ANTISEPTICS & DISINFECTANTS on microbes.pptx
- 1. ANTISEPTICS AND DISINFECTANTS KAWALYA STEVEN
- 2. Antiseptics and disinfectants Definition • Group of agents that are able to inhibit the growth, development or lead to death of microorganisms in the environment surrounding the patient or on the surface of the body.
- 3. Antiseptics and disinfectants • Antiseptics -(anti- against; septicas - putrid). used in wounds (skin, mucous membranes) in the gastrointestinal tract and urinary tract. • Disinfectants – • medical instruments, utensils, facilities, equipment, etc.
- 4. Antiseptics and disinfectants • Drawing a sharp line between antiseptics and disinfectants is not always possible, because many substances used in low concentrations as antiseptics, and higher - for disinfection
- 5. Requirements for antiseptics and disinfectants. • Must have a broad spectrum of action; • Rapid onset of action; • Should have a small latency period; • Must be chemically resistant;
- 6. Requirements for antiseptics and disinfectants. • High availability and low cost; • Lack of local irritant or allergic effects on tissues; • Minimal absorption from the place of their application; • Low toxicity.
- 7. Classification of Antiseptics and Disinfectants • According to chemical structure 1. Inorganic 2. Organic
- 8. Classification of Antiseptics and Disinfectants • Inorganic substances 1. Halogens 2. Oxidizing agents 3. Acids and alkali 4. Metallic salts
- 9. Classification of Antiseptics and Disinfectants (according chemical structure) • Organic substances 1. Aldehydes 2. Alcohols 3. Phenol derivatives 4. Dyes 5. Detergents 6. Tar, resins, products of petroleum 7. Nitrofuran derivatives 8. Antiseptics from medicinal plants
- 10. Antiseptics and disinfectants INORGANIC SUBSTANCES
- 11. Halogens The mechanism of antimicrobial action • Denaturation of proteins of the protoplasm of microbial cells by reacting with the amino group of the proteins, displacing hydrogen. • Denatured protein loses its activity.
- 12. Halogens (Iodines) Iodine - active bactericidal element. • Alcoholic solution of Iodine 5% • INDICATIONS: Disinfection of the surgical field, disinfection of wounds, the surgeon's hands, in myositis, neuralgia. • Iodine is partially absorbed into the blood from the skin. • SIDE EFFECT: Chemical burns, dermatitis.
- 13. Halogens (Iodine) • LUGOL'S SOLUTION • INDICATION: Mucosal lubrication in pharynhitis and larynhitis. • IODDICERINE (Iodine, dimethyl sulfoxide, glycerol) • Fungicidal, antibacterial, antiviral, antinecrotic, antioxidant effect. • !!!The most active Iodine preparation!!!
- 14. Halogens (Iodine) • Doesn’t irritate tissue, does not cause pain reaction, deeply penetrates into the tissue. • INDICATION: Inflammatory infection (purulent wounds, infectious ulcers, sore throats, tonsillitis, pulpitis, otitis, erosion of the mucous membranes, mastitis, candidiasis, inflammatory diseases of the genital organs). • Topically in the form of tampons, napkins, irrigation, washing.
- 15. Halogens (Chlorine ) CHLORINE - active bactericidal element • INDICATIONS: For the disinfection of premises, infective patients discharge (pus, sputum, urine, feces). • Corrosive to metals. CHLORAMINE B • INDICATION: eye wash, hand disinfection, douching treatment of purulent wounds, burns, pustular skin diseases . Disinfection of premises, health products and non-metallic tool.S
- 16. Halogens (chlorine) chlorhexidine bigluconate (bisdiguanidine derivative). • Has the properties of chlorine and detergent compounds. • Strong antibacterial and fungicidal action. • Bactericidal activity against GR+, Gr- bacterials, active against Treponema, gonococci, trichomonas.
- 17. Halogens (chlorine) indications: surgical area, the surgeon's hands, tools, burn surfaces, sepsis • tablets. - in infectious and inflammatory diseases of the mouth and throat. • 0.2% solution inhibits the formation of plaque and effective in treating gingivitis.
- 18. Halogens (chlorine) SIDE EFFECTS: Dry hands, itchy skin, dermatitis. • CHLORHEXIDINE is often used as an active ingredient in mouthwash to reduce dental plaque and oral bacteria. • It has an immediate bactericidal action and a prolonged bacteriostatic action due to adsorption onto the pellicle-coated enamel surface.
- 19. Oxidizing agents( hydrogen peroxide) • H2O2 = 2H + O2 molecular form of oxygen that is responsible for antimicrobial effect • Releasing oxygen makes foam that cleans and deodorizes putrid wounds and ulcers. • Hydrogen peroxide is used in treatment of infected wounds and to stop small bleeding.
