating the surgeon's hands before surgery (there is a form of Vokadin in the form of soap), for treating the operating field, and for local treatment of wounds (1% solution for local use and 5% ointment for external use) and prevention of infection before surgical interventions or diagnostic procedures in the vagina (vaginal suppositories and tablets).
Polyvinylpyrrolidone iodine can be used in all phases of the wound process.
A huge problem in almost all hospitals (not only surgical, but also neurological, therapeutic) is pressure ulcers that form in patients with limited mobility. Traditional methods of preventing the formation of pressure ulcers by treating problem areas of the skin (sacrum, shoulder blades, heels and other areas) with a solution of potassium permanganate today can be considered as an ineffective method that promotes the involvement of deep anatomical structures in the purulent process. A solution of potassium permanganate is not active against the main causative agents of hospital infections. The dense scab that forms as a result of daily skin treatments with this antiseptic creates ideal greenhouse conditions for the development of deep phlegmon. At the same time, when using a solution or a water-soluble ointment polyvinylpyrrolidone-iodine, favorable conditions for the reproduction of microorganisms are not created, since thanks to PVP, a conductor of iodine, the drug penetrates well under the scab.
A serious problem of modern health care both in our country and in the whole world is the treatment of severe forms of venous insufficiency, accompanied by trophic disorders.
It is now generally accepted that venous trophic ulcers occur in 2% of the adult population of industrially developed countries.
In our country, insufficient development of the system of public phlebological care leads to the fact that often patients turn to a specialist with a long-standing trophic ulcer. Many patients prefer to be treated for a long time on their own using various systemic and local remedies, which in no way improves their condition.
In general, there is such a situation that patients most often seek qualified help for purulent inflammation.
Wound infection plays an important role in stimulating local autoimmune processes, thus turning on "negative feedback" and chronic inflammation exists for a long time, creating, in turn, conditions for the persistence of infection.
A feature of the treatment of venous ulcers is the impossibility and senselessness of using most topical forms of antibiotics, because in an acidic environment, they break down very quickly and do not have the desired therapeutic effect. In this regard, local antiseptics and antibiotics should be used that work at low pH values. In the exudation phase, antiseptics are one of the important components of treatment, since it is necessary to achieve maximum cleansing of the ulcer from necrotic tissue and suppress the infection. It would be logical to use a PVP-iodine solution (this allows you to wash the wound). In the repair phase, one of the goals of treatment is the prevention of reinfection, and here also antiseptics cannot be dispensed with. In this phase, it is possible to use the ointment form of the drug.
In the outpatient practice of outpatient surgeons, a large place is occupied by the treatment of purulent-destructive processes in the soft tissues of the hand and foot (panaritium, paronychia, phlegmon). The most important condition for successful treatment is drainage of the focus, evacuation of purulent discharge, systemic antibacterial therapy and, of course, local treatment, which is unthinkable without the use of antiseptics. In such cases, polyvinylpyrrolidone-iodine turns out to be indispensable, since the polymer molecule allows iodine to penetrate into inflamed tissues.
Thus, the polyvinylpyrrolidone-iodine complex is a highly effective, safe and convenient local antiseptic agent. Vokadin can be widely used in surgical practice for the treatment of various wounds, surgical infections, burns, bedsores, trophic ulcers. Iodophores must necessarily be included in the medication kit when recruiting supplies for emergency medicine teams, military medical service.

Literature

1. Blatun L.A. Modern iodophores are effective drugs for the prevention and treatment of infectious complications. Consilium medicum. 2005, volume 7 No. 1.
2. Oganesyan E.A., Pavlov S.I., Petkova V.A. Epidemiological surveillance of nosocomial infections in the Kaluga region. In collection: Modern problems of epidemiology, diagnosis and prevention of nosocomial infections. SPb., 2003; from. 61-63.
3. Belozer A.A., Smirnov O.A., Petkova V.A. Infection control of nosocomial infections in an emergency hospital. Modern problems of epidemiology, diagnosis and prevention of nosocomial infections. SPb., 2003; from. 75-77.
4. Novikova N.F., Mordovtsev V.N., Parenkova T.V. New possibilities for the treatment of trophic ulcers, skin and soft tissue wounds, bedsores and fistulas. - Consilium provisorum, 2001, vol. 1, N4. - p.30.
5. Phlebology. A guide for doctors under. ed. V.S.Saveliev. M., Medicine. 2001.
6. Lode H. Catheter-associated infections in the ICU. Materials of the International Conference "Nosocomial infections in intensive care units". 1998; from. 15-16.

