Irritants. Pharmacodynamics of drugs
Irritating drugs are called drugs that, when in contact with sensitive nerve endings, cause their depolarization and excitation, providing a local irritant effect, accompanied by reflex reactions in the form of improved blood supply and tissue trophism, and pain relief.
Neurohumoral action. Due to the resorptive effect of biologically active substances that were formed in the zone of skin irritation, as well as increased afferent impulses from neurons of the reticular pharmacy. In this case, there is a change in the exchange of brain mediators:
Antinociceptive factors are released: -endorphin, enkephalin.
The release of nociceptive mediators decreases: substance P, somatostatin, cholecystokinin.
The secretion of releasing hormones, ACTH, TSH increases, which ultimately increases the activity of the hypothalamic-pituitary-thyroid and hypothalamic-pituitary-adrenal systems, which have an anti-inflammatory effect.
M 
enthol (Menthol) It is an alcohol of the terpene series, has a very strong mint smell and a cooling taste. The local action is associated with an effect only on cold receptors, therefore, immediately after application, it causes a sensation of a feeling of cold, turning into a light terminal anesthesia. At the same time, vasoconstriction of the skin and mucous membranes develops at the site of application of menthol and edema decreases. Thus, the local action of menthol has a number of significant differences from the action of other irritants.
The reflex action is associated with the development of skin-visceral reflexes, the reflex arc of which does not affect the brain, but closes at the level of the spinal cord. It manifests itself in the form of an expansion of the spasmodic vessels of the internal organs and skeletal muscles, as well as a contraction of the vessels of the meninges. Previously, they tried to use menthol to stop angina attacks (as part of Validol tablets for sublingual use). However, its effect was comparable to the placebo effect. This is explained by the fact that the attacks of classical angina pectoris are based not on a functional spasm, but on an organic narrowing of the vessel lumen by atherosclerotic plaques.
Additional effects:
In small doses, when administered orally, it has a carminative (carminative) effect, which is characterized by moderate stimulation of gastrointestinal motility and relaxation of the sphincters, resulting in improved gas discharge.
When taking large doses, it can have a resorptive effect, which is manifested by a decrease in blood pressure and depression of the central nervous system.
At the site of application, it has a non-selective antiseptic effect due to the dissolution of bacterial cell membranes in lipids and disruption of their normal functioning.
Indications for use and dosing regimens:
In inflammatory diseases of the upper respiratory tract (rhinitis, pharyngitis, laryngitis, tracheitis) - in the form of inhalations, lozenges and instillations into the nose 4-6 times a day.
With neuralgia, myalgia and arthralgia - in the form of rubbing a 2% alcohol solution or 10% oil suspension 3-4 times a day.
With migraine - rubbing the reflex zones of the trigeminal nerve (temporal, forehead) with a pencil during an attack.
To stop nausea - resorption of lozenges or tablets.
To eliminate the undesirable effect of nitroglycerin (facial flushing and headache due to vasodilation of the meninges) - in the form of a tablet under the tongue at the same time as taking nitroglycerin.
NE: Ingestion in large doses causes abdominal pain, nausea, vomiting, dizziness. In children of the 1st year of life, upon contact with the mucous membranes of the nasopharynx, it can cause reflex depression and respiratory arrest. Sometimes causes allergic reactions in the form of contact dermatitis.
PV: powder, menthol oil 1 and 2% in 10 ml vials, alcohol menthol solution 1 and 2%, menthol pencil ( stylusMentholi). Combined drugs: ointment "Gevkamen" ( « Geucamenum» ), Pectussin tablets ( « pectus sinum» ), validol (25-30% solution of menthol in isovaleric acid methyl ester) tablets of 60 mg, etc.
Purified turpentine oil (OleumTerebinthinaerectificatum) It is an essential oil (the main component is -pinene), obtained by distillation of resin from Scots pine (Pinussilvestris L.). It has the appearance of a clear, colorless mobile liquid with a characteristic odor and a pungent taste.
It has a local and reflex irritant effect, neurohumoral effect. It is mainly used externally as part of ointments and liniments for rubbing with neuralgia, myositis, neuritis. Sometimes prescribed for inhalation (10-15 drops per 200 ml of hot water) for purulent bronchitis, bronchiectasis.
