What are antiseptic properties? Modern antiseptics in medicine names

Antiseptics (antiseptics) are substances that destroy microorganisms or inhibit their development.

Antiseptics are active to one degree or another against all microorganisms, that is, unlike chemotherapeutic agents, they do not have selectivity of action. The action of antiseptics, leading to a delay in the development or reproduction of microorganisms, is called bacteriostatic, leading to their death. The latter effect can be called disinfectant. Some antiseptics can have both bacteriostatic and bactericidal effects, which depends on their concentration and duration of action, the sensitivity of microorganisms to them, temperature, and the presence of organic substances in the environment (pus, blood weaken the effect of some antiseptics).

Antiseptics are very different in nature. The following groups are distinguished. I. Halides: , iodine, . II. Oxidizing agents: potassium permanganate, . III. Acids: , salicylic. IV. : . V. Compounds of heavy metals: , (xeroform), copper, . VI. (ethyl, etc.). VII. : , lysoform, . VIII. : , lysol, phenol. IX. Tars, resins, petroleum products, mineral oils, synthetic, preparations (tar, refined naftalan oil,). X. Dyes: , methylene blue, . XI. Nitrofuran derivatives: . XII. 8-hydroxycholine derivatives: . XIII. Surfactants, or detergents: diocide. They are also used as antiseptics for external use () and.

To characterize the antimicrobial activity of antiseptic agents, the phenol coefficient is used, which shows the strength of the antimicrobial action of a given agent compared to phenol.

Antiseptics are used topically in the treatment of infected and long-term non-healing wounds or ulcers, phlegmon, mastitis, joint injuries, diseases of the mucous membranes, for washing the bladder, urethra, as well as for rooms, linen, objects, surgeon's hands, instruments, disinfection of secretions . Antiseptics are usually not used to treat general infections.

Contraindications for use, as well as a description of individual antiseptics - see the articles on the names of the drugs [for example, etc.].

Antiseptics are antimicrobial substances used for local action in the treatment of purulent, inflammatory and septic processes (infected and long-term non-healing wounds or ulcers, bedsores, abscesses, phlegmon, mastitis, joint injuries, pyoderma, diseases of the mucous membranes), as well as for disinfection premises, linen, patient care items, surgeon's hands, instruments, disinfection of secretions. These substances are usually not used to treat general infections.

Antiseptics act germistically, and in high concentrations they exhibit a germicidal effect. Therefore, some antiseptics can be used as disinfectants (see). In addition, antiseptics are used to preserve medicines and food products. The antimicrobial activity of antiseptics is expressed using the phenol coefficient - the ratio of the bactericidal concentration of phenol to the bactericidal concentration of a given antiseptic.

The degree of effectiveness of antiseptics depends on a number of conditions: the sensitivity of the microorganism to it, the concentration of the antiseptic, the solvent in which it is used, temperature, and the time of exposure to the drug. Many antiseptics lose activity to a greater or lesser extent in the presence of proteins, so it is advisable to use them only after cleansing infected surfaces of exudate. Antiseptics act on all types of bacteria and other microorganisms, without showing the selectivity inherent in chemotherapeutic substances. Many antiseptics can damage living cells of the macroorganism. As a result, the assessment of antiseptics necessarily includes the determination of their toxicity to humans and animals using the “toxicity index” - the ratio between the minimum concentration of the drug that causes the death of the test microorganism within 10 minutes, and the maximum concentration of the same drug that does not inhibit the growth of chicken tissue culture embryo. For medical practice, the most valuable are antiseptics, which, other things being equal, have the least toxicity.

Antiseptics are diverse in nature. They can be divided into the following groups. I. Halides: chlorine gas, bleach, chloramines, pantocid, antiformin, iodine, iodoform. II. Oxidizing agents: hydrogen peroxide, potassium permanganate, bertholet's salt (potassium hypochlorite). III. Acids: sulfuric, chromic, boric, acetic, trichloroacetic, undecylenic, benzoic, salicylic, mandelic and some others. IV. Alkalis: calcium oxide, ammonia, soda, borax. V. Compounds of heavy metals: 1) mercury; 2) silver; 3) aluminum - basic aluminum acetate (Burov's liquid), alum; 4) lead - basic lead acetate (lead water); 5) bismuth - xeroform, dermatol, basic bismuth nitrate; 6) copper - copper sulfate, copper citrate; 7) zinc - zinc sulfate, zinc oxide. VI. Alcohols: ethyl, isopropyl, trichloroisobutyl, some glycols. VII. Aldehydes: formaldehyde, hexamethylenetetramine (urotropine). VIII. Phenols: phenol, or carbolic acid, cresol, creolin, parachlorophenol, pentachlorophenol, hexachlorophen, resorcinol, thymol, tricresol, phenyl salicylate (salol), benzonaphthol. IX. Products of dry distillation of organic materials: various resins and tars, ichthyol, albichtol. X. Dyes: brilliant green, rivanol, trypaflavin, methylene blue and gentian violet. XI. Nitrofuran derivatives: furatsilin, furadonnn, furazolpdon. XII. 8-hydroxyquinoline derivatives: quinozol, yatrene. XIII. Surfactants, or detergents. There are cationic, anionic and nonionic detergents. Cationic detergents (for example, cetylpyridinium bromide) are most active. XIV. Antibiotics (see): gramicidin, neomycin, microcide, usnic acid. XV. Phytoncides (see): preparations of garlic, onion, St. John's wort, burnet, eucalyptus, etc.