Very large. And x use in the treatment of infected wounds, microorganism lesions of the skin and mucous membranes, for the treatment of water and food, for the disinfection of medical instruments, linen, etc.

Antiseptics and disinfectants should have a wide spectrum of action against microorganisms, protozoa and fungi, be characterized by a short latency period of action, high activity, including in the presence of biological substrates. It is important that the drugs are chemically resistant and affordable in terms of their production and cost.

For example, before surgery, biopsy, injections, punctures, circulation and bladder catheterization. Active ingredients: polyvidone iodine, iodine. This article is only a pharmacy. Read the package leaflet and consult your doctor or pharmacist for risks and side effects.

Christian Mayr and ao. Markus Nagl from the Section for Hygiene and Medical Microbiology, recognized by the German Rudolf Schulke Foundation. Every two years, the Rudolf Schulke Foundation in Hamburg awards the Hygiene Prize to scientists who have achieved special problem solutions in the fields of hygiene, microbiology and preventive medicine.

Important requirements for antiseptics are the absence of a local negative (for example, irritating) effect on tissues, minimal absorption from the site of their application, the absence of an allergenic effect and low toxicity.

Disinfectants should not damage the processed items (discoloration, corrode metals, etc.). It is desirable that they have no unpleasant odor.

This is the conclusion of the Innsbruck working group led by Professor Brazen, who excelled at the university. Section of Hygiene and Medical Microbiology. Honey is one of the oldest foods known to mankind, with records of its consumption by the Greek mathematician Pythagoras in 585 BC. Brazil is the 9th largest food exporter in the world.

Honey is also one of the most studied phytotherapeutic substances in the world and is extremely rich in medicinal properties. Its most famous functions are anti-inflammatory, immunomodulatory and mucolytic action - it dissolves mucus in the airways, helping in phlegm.

A common criterion for assessing the activity of antiseptics is the so-called phenol ratio (the ratio of the concentrations of phenol and the tested antiseptic, in which the substances have the same antimicrobial effect).

The mechanism of action of different antiseptics and disinfectants is not the same and may be associated with protein denaturation, impaired plasma membrane permeability., inhibition of enzymes important for the vital activity of microorganisms.

In addition to being a delicious food, it has antiseptic properties, heals and also invigorates. Its minerals are easily assimilated and contribute to the maintenance of the skeleton - with calcium - and the regeneration of blood - with iron, says native Maximo Asinelli.

Check out some fun facts about honey. During honey production, bees add an enzyme called glucose oxidase, ensuring that a small amount of hydrogen peroxide is constantly produced in the sugar in the food. Thus, honey acts as a kind of disinfectant, preventing inflammation and encouraging new tissue to regenerate in place.

Classification of antiseptics and disinfectants (by chemical structure)
1. Detergents Zerigel, rokkal and others.

2. Derivatives of nitrofuran Furacilin (furazolidone)

3. Phenol group and its derivatives Pure phenol Resorcinol Birch tar

4. Dyes Brilliant green Methylene blue Ethacridine lactate

Those with lazy guts can bet on this food to help the body. Honey contains soluble fiber that enhances involuntary bowel movement by functioning as a regulator of this organ and aiding digestion. Fifty years ago, women often cared about beauty with homemade products. Honey, with its strong moisturizing and healing properties, was among the favorites. Today, it is still a great beauty ally, whether in home masks or as a staple in cosmetics.

5. Halogenated compounds Chlorhexidine Chloramine B Alcohol solution of iodine, etc.

6. Compounds of metals Mercury dichloride Mercury oxide yellow Silver nitrate Copper sulfate
Zinc oxide Zinc sulfate
7. Oxidants Hydrogen peroxide solution Potassium permanganate

8. Aldehydes and alcohols Formaldehyde solution Ethyl alcohol

According to cosmetology professor Mauricio Pupo, honey has a great ability to fight dryness of the upper layer of the skin and has a long-lasting effect. The hydration is so intense that it improves the appearance of wrinkles, and the enzymes it contains make it a powerful antioxidant, which helps reduce collagen degradation in the skin, he says. Honey, which can be found in markets and pharmacies, is easy to buy and great for making a homemade mask once a week.