NE: Nausea, vomiting, albumin- and hematuria when taken orally. When applied topically in high doses, it causes erythema and a vesicular eczema-like rash.
VW: vials of 50.0; turpentine ointment (Unguentum Terebimthinae) cans of 50.0 each; complex turpentine liniment (Linimentum Olei Terebinthinae compositum) bottles of 80 ml.
Ammonia solution (SolutioAmmoniicaustici) It is an official solution of 9.5-10.5% ammonia in water with a sharp characteristic odor, strongly alkaline reaction.
MD: It has a reflex irritant effect when inhaled vapors. Ammonia activates the receptors of the sensitive endings of the trigeminal nerve in the nasopharynx and enhances the flow of impulses from them to the nuclei of the respiratory center and the activating part of the reticular formation of the brain stem. This causes increased and deepening of breathing, increased vascular tone.
Application:
As a means of emergency care for syncope to return the patient to consciousness. To do this, a small piece of cotton wool or a gauze ball is moistened with an ammonia solution and brought to the nostrils for 0.5-1 s.
Inside as an emetic (5-10 drops per ½ cup of water) for alcohol and drug intoxication (only if the patient is conscious).
Earlier in surgical practice, it was widely used for washing hands according to the method of S.I. Spasokukotsky - I.G. Kochergin based on the nonspecific antimicrobial effect of ammonia associated with lipid damage to bacterial membranes. Used at the rate of 25 ml per 5 liters of warm boiled water (0.5% solution).
NE: When inhaling high concentrations of ammonia vapor, reflex respiratory arrest is possible. Locally - colliquative burns of mucous membranes and skin. Help for burns is to wash the place of contact with ammonia with water for 15 minutes or a 0.5-1.0% solution of citric acid. Oils and oil-based ointments should not be used in first aid for 24 hours after a burn.
VW: liquid in vials of 10.40 and 100 ml, ampoules of 1 ml. Combined preparations: ammonia liniment ( Linimentumammoniatum), ammonia-anise drops ( LiquorAmmoniianisatus) liquid in vials of 25 ml.
1 Drugs from the group of expectorants, bitters, choleretic and laxatives will be discussed in the relevant sections on the pharmacology of drugs that affect the functions of the executive organs.
2 The dependence of the amount of ionized and non-ionized fraction of the main drug substance in tissues at different pH is determined by the Henderson-Hasselbach ratio:
. By substituting in turn the minimum and maximum values of pH and pK BH + into the equation, it is easy to calculate the proportion of non-ionized drug.
3 Previously used as a local anesthetic, cocaine differs in its resorptive action from other local anesthetics: it causes CNS stimulation, increased heart rate, tachycardia, and increased blood pressure due to vasoconstriction. This uniqueness is due to the combination of local anesthetic and sympathomimetic effects in cocaine.
4 The antiarrhythmic properties of lidocaine are discussed in more detail in the corresponding section.
5 Previously, the pharmaceutical industry produced 250 mg tablets for the oral treatment of arrhythmias. However, taking pills had no effect on the course of arrhythmia, since their bioavailability was less than 1% due to intensive first pass metabolism.
6Currently Helicobacter pylori one of the leading roles in the development of gastric ulcer and duodenal ulcer is assigned.
7 In the treatment of diarrhea of infectious genesis (preservation of loose stools for more than 48 hours or the presence of fever), it is also necessary to prescribe antibacterial agents and replenish fluid losses.
The number of substances that can cause skin irritation is very large. In contact with living tissues (skin), they cause a feeling of pain (burning, tingling), its redness and an increase in (local) temperature. Moreover, some substances enter into a chemical reaction with living protoplasm (alkalis dissolve proteins, halogens oxidize). Other substances, which are chemically indifferent, act more or less selectively - in small concentrations, they predominantly excite the endings of sensory (afferent) nerves. Such substances are used for medicinal purposes, they form a group of special irritants. These include many essential oils, some ammonia preparations.