The mechanism of action of antiseptics is different and is determined by their chemical and physicochemical properties. The antimicrobial effect of acids, alkalis and salts depends on the degree of their dissociation: the more a compound dissociates, the greater its activity. Alkalis hydrolyze proteins, saponify fats, and break down carbohydrates of microbial cells. The effect of salts is also associated with changes in osmotic pressure and disruption of the permeability of cell membranes. The effect of antiseptics that lower surface tension (soaps, detergents) is also associated with changes in the permeability of bacterial membranes. The effect of heavy metal salts is explained by their ability to bind sulfhydryl groups of substances in the bacterial cell. The antiseptic effect of formaldehyde is due to its ability to denature proteins. Compounds of the phenol group have detergent properties and are capable of denaturing proteins. Oxidizing agents cause the death of microbial cells as a result of oxidation of its constituent parts. The mechanism of action of chlorine and chlorine-containing compounds is associated with the formation of hypochlorous acid (HClO), which acts both as an oxidizing agent, releasing oxygen, and as a means of chlorinating the amino and imino groups of proteins and other substances that make up microorganisms. The antimicrobial effect of dyes is associated with their ability to selectively react with certain acidic or basic groups of substances in bacterial cells with the formation of sparingly soluble weakly ionizing complexes. The antimicrobial effect of nitrofuran derivatives is due to the presence of an aromatic nitro group in their molecule. Antiseptics inhibit the activity of many bacterial enzymes. For example, the bactericidal effect of antiseptics is closely related to their ability to inhibit the dehydrase activity of bacteria. Under the influence of antiseptics, the process of cell division stops and morphological changes occur, accompanied by a violation of the cellular structure. Selected antiseptics - see relevant articles.

ANTISEPTIC AND DISINFECTANTS

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

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

Features of antiseptics and disinfectants:

the mechanism of action is mainly associated with protein coagulation

nature of action is bactericidal

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

microflora does not become addictive

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

a) Chlorine preparations

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

Chloramine B– a good antiseptic with a deodorizing effect. Contains 25-28% active chlorine. Does not irritate the skin. Used:

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

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

5% - treatment of secretions of a tuberculosis patient

b) Iodine preparations

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

Pharmacological effects of iodine:

antiseptic

antisyphilitic

antifungal

expectorant

anti-sclerotic (improves lipid metabolism)

antithyroid

absorbable

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

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

Biguanides.

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

Oxidizing agents:

Hydrogen peroxide– upon contact with tissues, it decomposes in two ways:

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

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

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

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

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

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

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

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 low concentrations it is used for infectious eye diseases (trachoma, conjunctivitis), and in higher concentrations for the treatment of skin ulcers, erosions, cracks, as well as for the removal of excess granulations and warts.

Protargol, collargol– organic silver preparations.

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

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

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

Acids and alkalis: interact with proteins, the nature of the action depends on the concentration of the substance.

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

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

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

Ammonia solution(ammonia) has antiseptic and cleaning properties. Used for washing the hands of medical personnel and for cleaning premises.

Aldehydes and alcohols:

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

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

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

Cetylpyridinium chloride as part of the drug "Zerigel" used for hand treatment.

Aromatic antiseptics:

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

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

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

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

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

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

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

Nitrofurans.

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

Detailed instructions on different types of medical antiseptics for treating wounds: what antiseptics are, how they work and how to choose the right drug for different types of injuries

Summer has come - a time for active recreation, summer cottages and vegetable gardens. A time of abrasions and wounds, and therefore a high demand for antiseptics. More than 250 trade names of antiseptics in the form of ointments, solutions, sprays and powders are registered in Russia. Let's figure out which drugs are classified as antiseptics in medicine, how they differ from each other, and which of them can be recommended for every home medicine cabinet.

First of all, we note that the pharmacist independently selects the product only for external use, and the choice of antiseptic for the mucous membranes of the nasopharynx, gastrointestinal tract, respiratory and urinary tract, as well as for the genital organs remains with the doctor. We also remind you that many antiseptics cannot be applied to injured skin. Here are two main points to consider when selling and talking to a client. The mechanism of action of antiseptics may be different, depending on the main active ingredient.