Here's the basic recipe: After exfoliating your skin lightly with soap, apply a layer of pure honey to your face and let it work for an hour. After this period, remove the product. Contraindicated for children under one year of age. In search of a more natural way to sweeten juices and teas, mothers choose honey, unaware that the consumption of the product is contraindicated for infants under one year old. The recommendation comes from the National Sanitary Inspection Agency. Maisa Helena de Aguiar Toloni, a researcher at the Federal University of São Paulo with nearly 300 parents, found that 73% of them offered honey to their children at this stage.

9. Acids and alkalis Boric acid Ammonia solution

Detergents , or cationic soaps, have detergent and antiseptic properties. They affect many bacteria and fungi. One of these drugs is cerigel. It contains a cationic detergent - cetylpyridinium chloride mono-quaternary ammonium salt, as well as polyvinyl butyral and ethyl alcohol. This group also includes rockcal, which has a pronounced surface activity. It is a mono-quaternary ammonium salt. Detergents are used to treat the hands of the surgeon, sterilize instruments and equipment. In normal concentrations, they do not cause tissue irritation.

The danger lies in microorganisms that may be present in food. “Until the first year of life, the child's immune system is not mature enough,” says the nutritionist. She also warned that including sweet tastes at this age will lead a child to develop inappropriate eating habits, which can lead to obesity and diabetes.

No need to sweeten baby food. It is recommended to avoid sugar to the maximum, as its introduction into the diet of a small one can anticipate the rejection of breast milk, the development of tooth decay and other diseases such as hypertension, he says. Pregnant women and babies should also avoid substance use, as pathogens can pass from mother to baby through the umbilical cord or breastfeeding.

Detergents cannot be combined with anionic soaps, as their antimicrobial activity decreases. The action of detergents is also reduced in the presence of organic substances.

An important group of antiseptics are nitrofuran derivatives ... These include furacilin (nitrofural, nitrofurazone). Nitrofurans are broad-spectrum. They have a detrimental effect on gram-positive and gram-negative bacteria, protozoa.

Against hospital and skin infections. A specific type of honey called Manuka, produced in New Zealand, contains a substance that is toxic to bacteria, making it effective against hospital and skin infections. The study was conducted by Professor and Researcher Dee Carter of the Faculty of Life Sciences at the University of Sydney in Australia. The idea is that this variety can replace antibacterial foods for sterilizing, treating cuts, insect bites and other skin problems.

While it is more natural, honey is just as bad for diabetic health as regular sugar. It contains a large amount of carbohydrates, about 12 g for each tablespoon. “This is the same amount of fruit, but the absorption in fruit is slower due to the fiber,” says Denise Duarte Iezzi, endocrinologist at Sirio Libane Hospital. "Swapping sugar for honey has questionable benefits, both are long-chain carbohydrates and are absorbed quickly," he says.

Furacilin is used mainly externally for the treatment of wounds, skin, mucous membranes, for washing serous and articular tissues. Furacilin is generally well tolerated. Sometimes it causes sensitization, dermatitis.

Phenol group and its derivatives include many well-known aromatic antiseptics. These include oxybenzenes ( pure phenol)and dioxybenzenes ( resorcinoland etc.). Phenol acts mainly on vegetative forms of bacteria and fungi. Phenol solutions use for disinfection of tools, household items.

It should be borne in mind that toxic phenol with high lipophilicity is easily absorbed from the skin and mucous membranes. and causes poisoning !!!

Resorcinolin antiseptic action it is inferior to phenol. In small concentrations, resorcinol has keratoplastic properties, in large concentrations - irritating and keratolytic. It is used for some skin diseases (for example, eczema, seborrhea, etc.), with conjunctivitis.

The goal, as well as the pioneering museum in this action, is to collect honey and sell it or donate it to workers. The production at the Grand Palace Museum is about 50 kilograms. In addition to promoting pollination and the subsequent diversification of the local flora, French experts found the honey from the rooftops of Paris tastier and with fewer impurities. The reason would be the absence of pesticides in the colors of cities other than the colors of the fields.

If you have no familiarity with medical terms, or this is your first time at the pharmacy to take a drug with this property, you may be a little rocky in front of the antiseptic word. Of course, it seems like it seems very difficult, but without worrying about what you think: it is a word derived from the Greek language, or rather from the union of two terms in this language that are antiseptics, which means against and rottenness. In short, an antiseptic drug, when taken, destroys the bacteria that are responsible for the pathology or prevents the affected person from decomposing or decomposing.