Ammonia solution (ammonia)
Transparent colorless volatile liquid with a pungent characteristic odor - 10% ammonia solution in water. Easily penetrates into tissues, exerting a stimulating effect on the central nervous system (breathing becomes more frequent, blood pressure rises). High concentrations may cause respiratory arrest. It is used to bring the patient out of a fainting state, for which a small piece of cotton wool moistened with ammonia is carefully brought to the nasal openings. Inhalation of it, acting on the receptors of the upper respiratory tract (the end of the trigeminal nerve), has an exciting effect on the respiratory center (excites breathing). Applied inside (2-3 drops) in half a glass of water for acute alcohol poisoning. The solution also has an antimicrobial effect and cleanses the skin well.
Peppermint
Peppermint is a cultivated perennial herb that contains an essential oil containing menthol.
An infusion of peppermint leaves (5 g per 200 ml of water) is used internally against nausea and as a choleretic agent.
Peppermint oil is obtained from the leaves and other ground "parts of the plant, contains 50% menthol, about 9% menthol ester with acetic and valeric acids. It is included in rinses, toothpastes, powders as a refreshing and antiseptic agent. It is an integral part of the Corvalol preparation. "("Valocordin"). The sedative and antispasmodic effect is associated with the presence of menthol.
Peppermint tablets - used as a sedative and antispasmodic for nausea, vomiting, spasms of smooth muscles, 1-2 tablets per intake under the tongue.
Mint drops - consist of tincture of alcohol mint leaves and peppermint oil. Applied inside 10-15 drops per reception as a remedy for nausea, vomiting, analgesic for neuralgic pain.
Tooth drops, composition: mint oil, camphor, valerian tincture, painkiller.
Menthol
Colorless crystals with a strong mint odor and a cooling taste. Obtained from peppermint oil, as well as synthetically. When rubbed into the skin and applied to mucous membranes, it causes irritation of nerve endings, accompanied by a feeling of slight cold, burning, tingling, and has a local analgesic effect. Externally used as a sedative and analgesic for neuralgia, arthralgia (rubbing an alcohol solution, oil suspension, ointments). With migraines, they are used in the form of menthol pencils. In inflammatory diseases of the upper respiratory tract (runny nose, pharyngitis, laryngitis, etc.), menthol is used for lubrication and inhalation, as well as in the form of nose drops. Lubrication of the nasopharynx with menthol is contraindicated in young children due to possible reflex inhibition and respiratory arrest. Menthol is an integral part of Zelenin drops.
Validol
A solution of menthol in menthol ester of isovaleric acid. It is used for angina pectoris, as it can, as a result of irritation of the receptors of the oral mucosa, reflexively cause the expansion of the coronary vessels. Used for nausea, neuroses. 2-3 drops per piece of sugar (bread) or tablet - under the tongue for a faster and more complete effect of the drug. Hold until complete resorption.
Pectusin
Tablets, composition: menthol, eucalyptus oil, sugar, other fillers. Used for inflammatory diseases of the upper respiratory tract. Keep in the mouth until completely absorbed.
eucalyptus leaf
Dried leaves of cultivated eucalyptus trees. Contains essential oil, organic acids, tannins and other substances. The decoction is prepared from the calculation: 10 g of leaves are poured into a glass of cold water and boiled over low heat for 15 minutes, cooled, filtered. For rinsing with diseases of the upper respiratory tract, for the treatment of fresh and infected wounds, inflammatory diseases of the female genital organs (lotions, washings) and inhalations: 1 tablespoon per glass of water.
Eucalyptus tincture - inside as an anti-inflammatory and antiseptic, sometimes as a sedative 10-15 drops per glass of water.
Eucalyptus oil, indications are the same, 10-15 drops per glass of water.
Capsicum fruit - mature dried fruits of capsicum.
Capsicum tincture
Applied externally for neuralgia, radiculitis, myositis for rubbing.
Ointment for frostbite
Ingredients: tincture of capsicum, formic alcohol, ammonia solution, camphor oil and castor oil, lanolin, lard, petroleum jelly, green soap. Used to prevent frostbite. Rub a thin layer on the exposed parts of the body.