Classification of antiseptics

Halides (halogens and halogen-containing compounds) Chlorine or iodine compounds (antiformin, iodoform, iodinol, Lugol's solution, chloramine B, chlorhexidine). The bactericidal effect is based on the fact that upon contact with organic substrates, these products release active halogens - chlorine and iodine, which destroy the proteins of microorganisms. Due to their high bactericidal activity, they are widely used both in medical institutions and at home. Oxidizing agents (hydrogen peroxide, potassium permanganate, hydroperite). In contact with tissues, they release active oxygen, which creates unfavorable conditions for the development of anaerobic and putrefactive microbes. They are used to a limited extent due to their moderate bactericidal activity and short shelf life. Acids (salicylic, boric). A shift in pH to the acidic side leads to denaturation of the protoplasmic protein of the bacterial cell. Salicylic acid has a weak antiseptic effect, and boric acid has a large number of side effects associated with toxicity. Currently, antiseptics for treating skin are practically not used as antiseptics. Alkalis (ammonium hydroxide, sodium tetraborate). Currently, drugs are practically not used as antiseptics due to their low antiseptic activity. Aldehydes (formalin, lysoform). Penetrating inside the microbial cell, they come into contact with the amino groups of proteins, which leads to cell death. The same effect explains the strong irritant effect on human mucous membranes and skin. Currently, they are used more for disinfecting surfaces in medical institutions. Alcohols (ethyl). They dehydrate tissues and irreversibly coagulate the proteins of microorganisms. They are used quite widely and have a pronounced antiseptic effect. In 2006, the WHO declared alcohol-based hand sanitizers to be the gold standard for hand sanitizer. Cationic antiseptics (benzyldimethyl-myristoylamino-propylammonium). The active substance acts on the membranes of microorganisms, leading to their death. It has a very wide spectrum of antimicrobial action, stimulates the immune system, and accelerates the healing process of wounds. Widely used in surgery, obstetrics, gynecology, traumatology, burn therapy, otorhinolaryngology and other areas of medicine. Salts of heavy metals (preparations of mercury, silver, copper, zinc, lead). The antimicrobial effect is associated with blocking the sulfhydryl groups of microbial enzymes. Use is limited due to toxicity. Dyes (methylene blue, brilliant green, fucorcin). They are active against gram-positive bacteria and cocci. Methylene blue has a very weak antiseptic effect and is practically not used. Herbal antibacterial drugs (urzaline, calendula tincture, imanin and others). Weak antiseptic properties. Rarely used.

All these substances have different degrees of activity, antimicrobial spectrum and toxicity. To understand how to choose the right antiseptic, you need to be guided by all these characteristics in accordance with the intended purpose: primary wound treatment, treatment of festering wounds, or treatment of damaged mucous membranes or intact skin/mucous membranes. When choosing which antiseptic to treat a particular wound, you must also follow the instructions in order to avoid side effects, as well as determine the dosage required in a particular case. Let's take a closer look at the most popular antiseptics.

Ethyl alcohol

At a concentration of 40 to 70% it exhibits its disinfecting properties, above 70% it exhibits tanning properties. It is commercially available in the form of alcohol-containing wipes and alcohol solutions. Do not apply to mucous membranes as it causes chemical burns. Only the edges of the pre-washed wound are treated with ethyl alcohol. It is not recommended for use in children, since even when applied externally it can be absorbed into the systemic bloodstream and depress the respiratory center.

Hydrogen peroxide

Only a 3% solution is used to treat wounds (a higher concentration can cause a chemical burn). It is also used as a hemostatic agent. Hydrogen peroxide is an excellent remedy for primary wound treatment (washing), as it has great cleaning ability - dirt particles and damaged cells are mechanically removed with the resulting foam. You can treat wounds both on the surface of the skin and on the mucous membranes. Hydrogen peroxide is generally not used on healing wounds, as it prolongs the period of complete healing. It is also not used for deep wounds and is not injected into body cavities. When stored in light, it loses its active properties. Opened packaging is stored for about a month, closed - 2 years.

Iodine/povidone-iodine

Used in an alcohol solution (the so-called “tincture of iodine”) or in Lugol’s solution. Only the edges of the wound are treated with iodine so as not to cause soft tissue burns. The great advantage of iodine is its wide spectrum of antimicrobial activity: it kills all major pathogens and, with prolonged exposure, even spores - the most resistant forms of microorganisms. The use of large quantities of iodine is contraindicated in cases of hypersensitivity to it, hyperfunction of the thyroid gland, formations of the thyroid gland, dermatitis, and kidney diseases. Application to mucous membranes is not advisable, especially in children.