Part birch tar includes phenol and its derivatives, resins and other compounds. The preparation is obtained by dry distillation of birch bark. Birch tar has antimicrobial, keratoplastic, keratolytic and irritating effects. It is used in the treatment of a number of skin diseases and scabies.

Birch tar is one of the constituent parts of balsamic liniment according to A.V. Vishnevsky (Vishnevsky ointment), used in the treatment of wounds, as well as Wilkinson's ointment, prescribed for scabies and fungal skin lesions.

There are also some drugs that, in addition to killing bacteria and germs, can prevent them from reforming or preventing their growth. An antiseptic preparation, in addition to destroying and preventing the proliferation of bacteria in the affected organs, is able to counteract or effectively slow down the action of smaller and more harmful organisms such as viruses and other microorganisms. Antiseptic properties, in addition to bacteria and antiviral drugs, can be found, for example, in many disinfectants used by parents to treat childhood injuries when they are badly damaged, or body parts - knees and elbows. this is only in the pharmaceutical field: some of the cleaning products commonly used by housewives are actually antiseptic, so they are able to sterilize surfaces and kill any bacteria found on them, thereby avoiding the spread of many dangerous diseases.

To the group of dyes includes a number of compounds of different chemical structures. The most widely used derivative of triphenylmethane brilliant green... Sometimes a phenothiazine derivative is used methylene blue and acridine derivative ethacridine lactate.

Particularly sensitive to dyes gram-positive cocci.

Antiseptics, drugs in which we find

There are many drugs on the market that have antiseptic properties, and it is very difficult to compile an exhaustive list, as they go back to the pharmacy every year. However, among them one can find five groups that are most commonly used and which are the most common, such as alcohols, biguanides, halogenated compositions, peroxides and boric acids. Alcohols, which are also widely used in surgery, deal with trauma-free skin disinfection and are mainly composed of ethyl alcohol. Biguanides are also used to treat skin integrity, but are more effective against certain types of bacteria and fungi and are not particularly toxic.

Brilliant green is a highly active and relatively fast-acting antiseptic. AT the presence of proteins decreases its effectiveness. It is applied externally, mainly with purulent skin lesions (pyoderma).

Methylene blue (methylthionium chloride, methylene blue) is inferior in activity to brilliant green. Apply it externally as an antiseptic, internally for urinary tract infections, and also intravenously for cyanide poisoning. The effectiveness in the latter case is explained by the fact that methylene blue (in large doses) converts hemoglobin into methemoglobin, which binds with cyanides, forming non-toxic cyanmethemoglobin.

Instead, halogenated compositions, which are also found in many hygiene products, although of low toxicity, are less effective than other antiseptics. Peroxides, being very effective in the treatment of skin diseases, especially in the case of escorts and injuries, it is fear of children and adults, because they always cause mild pain.

An antiseptic drug can affect the human body in different ways. Overall, looking at most of the products that we find in the pharmacy, and many of which can be bought without a prescription, the antiseptic acts on the cell membrane and microscopic organisms that are sensitive to this chemical agent.

Ethacridine lactate (rivanol) colored yellow. His activity is quite high, but the action develops slowly. Apply it externally and for washing infected cavities (pleura, peritoneum), bladder, uterus.

Halogenated antiseptics are represented by preparations containing chlorine and iodine. The most active are antiseptics containing elemental halogens or releasing them. One of the drugs that split off chlorine is chloramine B, with antiseptic and deodorant properties. It is used for disinfecting the secretions of patients (for example, with typhoid fever, cholera, tuberculosis, etc.), household items, non-metallic instruments, as well as for treating hands and infected wound surfaces.

Among the effective chlorine-containing antiseptics is the biguanide derivative chlorhexidine(hibitan). It provides antibacterial and fungicidal action. It is applied for treatment of the surgeon's hands, the operating field, wounds, bladder, as well as for sterilizing instruments... When treating the hands of a surgeon, dry skin and dermatitis are possible.

More specifically, however, an antiseptic can alter the structure of the cells of microorganisms, causing them to die or preventing growth, or destroying the permeability of their cell membranes. In the case of ethyl alcohol and other disinfectants, denaturation of proteins can occur inside the microorganism, that is, the loss of the original characteristics and functioning of the molecule, which leads to the neutralization of the pathogen and its death.