Pepper plaster
A mass containing an extract of capsicum, belladonna, arnica tincture, natural rubber, pine rosin, lanolin, vaseline oil, applied to a piece of cotton fabric. It is used as an anesthetic for radiculitis, neuralgia, myositis, etc. Before applying the patch, the skin is degreased with alcohol, cologne, ether and wiped dry. The patch is not removed within 2 days, if there is no strong burning sensation. When irritation is removed, the skin is lubricated with petroleum jelly.
Turpentine oil (purified turpentine)
An essential oil obtained by distillation of resin from Scots pine. It has a local irritant, analgesic and antiseptic effect. Applied externally in ointments and liniments for rubbing with neuralgia, myositis, rheumatism, sometimes inside and for inhalation with putrefactive bronchitis, bronchiectasis and other lung diseases. Contraindicated in lesions of the parenchyma of the liver and kidneys.
See also:
Various laxatives.
Magnesia white (basic magnesium carbonate) - white light powder, practically insoluble in water. As a mild laxative, adults are prescribed 1-3 g, children under one year old - 0.5 g each, from 6 to 12 years old - 1-2 g per dose 2-3 times a day. White magnesia is also used externally as a powder and inside - with increased acidity of gastric juice ...
Irritants- drugs, the pharmacological action of which is mainly due to the stimulating effect on the endings of the afferent nerves of the skin and mucous membranes.
Irritants include some synthetic substances and products of plant origin. From synthetic substances R.'s properties with. possess ammonia, formic acid, ethyl alcohol, dichloroethyl sulfide (yperite), trichlorotriethylamine, methyl salicylate, nicotinic acid derivatives (for example, b-butoxyethyl ester of nicotinic acid, ethyl nicotinate), etc. These substances are used as R. with. in various dosage forms intended for external use. for example, ammonia is used in the form of a solution of ammonia (Solutio Ammonii caustici) and ammonia liniment (Linimentum ammoniatum; synonymous with volatile ointment); formic acid - in the form of formic alcohol (Spiritus Acidi formici), which is a mixture of 1 part of formic acid and 19 parts of 70% ethyl alcohol. Dichlordiethyl sulfide is part of the Psoriasin ointment, trichlorotriethylamine is part of the Antipsoriaticum ointment, b-butoxyethyl ether of nicotinic acid, together with vanillylamide of nonilinic acid, is part of the Finalgon ointment (Unguentum Finalgon), and ethyl nicotinate together with capsaicin, ethylene glycol salicylate and lavender oil - in the composition of the cream Nicoflex (Nicoflex). Methyl salicylate is used per se or mixed with other R. s. as part of a number of dosage forms, for example, Bom-Bengue ointment (Unguentum Boum-Benge), complex methyl salicylate liniment (Linimentum Methylii salicylatis compositum), Sanitas liniment (Linimentum "Sanitas"), salinimentum (Salinimentum).
Of the products of plant origin, many essential oils, some alkaloids, glycosides, saponins, and others have irritating properties. essential oils include peppermint oil and the main active ingredient of this oil is menthol, eucalyptus oil (Oleum Eucalypti), essential mustard oil, purified turpentine oil (synonymous with purified turpentine), camphor, etc.
Essential oils as R. s. used both in pure form and as part of various dosage forms and combined preparations containing essential oils and other plant and synthetic irritants. These drugs include, for example, Efkamon ointment (Unguentum Efcamonum), which includes camphor, clove oil, mustard essential oil, eucalyptus oil, menthol, methyl salicylate, capsicum tincture, thymol, chloral hydrate, cinnamon alcohol, spermaceti and petrolatum; aerosol "Camphomenum" (Aerosolum Camphomenum), containing menthol, eucalyptus, camphor and castor oils, furacilin solution, olive oil. The irritating effect of mustard plasters is due to the presence of essential mustard oil in them.