Chlorhexidine bigluconate

Belongs to the group of halogens. Typically used in concentrations of 0.5–4.0%. At lower concentrations, the bactericidal activity of chlorhexidine decreases, therefore, as an antiseptic in this case, it is used only in an alcohol solution. Chlorhexidine has bacteriostatic, fungicidal, antiviral properties. However, 1% chlorhexidine against fungi and mycobacterium tuberculosis has a weaker effect compared to povidone-iodine. The drug can be used for the initial treatment of injured skin areas, as well as to accelerate the healing of purulent wounds and for the treatment of damaged mucous membranes. In most cases it is well tolerated. There are no age restrictions for use - a good antiseptic option for children. It is not recommended to use together with iodine preparations (often skin irritation).

Benzyldimethylmyristoylaminopropylammonium

It is used as a solution for washing wounds or as an ointment for application to purulent wounds. It is active against viruses, bacteria, fungi, and protozoa, but has virtually no effect on human cell membranes, unlike chlorhexidine. It has an antiseptic, immunostimulating and wound-healing effect. The immunostimulating effect is associated with the ability of the drug to increase the activity of phagocytes and macrophages. The positive effect on wound healing is explained by the fact that the active substance absorbs pus and fluid released during inflammation of wounds. At the same time, the product does not irritate healthy tissues and does not interfere with the growth of new tissues. The main indication for use is the prevention of suppuration and treatment of purulent wounds. Can be applied to mucous membranes. Can be used to treat wounds for children over 3 years of age.

Potassium permanganate (potassium permanganate)

Currently used mainly in hospital settings. In the pharmacy, the antiseptic is sold in the form of a powder for preparing a solution. Potassium permanganate is used to wash wounds of the skin and mucous membranes. Suitable for primary treatment and for treating festering wounds (has cleansing properties due to active oxygen), especially when there is a danger of anaerobic microorganisms entering the wound. Before washing the wound, you need to prepare a fresh solution each time.

Brilliant green solution

Everyone's favorite "green". Available in the form of alcohol solutions and pencils. It has a moderate antiseptic effect and is effective against gram-positive bacteria. Only the edges of the wounds are treated with the solution, without going into damaged tissue. Has a drying effect. It is used until fresh granulation tissue begins to appear in the wound, since long-term use prevents adequate healing of the wound edges. Can be used as a children's antiseptic.

Fukortsin

Coloring antiseptic. A combination of fuchsin, boric acid, phenol, acetone, resorcinol and ethanol. Indications for the use of fucorcin are fungal and pustular skin diseases, abrasions, cracks, etc. Apply to the edges of wounds. Has less drying effect than brilliant green and iodine. It is used much less frequently in wound treatment. It is undesirable to use in children due to boric acid and phenol, which have a large number of side effects. When applied to the skin, boric acid easily penetrates the blood (especially in children) and enters the internal organs and tissues, accumulating there. Therefore, long-term use can cause intoxication. This property forced us to sharply limit the use of boric acid, especially in childhood. Phenol also has the ability to easily penetrate the skin and lead to intoxication of internal organs.

Octenidine (octenidine dihydrochloride)

A cationic surfactant with antimicrobial activity against gram-positive and gram-negative bacteria, viruses, as well as against yeast-like fungi and dermatophytes (fungi that feed on keratin and cause dermatomycosis). Similar in action to quaternary ammonium compounds (QAC). The damaged surface is completely processed. Can be used on mucous membranes. The antiseptic has no age restrictions and is used for children. Currently, it is the drug of choice in Europe as an antiseptic due to its wide spectrum of action and maximum speed of achieving effect.

Table 1.
Comparative characteristics of the main antiseptics

Antiseptic	For leather processing	For treating wounds	For mucous membranes	Applicability for children
Ethyl alcohol	+	_	_	-
Hydrogen peroxide	+	+	+	+
Iodine	+	_	- / +	- / +
Chlorhexidine	+	+	+	+
Potassium permanganate	+	_	_	+
Diamond green	+	_	_	+
Fukortsin	+	_	_	_
Benzyldimethylmyristoylaminopropylammonium	+	+	+	+
Octenidine	+	+	+	+

In every first aid kit

So, what products can a pharmacy worker recommend to a buyer for a home first aid kit? First of all, these are benzyldimethyl-myristoylamino-propylammonium and octenidine, as the most universal and safe agents. These drugs are the drugs of choice and should be recommended first. Chlorhexidine is also quite versatile, which is used on intact tissues and for treating wounds, including mucous membranes. As for solutions of brilliant green and iodine, it is necessary to inform the buyer that these antiseptics are only suitable for treating wound edges and should not be used on mucous membranes. Thus, among the entire list of antiseptics presented on the pharmaceutical market, a fairly small number of drugs have universal application possibilities.