Treatment of children in children, adolescents and adults

Surface disinfection of the skin before small performances. Treatment of severe caries. Tumor removal treatment. In dentures, it is advisable to use the Iodisol solution for immersing the fingerprints by immersing it in a dilute iodisol solution.

In addition, preparations containing elemental iodine include lugol's solution (consists of 1 part of iodine, 2 parts of potassium iodide and 17 parts of water), used to lubricate the mucous membrane of the pharynx and larynx in inflammatory processes.

A significant number of antiseptics submitted compounds (salts) of metals.

Non-medical use for children, adolescents and adults

Hand disinfection; treatment of minor skin lesions; haze treatment; treatment of inflammation of the oral mucosa; treatment after insect bites. Iodizol is a highly effective disinfectant. It is a 3% solution of a complex compound with a wide range of applications. It has a wide range of effects on proliferating forms of microorganisms, i.e. bacteria, fungi and viruses. Iodine bound in the complex is released in a concentration sufficient for disinfection, but does not damage the skin or mucous membranes.

Mechanismantimicrobial action of metal salts in low concentrations is associated with blocking sulfhydryl groups of enzymes of microorganisms... At high concentrations, depending on the nature of the metal and acid residue, salt concentration, degree of its dissociation and solubility, various local effects can occur: astringent, irritating, cauterizing (necrotizing).

Local action of metal salts associated with protein denaturation... The resulting albuminates can be dense and loose. In the first case, a film forms on the surface of the tissue, the tissue thickens, the inflammation decreases, this picture is typical for the astringent action. With a deeper penetration of the substance, irritation of cells and nerve endings occurs. An extreme manifestation is the cauterizing effect of metal salts. The latter is the more pronounced, the more soluble albuminates.

According to the solubility of the formed albuminates in water and biological fluids, metals can be arranged in the following row: Pb, ... A1, Zn, Cu, Ag, ... Hg.

In lead salts, the astringent effect is most pronounced (they form dense albuminates), in mercury salts, it is cauterizing. At the same time, antimicrobial activity grows in this series from lead to mercury.

As antiseptics, salts of metals located on the right side of the row are of greatest interest, especially mercury and silver.

Of mercury salts the following drugs are used in the role of antiseptics:

a) well soluble in water mercury dichloride (mercuric chloride) - HgCl 2;

b) water-insoluble mercury amidochloride (mercury sedimentary white) and mercury oxide yellow (sedimentary yellow mercury).

Well soluble and dissociating mercury dichloride has high antimicrobial activity. The drug is used for processing the skin of hands, dishes, premises, etc.It is not suitable for disinfection of metal objects, as it causes corrosion of metals. AT the presence of proteins, the activity of mercury dichloride decreases, therefore, the drug is not used to disinfect the secretions of patients containing protein components. It has a pronounced irritant effect, and therefore it can only be used occasionally for treating the skin of the hands. You should also consider that mercury dichloride is very toxic... A complicating point is the ability of the substance to penetrate the skin and mucous membranes.

Mercury oxide yellow most often used with infectious eye lesions(with conjunctivitis, keratitis). Mercury amidochloride is usually prescribed with skin diseases such as pyoderma.

Acute poisoning with mercury compoundsis usually associated with accidental or deliberate ingestion of mercury dichloride. It is manifested by pain in the abdomen, vomiting, diarrhea (the result of a cauterizing effect on the mucous membrane of the digestive tract), as well as changes in the central nervous system (excitement followed by depression) and the cardiovascular system (acute heart failure, collapse). After 2-4 days, the symptoms associated with necrotic changes in the kidneys ("sublimate kidney") and the digestive tract (stomatitis, ulcerative colitis) increase. Such localization of lesions is explained by the fact that the main route of elimination of mercury compounds is through the kidneys, as well as the colon and salivary glands.

Treatment of acute mercury dichloride poisoning is primarily to prevent the absorption of the drug. For this purpose, the stomach is washed, a solution of the antidote of mercury compounds of unitiol is introduced into it (contains sulfhydryl groups that bind mercury). Sometimes activated carbon, small volumes of astringent solutions, milk, egg white are introduced. Gastric lavage should be performed with great care, as mercury dichloride damages the lining of the esophagus and stomach. Then laxatives are prescribed, as well as siphon enemas with a solution of unitiol. To inactivate the absorbed drug, unitiol is administered intravenously. For mild to moderate poisoning, forced diuresis is effective. With severe poisoning, especially with impaired renal function, it is necessary to resort to hemodialysis and peritoneal dialysis, carried out against the background of intravenous administration of unitiol and tetacin-calcium (CaNa 2 EDTA).