- 20. Oxidizing agents( hydrogen peroxide) Indications: - rinsing the mouth and throat, wounds that are infected with anaerobic microflora. Concentrated solutions (20-30%) is indicated for the treatment of warts, lichen planus (autoimmune inflammatory condition of the skin and mucous membrane). Side effects: - burn mucosa. Not used in deep wounds, and not introduced into a body cavity - may cause embolism.
- 21. Oxidizing agent (potassium permanganate) • 2KMnO4 + H2O = 2KOH + 2MnO2 + 3O2 It liberates oxygen in atomic form. • Highly water soluble. • Higher concentrations cause burns and blistering. • It promotes rusting. Clinical uses: • Gargling, irrigating cavities, urethra and wounds. • Stomach wash in alkaloid poisoning. • In a 2-5% solution is used for burns, bites of mosquitoes and snakes, for quick healing of wounds. • Disinfection of water
- 22. Heavy metal compounds. • M.O.A: block sulfhydryl, carboxyl and amino groups of proteins and enzymes of microorganisms. • Metal ions are formed by dissociation of the salts, interaction with these active biosubstrates functional groups cause their denaturation. • At a deeper penetration of the substance in the tissue causes irritated cells and nerve endings effect, and the extreme manifestation of a cauterizing effect of metal salts.
- 23. Heavy metal compounds. • Hydrargyri dichloridum (Hg- mercury) • Hydrargyri amidochloridum (Hg-mercury) • Silver nitrate • Copper sulfate • Zinc sulfate • Zinc oxide • Pb (lead), Al (aluminium), Zn (zinc), Cu (copper), Ag (silver), Hg (mercury).In such sequence of increasing antimicrobial activity. As antiseptics most active are metal salts on the right side of the row.
- 24. Heavy metal compounds. • Prolonged use of salts of heavy metals can be cytotoxic due to the inhibition of thiol enzymes in the tissues. • Symptoms of poisoning with salts of heavy metals: a chemical burn of GIT mucosa, the weakening of cardiac activity, kidney and liver damage.
- 25. Heavy metal compounds. • In cases of poisoning: gastric lavage with water, tea solution with activated carbon, milk, raw eggs, Unithiol (2,3 –dimecapto-1- propane-sulfonate),Tetacin calcium or Sodium thiosulfate. Symptomatic treatment: cardiac glycosides, sympathomimetic, plasma expanders, vasoconstrictors, narcotic analgesics.
- 26. Acids and alkalis (acids) • boric acid, salicylic - Shift the pH to the acid side → protein denaturation of microbial cell protoplasm. Act on proteins of the skin and mucous membranes forming dense, insoluble albuminates, that provides anti- microbial, anti-inflammatory, antifungal effects. • In high concentrations cauterize tissue (coagulative necrosis )!
- 27. Acids and alkalis (acids) • Boric acid: used for washing and rinsing of the mucous membranes of the mouth, diaper rash, acute and chronic otitis media, colitis, pyoderma, pediculosis. • Side effect: It penetrates through the skin and mucous membranes, especially in children. • With long-term use in patients with impaired renal function develops acute and chronic poisoning (nausea,vomiting, diarrhea, skin rashes, confusion, loss of consciousness, convulsions, oliguria, sometimes shock).
- 28. Acids and alkalis (acids) • Salicylic acid: Weak antiseptic, irritant, low concentrations (1-3%) – keratoplastic, in high (5% -10%) - keratolytic effect. • Application: Oily seborrhea, acne, eczema, psoriasis, warts etc.
- 29. Acids and alkalis (Alkalis) • NaHCO3, sodium tetraborate, sol. of ammonia. • NaHCO3, sodium tetraborate – melt mucin, a softening effect. In Inflammatory exudate and pH shifts to the alkaline side reducing the manifestations of inflammation. • 10% ammonia solution exhibits antiseptic effect, manifests cleaning properties, dissolves fat. Given these properties, it is suggested for washing hands before surgery (25 ml solution of ammonia diluted in 5 liters of water).
- 30. Antiseptics and disinfectants ORGANIC SUBSTANCES
- 31. Organic antiseptics (Phenol) carbolic acid • 3-5% solution for disinfection of furniture, hospital linen. • 0.25-1% - sometimes in skin diseases accompanied by itching. • 0.1-0.5% - conservation of serum and suppository. • Readily absorbed through intact skin and mucous membranes, causing intoxication (short-term stimulation of the CNS, respiratory depression and cardiac activity, decrease in body temperature, damage of parenchymal organs).