Sources

1. Kharkevich D. A. Pharmacology. M. Geotar Medicine. 2010.
2. Blatun L. A. Miramistin in a comprehensive program to combat hospital infections in a surgical hospital // Miramistin: application in surgery, traumatology and combustiology: collection of works / ed. Yu. S. Krivosheina. M., 2006.
3. Carolin Fromm-Dornieden, Gorovtsov A. V., Nadine Schӓfer, Ewa K. Stuermer. Comparison of the rate of suppression of the growth of E. COLI, STAPHYLOCOCCUSAUREUS and PSEUDOMONASAERUGINOSA by modern antiseptics for the purpose of their use for infected wounds // Fundamental Research. - 2013. - No. 10–2.

Antiseptic is a substance that is used in medicine and everyday life to completely destroy pathogenic microflora or delay its reproduction. There are quite a lot of such drugs on the pharmacological market. They are systematized according to various criteria, ranging from the strength of the effect on microorganisms and ending with the area of ​​application. So what are antiseptics, what are their types and areas of application? Are antiseptics in medicine and everyday life the same thing, or is there a significant difference? Let's figure it out.

What is an antiseptic for?

The word “antiseptic” is Greek in origin and literally means “against rotting.” In medicine, an antiseptic is one of the methods of disinfection, which involves influencing pathogenic microorganisms through various influences: physical, chemical, mechanical or biological. The action of such a substance should lead to the complete destruction or cessation of the development of bacterial, fungal, microbial microflora.

In order for a pathogenic microorganism to develop and multiply, it needs a special environment and conditions. For example, the presence of oxygen and moisture, as well as stable temperature indicators, are important for the bacterial flora. Antiseptics in medicine are a common name for all disinfecting instruments that give the desired result. They are classified according to different indicators.

Types of antiseptics

1. Mechanical, allowing to clean the wounded surface and non-viable tissue. This means washing the surface with purulent formation, cleaning the bottom of the wound, and excision of its edges.
2. Chemical antiseptic techniques are used to treat wound infections, as well as for preventive purposes. Such antiseptic solutions are considered harmful to microorganisms.
3. Biologicals are the largest group of drugs. This includes, for example, vaccinations. Their action also extends to microbial cells, affecting its toxins. This disinfection further increases the body’s protective functions.

A separate type is the simultaneous use of several drugs as an antiseptic. This group is also quite common. Thus, to treat a wound, doctors use several antiseptic methods - mechanical (external surface treatment) and biological (administration of antitetanus serum).

Each type implies a huge number of different ones. They are used:

• for the treatment or prevention of infectious suppuration;
• for disinfection of premises and instruments;
• dual use.

Antiseptics are used in medicine depending on what effect they are designed for - internal or external. For external use, preparations are usually used in the forms of ointments, sprays, lotions, rinses, etc. Antiseptics for oral administration (in most cases, these are antibiotics) are available in the form of tablets, powders, and sometimes rectal suppositories.

Each antiseptic has instructions for use, which clearly indicate how it should be used. If the package says “For external use,” then this drug should never be swallowed. Even if it is used to rinse the oral mucosa, it should be spat out.

Classification of antiseptics

Classification of antiseptics. Photo: acs-nnov.ru

At their core, antiseptics and disinfectants, as well as products with a bactericidal effect, are one and the same thing. They are destructive for pathogenic microflora or create conditions for the impossibility of its development and existence. It has already been said that the systematization of such drugs can be carried out according to various criteria. Let's look at some of the main classes into which antiseptics are divided in medicine, and look at their types in more detail.

According to the direction of action, antiseptics are distinguished:

• antiviral;
• antibacterial;
• antifungal.

From this classification it becomes clear which pathogenic microflora the product affects. An antiseptic acts on a living cell. Depending on the mechanism of the negative effect of the drug on its structure, they are classified:

• on direct-acting drugs, in which the antiseptic effect occurs on the destruction of any of the structural components of the cell or on its vital processes;
• on means of indirect influence, in which more attention is paid specifically to the immune response of the human body to infection.

The effectiveness of such funds also depends on many factors:

• on the concentration of the solution;
• on the duration of the effect of the antiseptic on the affected area;
• on how sensitive the pathogenic microflora is to the drug that is used as an antiseptic;
• on temperature indicators, as well as the chemical components of the environment in which the processing takes place.

As you can see, there are quite a lot of classifications. All disinfectants may fall under one of them, but in medical practice grouping by chemical composition is most often used. According to this classification, an antiseptic, based on its combination of chemical elements, can fall into one of the groups:

• halides;
• acid;
• oxidizing agents;
• alcohols;
• alkalis;
• salt;
• resins, tars, petroleum products;
• plant substances.