In the case of chronic poisoning with mercury drugs (the so-called mercurialism ) the mucous membrane of the oral cavity (stomatitis), as well as the central nervous system, hematopoiesis, etc. are affected. Most often this is the result of professional poisoning associated with working with mercury preparations. In this regard, the first and main measure is to eliminate the source of poisoning. Use as antidotes unitiol, as well as tetacin calcium, sodium thiosulfate. In addition, measures are taken to accelerate the excretion of the substance from the body, and symptomatic therapy is also carried out.

Of silver preparations use silver nitrate (lapis; AgNO 3), protargol (silver proteinate) and collargol(colloidal silver). They have antimicrobial, astringent and anti-inflammatory effects. They are used in ophthalmology (with conjunctivitis, blennorrhea), for irrigation of wounds, washing the urethra and bladder. In addition, silver nitrate in high concentrations and in sticks is used externally as a cauterizing agent for erosions, ulcers, excessive granulation, as well as trachoma.

Also used as antiseptics and astringents in ophthalmology copper sulfate (copper sulfate; CuSO 4 ∙ 5H 2 O), zinc sulfate (ZnSO 4). For trachoma, special eyeliners are used containing copper sulfate, potassium nitrate, alum and camphor. Soluble salts (copper sulfate and zinc sulfate) can be used to douch the urethra and bladder.

To the group of oxidants relate hydrogen peroxide (H 2 O 2) and potassium permanganate (potassium permanganate; KMnO 4). They have antiseptic and deodorant effects. The principle of action of both drugs is in the release of oxygen.
When applied to tissues in the presence of proteins, hydrogen peroxide is decomposed under the influence of catalases with the release of molecular oxygen.

H 2 O 2 → 2H + O 2.

However, the oxidative and therefore antimicrobial activity of molecular oxygen is negligible. More important in this case mechanical cleansing of wounds, ulcers, cavities, which is associated with the release of oxygen bubbles and the formation of foam... Hydrogen peroxide also has deodorant properties. The drug works for a short time. In addition, hydrogen peroxide helps to stop bleeding.

Potassium permanganate in the presence of organic substances splits off atomic oxygen.

2KMnO 4 + H 2 O → 2KON + 2MnO 2 + 30.

The antiseptic effect of atomic oxygen is more pronouncedmore than molecular. It provides antimicrobial and deodorant effects, and the resulting manganese oxide (MnO 2) - astringent. AT high concentrations of potassium permanganate has irritating and cauterizing effect.
Applythe drug in solutions for rinsing, douching, irrigation of wounds, treatment of burn surfaces, gastric lavage in case of poisoning with morphine, phosphorus, etc.

Some compounds also belong to antiseptics. from the group of aldehydes and alcohols... One of the representatives of aldehydes is a solution formaldehyde (formalin; contains 36.5-37.5% formaldehyde - НСНО). He possesses strong antimicrobial and deodorant properties. It is used as disinfectantas well as for leather processing with sweating. Under the influence of a formaldehyde solution, the epidermis thickens (due to denaturation of proteins), as a result of which sweating decreases. The drug has a pronounced annoying action.
The same group may include hexamethylenetetramine (urotropine). It is sometimes used as an antiseptic. with urinary tract infection... The bacteriostatic effect of hexamethylenetetramine is associated with its splitting in an acidic medium and the formation of formaldehyde (if necessary, the shift of the urine reaction to the acidic side, you can use ammonium chloride). Hexamethylenetetramine is prescribed orally and intravenously. In the stomach, it is partially destroyed. Of side effects should be borne in mind the possibility of an irritant effect on the kidneys, which is the basis for its cancellation.

Possesses pronounced antimicrobial properties ethanol... It is used for disinfection of instruments, treatment of the surgeon's hands, the operating field... The antimicrobial activity of ethyl alcohol increases with an increase in its concentration. However, for for skin disinfection, it is better to use 70% ethyl alcohol, which penetrates into the deeper layers of the epidermis than 95%.