- 32. Organic compounds (Phenols) Resorcinol • In small doses has keratoplastic property, in high doses - keratolytic. • Used for the treatment of skin diseases (eczema, seborrhea), fungal infections (2-5% solutions, 5-20% ointment, paste). Birch tar • Has: antimicrobial, keratoplastic, keratolytic and irritant effect. • Is used to treat a number of skin diseases and scabies.
- 33. Group of aldehydes and alcohols Formaldehyde solution (Formalin) • Has antimicrobial (vegetative forms and spores) and deodorizing effects. • MECHANISM OF ACTION: dehydration of microbial cells protoplasm proteins causing its destruction. • Is used as a disinfectant and deodorant, skin treatment with sweating (0.5-1%), disinfection of tools (0.5%). For the preservation of anatomical objects.
- 34. Group of aldehydes and alcohols Ethyl alcohol • Bactericidal activity starts with alcohol 20% and increases with concentration. On the spore form does not affect. • High concentrations of alcohol in the protein environment form dense protein aggregates. • 70% - deeply penetrates into the deeper layers of the epidermis of the skin, sebaceous and sweat glands, provides a high antiseptic effect (antimicrobial strength of 70% is equal to 3% phenol sol.).
- 35. Group of aldehydes and alcohols • Application: disinfection of hands and operating field (70%). • Sterilization of surgical instruments (90-96%). • Disinfection of the skin before injection (70%). • For the preparation of medicaments.
- 36. Group of dyes Ethacridine lactate (rivanol), Brilliant green, Methylene blue • Antimicrobial activity of this group falls In the protein environment • The most sensitive Gr + bacteria, cocci.
- 37. Group of dyes Ethacridine lactate (rivanol): - used in surgery, gynecology, urology, ophthalmology, dermatology. For washing of fresh and infected wounds, cavities (pleura, peritoneum), bladder, uterus. Brilliant green (1-2% water and alcohol sol.): - for the treatment of skin with scratches, pyoderma, blepharitis, and others.
- 38. Group of dyes Methylene blue: - used internally for urinary tract infections (cystitis, urethritis). - In case of poisoning with hydrocyanic acid or salts (in large doses translates hemoglobin to methemoglobin which forms a non-toxic form of cyanide complex cyanmethemoglobin). - To the contrary methylene blue in small doses restores methemoglobin in to hemoglobin (with nitrite poisoning, aniline, and others.)
- 39. Nitrofuran derivatives (furacillin, furazolidone) • Spectrum of action: Gr-, Gr + bacteria (staphylococci, streptococci, dysentery bacillus, intestinal coli, Salmonella paratyphi, the causative agent of gas gangrene, etc.) and protozoa (Trichomonas, Giardia). • Pharmacodynamic: nitrofuran undergoes reduction by microbes nitro reductase, and they transformation into toxic products for cells which forms covalent bonds with various cellular components such as DNA affecting protein synthesis
- 40. Nitrofuran derivatives (furacillin, furazolidone) • In the presence of pus does not lose effectiveness. • Apply for external treatment of wounds, skin, mucous membranes, wash serous and joint cavities, otitis media, conjunctivitis and others. Eye diseases and orally for the treatment of bacterial dysentery.
- 41. Detergents • Detergents - a substances with a high surface activity. • Show antiseptic and cleansing action. • Distinguish anionic and cationic detergents. • Anionic detergents include ordinary soaps (sodium or potassium salts of fatty acids). • As antiseptics mainly used cationic surfactants: benzalkonium chloride, cetylpyridinium chloride, miramistim.
- 42. Detergents • Benzalkonium chloride • Antibacterial, antiprotozoal, antiviral and antifungal • Used for treatment of skin, mucous membranes, wounds, rinsing the bladder, urethra.
- 43. Detergents Miramistim • Antiseptic, antiviral, antibacterial agent • Gr-, Gr +, anaerobes, fungi.. Application: used as a 0.01% solution as an antiseptic in dental practice for the treatment of infected wounds, burns, infections of upper respiratory tract, urogenital system, stimulates local non-specific immunity, accelerates regeneration.
- 44. Detergents Cetylpyridinium chloride in the composition of the drug "Tserigel" is used for hand washing before surgery.
- 45. QUIZE 1. Why haven’t we discussed the pharmacokinetics of antiseptics and disinfectants? 2. Discuss the following: • Tar, resins, products of petroleum • Antiseptics from medicinal plants
- 46. Thank you)))
- 47. Reference • Basic and clinical pharmacology (Bertram G. Katzung) • Goodman and Gilman’s The Pharmacological Basis of Therapeutics,13th Edition