The most well-known antiseptics for the common man are (diamond solution) and methylene blue. This is a separate group - dyes. Disinfection with them is usually associated with the skin for treating wounds. Let's look at some other groups in more detail.

Halide group

Classification of antiseptics. Photo: molaviajar.com

Chloramine, iodine solution, and Pantocid act as an antiseptic of this chemical class.

1. Chloramine is a product that contains up to 20% active chlorine. This antiseptic appears as a powder (yellowish in color) with a faint odor of chlorine. A solution is prepared from it, which can be used to wash wounds and apply moistened wipes to them. They also disinfect their hands and medical instruments.
2. The iodine preparation is obtained from seaweed. These are well-known antiseptics in medicine: and, as well as potassium and sodium iodite,. The first drugs are used as an effective antimicrobial agent for mucous membranes and wound treatment.
3. Pantocide are tablets containing 3 mg of active chlorine. They are most often used in diluted form to treat hands and medical instruments, a 0.15% solution is used to treat wounds, and 2 tablets are used to disinfect 0.72 liters of water.

Acids

Classification of antiseptics. Photo: pinterest.es

The list of antiseptics in this group is also very impressive. The most common one is easily soluble in alcohol and hot water. In a percentage of up to 5% it is used as an external antiseptic; in a more concentrated form (up to 10%) it can be used in ointments or pastes. Salicylic alcohol is considered a powerful bactericidal and anti-inflammatory agent. It is recommended to be used for wiping if the skin suffers from rashes. There are a large number of powders and pastes containing salicylic acid on sale.

It is also very often used as an antiseptic. You can find it in the form of an additive to Vaseline, in Taimurov’s paste, or in an alcohol solution.

Oxidizing agents

- This is the most prominent representative of this group. It is found in two preparations: a water-based solution and a concentrated substance. Both of them have a transparent appearance and a weak specific odor. Its action is based on a chemical effect in which oxygen gas is produced under the influence of peroxide. Hydrogen peroxide is used in the treatment of wounds and mucous membranes.

Hydroperite is an antiseptic agent in the form of tablets, which contains urea. They dissolve in water. The drug is used for the same purpose as the first mentioned drug from the group of oxidizing agents.

Potassium permanganate or potassium permanganate are dark-colored crystals that dissolve in water. It is used as an antiseptic treatment in douching, gastric lavage in case of poisoning, and for rinsing mucous membranes.

Other groups

Classification of antiseptics. Photo: uhs.ae

Ethanol, propyl and isopropyl alcohol in concentrations from 60 to 90% are classified as alcohols in their chemical composition. They are used as an effective skin antiseptic. It is most often used in medical practice for treating the epithelium before infusion and other interventions. What belongs to alkali group antiseptics? This is the well-known ammonia, sodium borate, bicarbamint. The first two drugs use hand treatments in surgery. Bicarbamint, like boric potassium, can be used for rinsing mucous membranes and washing wounds as an antiseptic.

The drug containing heavy metal salts can also be used for disinfection. This group of antiseptics is dangerous enough to be used on wounds or skin. When working with it, you should follow the rules of caution. Most often, it is used to disinfect linen, room walls, etc.

• mercury dichlorite;
• mercury monochloride;
• copper sulfate;
• zinc oxide, etc.

Many have heard that ointments and creams are made from tar and petroleum products, which act as disinfectants. Such drugs include: ASD, naphthalene ointment, Sulsena, etc.

Use of antiseptics

Use of antiseptics. Photo: grouplimas.eu

The concept of “antiseptic” covers not only the medical part of this issue. The disinfection and antiseptic effect of certain substances is also used in various industrial sectors. In the food industry, they are often used in the form of preservatives, which help the product stay fresh longer and not spoil. Everyone knows acetic acid, which is the main antiseptic in canning. It is also included in the list of antiseptics.

Disinfectants are also actively used in the construction industry. They are found in fairly large quantities in varnishes and paints. Their action is aimed at destroying saprophytic bacteria. There is also a wood antiseptic, which shows a powerful fight against mold, rot and other processes, increasing the service life of wood.

Housewives also use disinfectants in everyday life. Antiseptic solutions can be found in cleaning products for bathroom accessories, dishes, floors, etc. If you bought a household cleaning product labeled “has a bactericidal effect,” this means that it contains some kind of antiseptic. The skin of your hands must be protected when working with such products. Some of them require mandatory ventilation of the room or careful removal after use. All precautions are indicated on the packages and must be followed.

Some popular antiseptics in medicine can also be used in everyday life. For example, well-known solutions for hand treatment. They are used as emergency hygiene - as a way to stop the transmission of pathogenic microflora in society. Also, everyone in the house has iodine or brilliant green, alcohol, hydrogen peroxide, which we use as antiseptics in case of minor injury to the skin.