Can be used as antiseptics a number of acids and alkalis... So, for washing the mucous membranes and rinsing the mouth, it is sometimes prescribed boric acid solution (H 3 VO 3). It can also be used on the skin in ointments and powders. However, the antimicrobial activity of boric acid is low.
To antiseptics from the group of alkalis is ammonia solution (ammonia; NH 4 OH; contains 9.5-10.5% ammonia). Its 0.5% solution used to treat the hands of the surgeon.Moreover, it can be used inhalation for reflex stimulation of the respiratory center.

Test questions (feedback)

1. What is the difference between antiseptics and disinfectants?

2. What is phenol ratio?

3. What do you mean by antimicrobial spectrum?

4. What is the difference between the bacteriostatic and bactericidal effect?

5. Classification of antiseptic and disinfectants.

6. The main mechanisms of action of antimicrobial agents.

7., determining antimicrobial activity.

8. Comparative assessment of antiseptic agents from different groups.

9. Poisoning, measures of assistance, principles of antidote therapy.

Until the 19th century, most surgical operations ended in the death of the patient from infections brought in by medical workers. Fortunately, such medical advances as antiseptics have reduced the percentage of deaths from septicopyemia to a minimum. Modern surgery successfully uses various types of antiseptics, which we will discuss in this article.

What is an antiseptic and what is it for?

Even ancient healers, who unconsciously used natural ingredients with anti-inflammatory properties, guessed about the relationship of pathogenic microbes with purulent inflammation of wounds. Nevertheless, the real fight against surgical infections began in the second half of the 19th century, when the English physician J. Lister published an article in which he described his method of treating an open fracture using a 5% solution of carbolic acid. Since then, a new era in surgery has begun, where, with the development of medicine, new types of antiseptics have appeared.

Antiseptics in modern terminology means a set of measures and manipulations, the purpose of which is to destroy microorganisms, as well as their spores and toxins in tissues and macroorganisms. Along with this, the term "asepsis" is of great importance in surgery, which means a set of measures to prevent the development of pathogenic microbes in wounds. Aseptic techniques also include sterilization of surgical instruments and supplies. As well as the discovery of pain relief and blood groups, the types of asepsis and antiseptics that were discovered in surgery in the 19th century became one of the fundamental medical advances of that time. It was from that period that surgeons began to actively practice the still considered risky (almost 100% lethal) operations on the chest and abdominal cavity.

The main types of antiseptics in modern medicine

Asepsis, of course, plays a huge role in surgery and often does not require additional measures, however, as practice has shown, a complete rejection of antiseptic manipulations is impossible. The types of antiseptics in medicine can be conditionally divided by the nature of the methods used and by the method of application. In the first case, the types of antiseptics include:

• Mechanical antiseptic.
• Physical.
• Chemical.
• Biological.
• Mixed.

According to the method of application, chemical and antiseptics are divided into:

• Local in the form of processing some particular part of the body. Local antiseptics can be superficial or deep. Superficial means a toilet of wounds and injuries (washing with solutions, treatment with powders, ointments, compresses), and deep antiseptics is the introduction of chemical and biological anti-infectious drugs into the body through injections.
• General, implying infusion saturation of the body through the blood and lymph with antiseptic drugs (infusion of droppers).

Mechanical antiseptic

Mechanical antiseptics are performed using surgical instruments and include:

Physical antiseptic

Physical antiseptics includes a set of measures to prevent the multiplication of pathogenic microbes and the absorption of their waste products by the patient's tissues. Physical types of wound antiseptics include the following:

Chemical antiseptic

Chemical antiseptics include measures to destroy pathogenic microbes in the wound or the patient's body with the help of chemicals, among which are:

Biological antiseptic

Biological antiseptics includes agents of biological origin that can act both directly on microorganisms and indirectly. Biological antiseptics include:

Mixed antiseptic

The combined antiseptic uses the techniques and means of all types of antiseptic in combination. As combined means are used:

• Inorganic antiseptics.
• Synthetic analogues of biological agents.
• Synthetically produced organic matter.

Types of antiseptics for wood and other building materials

Various bacteria can cause putrefaction and decomposition processes not only in the organisms of humans and animals, but also in building materials, such as wood. To protect wooden products in the interior and exterior from damage by insects and house mushrooms, various types of wood antiseptics are used in construction. They can be.