From the preparations containing alkaloids, as R. page. mainly tincture and extract of capsicum are used, the active substance of which is the alkaloid capsancin. In addition, tincture of capsicum is part of the ointment for frostbite (Unguentum contra congelationem), capsitrin (Capsitrinum),
pepper-ammonia liniment (Linimentum Capsici ammoniatum), pepper-camphor liniment (Linimentum Carsici camphralum), and capsicum extract - in the composition of pepper plaster (Emplastrum Capsici). Of the products of plant origin, birch tar and preparations that contain it (for example, balsamic liniment according to Vishnevsky, Wilkinson's ointment) have moderately pronounced local irritating properties.In addition to the indicated R. s. there are drugs belonging to other groups of drugs that have irritant properties and cause certain pharmacological effects in a reflex way by stimulating mucosal receptors. For example, drugs that cause a reflex increase in the secretion of bronchial glands belong to expectorants reflex type of action; drugs that cause a laxative effect, to laxatives ; drugs that simulate bile secretion - to choleretic agents ; appetite stimulants, bitterness . In R.'s group with. also do not include drugs in which the local irritant effect is not the main, but a side effect.
R.'s mechanisms of action with. not studied enough. It is known that with local application of R. s. cause local tissue irritation, against which pharmacological effects of a reflex and trophic nature can develop.
Besides, R. page. able to relieve pain in the area of affected tissues and organs due to the so-called distracting action.An example of the reflex action of R. s. can serve as a stimulating effect of ammonia solution on respiration. When ammonia vapor is inhaled, a reflex excitation of the respiratory center occurs due to irritation of the receptors of the upper respiratory tract. In addition, ammonia vapors can probably affect the activity of the reticular formation of the brain stem, since. the afferent systems of the trigeminal nerve participate in maintaining its tone, the sensitive endings of which are partially localized in the upper respiratory tract. This explains the effectiveness of inhalation of ammonia solution vapors in respiratory depression and fainting. The reflex expansion of the coronary vessels of the heart (due to irritation of the receptors of the oral mucosa) also determines the effectiveness of menthol preparations, such as validol, in angina attacks.
Positive trophic influence of R. of page. on the internal organs is carried out, apparently, in various ways, primarily due to skin-visceral reflexes, the central links of which are located in the spinal cord. The afferent link of such reflexes is the cutaneous afferent nerves, and the efferent link is the sympathetic nerves emanating from the corresponding segments of the spinal cord. It is possible that some skin-visceral reflexes may also have the character of axon reflexes. In the mechanism of trophic effects of R. of page. the release of biologically active substances (for example,
histamine) that occurs when the skin is irritated. The trophic effect explains the therapeutic effect of irritants, mainly in diseases of the internal organs (for example, mustard plasters in diseases of the lungs).The diverting action of R. with. manifested by the weakening of pain in the area of the affected organs and tissues. This effect is due to the fact that in the c.n.s. there is an interaction of afferent impulses from the organs affected by the pathological process and from the skin (from the area of impact of R. s.), as a result of which the perception of pain weakens. In physiological experiments, the possibility of this kind of interaction of nerve impulses entering the central nervous system on somatic and visceral afferent systems, has been proven in relation to nerve centers located both in the spinal cord and in the brain. Based on this hypothesis, in order to obtain a distracting effect in diseases of the internal organs of R. s. should be applied to areas of the skin
Lecture No. 10Subject: " Irritants"
Plan:
1) General characteristics of irritants.
2) Mechanism of action.
3) The mechanism of reflex, "distracting" action.
4) Classification.
5) Application.
Irritants include drugs that excite the endings of afferent nerves, cause reflex and local effects: reddening of the skin, improved blood supply, tissue trophism, reduction of pain and inflammation. Applied externally in the form of rubbing, ointments, balms, nasal drops.
Mechanism of action: irritate, excite the endings of afferent nerves (receptors) embedded in the skin, which selectively respond to certain types of stimuli (pain, temperature). As a result, there is a local (local) release of autocoids, biologically active substances (kinins, histamine, prostaglandins), which have a local vasodilating, hyperemic (cause redness) effect with improved tissue nutrition, improved blood circulation. At the same time, deep blood vessels (for example, coronary) expand reflexively. As a result of the "distracting" effect of irritants, the pain in the areas of inflammation decreases or completely disappears.