Antiseptics are also used as a means of preventing the transmission of genital diseases. Taking them significantly reduces or minimizes infection.

What are antiseptics in medicine? These are drugs that are used to treat damage to the skin or mucous membranes by microorganisms. Antiseptics are active against protozoa, fungi, bacilli, bacteria, and have a wide spectrum of action. The most common antiseptics are represented by halogen-containing iodine preparations, substances from the group of oxidizing agents, for example, hydrogen peroxide, certain acids and alkalis (salicylic), dyes (diamond green) and so on.

Definition of antiseptics

What is antiseptics in medicine? Doctors and medical students know the definition by heart. This is a set of therapeutic and preventive measures carried out with the aim of destroying or significantly reducing the number of pathogenic microorganisms in the wound or the patient’s body as a whole. In the pre-antiseptic period, about 80% of patients died after operations due to putrefactive, gangrenous and purulent complications. Now (thanks to the use of antiseptic agents and aseptic methods) this can be avoided.

Antiseptics began to develop in the second half of the nineteenth century with the publications of J. Lister; in 1890, a new method was proposed by the German scientist Bergman, some of whose recommendations are still used today. Nowadays, many new methods of asepsis and antisepsis, as well as safe disinfectants, have appeared. In the last 25 years, dressing materials and medical instruments have begun to be introduced more widely.

Asepsis and antiseptics

In medicine, preventing infection during surgical interventions and minimally invasive methods of therapy and diagnosis is of fundamental importance. Infections can spread internally, that is, throughout the patient’s body, or externally, through the environment, including medical instruments, household items, and air.

The definition of asepsis and antisepsis in medicine is as follows: a set of measures aimed at preventing infection from entering the wound, organs and tissues of the patient during surgery and, accordingly, actions aimed at eliminating infection in the patient’s body in general or in the wound in particular. Antiseptics, as previously mentioned, can be performed for prophylactic or therapeutic purposes. In the first case, the wound is treated to prevent the development of infection, and in the second - if pathogenic microorganisms have already entered the body.

Aseptic and antiseptic measures

Actions aimed at preventing infections from entering the wound and the human body as a whole include: carrying out wet cleaning and regular ventilation in wards and other rooms; sterilization of instruments and devices used by orderlies, nurses and doctors, equipping operating rooms with special ventilation systems, as well as the use of sterile material. To eliminate infection for the purpose of therapy and prevention, bactericidal agents and antibiotics of general or local effect are used, bandages are applied and special solutions are used, wounds are opened and treated, foreign objects and dead tissue are removed from the wound cavity. Antiseptics and septic tanks in medicine are mutually exclusive (septic tanks mean rotting). To prevent infection, everything that touches a traumatic or surgical wound must be sterile.

Main types of antiseptics

Asepsis and antisepsis in medicine are part of surgical science. The concepts are closely interrelated and imply measures aimed at preventing infection from entering the patient’s body or treating an existing one. Methods and actions differ only formally. Thus, the types of antiseptics in medicine are:

1. Mechanical. Removing infected or non-viable ones, that is, opening and treating the wound, washing and other manipulations that ensure cleansing.
2. Physical. Treatment and prevention of infection through the use of physical factors that ensure the death of microbes or a significant reduction in their number. Example: the use of hypertonic solutions that draw the contents of the wound into a bandage.
3. Chemical. Exposure of pathological microorganisms to chemicals that have a bacteriostatic or bactericidal effect. It is better if such substances do not adversely affect healthy human cells and tissues.
4. Biological. Involves the use of biological products that act directly on microorganisms. These include antibiotics, bacteriophages, and antitoxins.
5. Mixed. Exposure to several types of antiseptics simultaneously.

In addition, there is a distinction between local and general antiseptics, and local is divided into superficial and deep. Superficial antiseptics involve the use of powders, creams, ointments, applications, while with deep antiseptics the drug is injected into the inflammatory focus (needling, penicillin-novocaine blockade). General antiseptics involves saturating the body with antiseptic substances, which are carried into the lesion through the blood and lymph flow, positively affecting the microflora.

The origins of antisepsis in surgery

Medieval doctors only guessed what an antiseptic was in medicine. Before the advent of modern drugs, only the mechanical method was widely used according to the principle: “If you see pus, let it out.” After the publication of J. Lister's work in 1867, the widespread use of antiseptics in medicine began. An English surgeon and scientist, inspired by L. Pasteur’s “microbial theory of putrefaction,” and convinced of the antiseptic properties of carbolic acid, applied a bandage to an open fracture. Before this, the Parisian pharmacist Lemer began to use acid.

Basics of the antiseptic method

The basics of the proposed antiseptic method were outlined by J. Lister in the article “On a new method of treating fractures...”, published in 1867. Thus, the surgeon created the first multicomponent method in history to combat pathogenic microorganisms that penetrate open wounds. Lister went down in the history of surgical science as the founder of antisepsis. The method involved applying a multilayer bandage, cleaning hands, sterilizing instruments, suture and dressing material, as well as the operating room.

In Russia, antiseptics were introduced by outstanding surgeons, among whom we can list K. Reyer, P. Pelekhin, who is the author of the first Russian publication on antiseptics, N. Sklifosovsky, S. Kolomin, I. Burtsev (the first surgeon who published his own results of introducing antiseptic method), N. Pirogov, L. Levshina, N. Velyaminov, N. Studensky.

Criticism and new methods

Lemaire's method found many supporters, but there were also opponents. What is an antiseptic in medicine when it comes to carbolic acid? This substance has a toxic effect on the patient’s tissues and organs, the surgeon’s hands, and the respiratory system (the solution was supposed to be sprayed in the operating room). This has led some surgeons to question the value of this method.

A quarter of a century later, the aseptic method replaced it, the results of which were so impressive that some doctors even began to abandon antiseptics. But over time, it became clear that in surgical practice one cannot do without antiseptics. Soon, several new agents were proposed, much less toxic than carbolic acid. Gradually, antisepsis became closely intertwined with asepsis. Currently, surgery is unthinkable without the unity of these two disciplines.

Common antiseptics

What is an antiseptic in medicine? This is a drug that has an antimicrobial effect. The mechanism of action of substances from different groups is not the same, some disrupt the permeability of the plasma membrane of a pathogenic microorganism, others disrupt the structure of the protein molecule or inhibit enzymes that are important for the life of fungi, viruses and bacteria. To ensure that antiseptics do not cause harm (after all, in appropriate concentrations they have a detrimental effect on most microorganisms), they must be used correctly.

The list of antiseptics in medicine that are most often used is as follows:

• alcohols (the most common are propyl, ethanol, isopropyl, mixtures thereof);
• (used in some disinfectants, antiseptic towels, toilet soap);
• boric acid (against herpes and in the treatment of fungal infections of the vagina);
• brilliant green (a dye still widely used as a solution to treat minor wounds and abscesses);
• chlorhexidine gluconate (antiseptic for skin and treatment of gum inflammation);
• hydrogen peroxide (used to treat wounds and scratches in everyday life);
• iodine solution (used for pre- and postoperative disinfection, not recommended for treating small wounds);
• octenidine dihydrochloride (the substance is active against a wide range of microorganisms);
• carbolic acid and other phenol compounds (used as a baby antiseptic powder for the navel, for rinsing the mouth and throat, and treating the hands of personnel).

Terms of use

Before treating any injury, you must wash your hands with soap, rinse the wound, or remove foreign bodies, remaining dirt, etc. with tweezers. If the wound or burn is extensive, then you should not pour antiseptic inside. For example, only the edges of the wound are treated with iodine so as not to cause a chemical burn, additional injury and lead to longer healing. It is not recommended to use antiseptic drugs for dermatological diseases without consulting a doctor.

Ethanol is used in medicine as an antiseptic, usually in or as part of other drugs in small dosages, but is not used in the mucous membranes of the eyes, throat or nose.

For the purpose of intimate prophylaxis, only the external genitalia, vagina and urethra are treated, but this is only possible with the help of suitable antiseptic drugs.

Antiseptics for the prevention and treatment of stomatitis, herpes, colds, pharyngitis, sore throat, and so on are available in various dosage forms. Rinse solutions, lozenges and lozenges, aerosols for inhalation, and more can be used. Some antiseptics may contain local anesthetics, deodorizing agents or essential oils.

Hand sanitizers

The simplest antiseptic, the use of which is sufficient to maintain hygiene rules, is ordinary soap. It is enough to wash your hands as needed: after a walk, before eating, before various body care activities, after visiting the toilet. You should not use an antiseptic every time - this will only disrupt the body's natural defenses.

Hand antiseptics in medicine and in everyday life are used as a means of hygiene in cases where ordinary soap and water are not available. It is advisable to use antiseptics that do not contain fragrances or alcohol. The formulations are usually available in the form of a spray or gel. Two milliliters of the drug are applied to dry skin of the hands and rubbed until dry, but for at least 15 seconds.

Non-medical use

Antiseptics are used in food production; for example, many preservatives are based on them. Paints and varnishes with antiseptic properties are used to protect wood from saprophytic microflora, protect against rot, insects, blue stains, mold, combustion and fire. Disinfectants are included in detergents.

Microbial resistance

With prolonged use of antiseptics, microbes may evolve and no longer accept such substances. Different antiseptics provoke bacteria to develop in different ways. The adaptation of microorganisms may also depend on the dosage: a low dose will not be enough to protect against infections. In addition, resistance to a particular compound may increase resistance to others.