The mechanism of reflex, "distracting" action: p In the presence of inflammation, pain impulses continuously enter the corresponding segment of the spinal cord, from there they enter the higher parts of the central nervous system, where they create a focus of persistent excitation of the nerve centers, the so-called "pain dominant focus". When an irritating agent is applied to the corresponding area of the skin, a new stream of impulses of a different nature arises. In the central nervous system, a new dominant focus of excitation is created, and the old one fades away, pain sensations weaken or disappear altogether. Therefore, irritants are applied to the area of the skin that receives afferent innervation from the same segment of the spinal cord as the diseased organ.
Classification:
1. Irritants containing essential oils of plants:
A) Menthol preparations from peppermint leaves:
"Validol" tablets, nasal drops "Pinosol" (menthol and pine oil),
peppermint tincture, 10% menthol oil solution, Menovazin alcohol solution (menthol, novocaine, anestezin).
Menthol preparations, when applied to the mucous membranes and skin, excite cold receptors, cause a feeling of cold, a reflex constriction of superficial blood vessels and a weakening of pain sensitivity at the site of application. However, the tone of blood vessels and smooth muscles of deeply located organs can expand. The mechanism of action of Validol tablets is based on this. It is taken sublingually, the menthol contained in it irritates the cold receptors of the oral mucosa, which causes a reflex expansion of the coronary vessels and a decrease in pain in the heart. Applied for pain in the heart from a spasm of the coronary vessels with mild angina attacks.
Mint tincture is taken orally, 15-20 drops per ¼ cup of water for spasms of the biliary tract. An oily 10% solution of menthol is instilled into the nose for rhinitis to reduce inflammation and facilitate nasal breathing. Ointments containing 1-2% menthol and "Menovazin" are used for skin diseases accompanied by itching, for rubbing with neuralgia, muscle, joint pain, migraine (rubbed into the temples) as well as other irritants.
B) Combined drugs:
aerosols "Ingalipt"(streptocid, norsulfazol, eucalyptus oil, peppermint oil); "Kameton" ( camphor, menthol, eucalyptus oil), ointments "Efkamon", "Gevkamen" ( menthol, camphor, clove oil, eucalyptus), "Ben Gay"(menthol, methyl salicylate), "Bom Benge"(camphor, menthol, eucalyptus oil).
From the fruits of capsicum, capsaicin is isolated, which is part of the combined ointments. Espol, Kapsitrin, Nikoflex, tinctures of capsicum, pepper plaster. Pepper patch is used for longer exposure.
From mustard seeds, the glycoside sinigrin, which is part of mustard plasters, is isolated. Mustard plasters are moistened only with warm water, because. in hot weather, synegrin is inactivated, in cold it is not activated, and in warm it is cleaved to form the irritating substance allylthiocyanate. When applied to the calf muscles, mustard plasters cause a reflex expansion of the coronary vessels and lower blood pressure, as a distraction, they are applied between the shoulder blades for chest pain in bronchitis, for sore throat on the back of the head and throat, for muscle pain in the lumbar region and ribs, with some gynecological diseases to the area below the navel.
Purified turpentine essential oil (turpentine) is obtained by distillation of common pine resin, used independently, as part of turpentine ointment and other ointments.
bee venom "Apizatron", "Apifor", "Ungativen";
snake venom "Viprasal", "Vipraksin", "Nayatoks", "Nayaksin".
3. Synthetic irritants:
10% ammonia solution (ammonia) is used for fainting, 1-2 drops are applied to a cotton swab and allowed to smell to the patient, while the receptors of the upper respiratory tract are irritated, which reflexively excites the central nervous system and consciousness returns.
For rubbing use formic alcohol, ointments "Capsicum" "Finalgon"(butoxyethyl ester of nicotinic acid). Finalgon is applied in a small amount, no more than a pea, distributed on the skin with a special applicator, and in case of severe pain, removed with a dry cloth.
Application: in the complex treatment of arthritis, myositis, neuritis, neuralgia, acute and chronic lung diseases, camphor alcohol is used to treat bedsores to improve local blood circulation.
Side effects: with prolonged contact of irritating agents with the skin, a burn is possible, followed by inflammation, therefore, if severe pain occurs, it is necessary to stop the effect of the drug.
Control questions for consolidation:
1. What is the difference between the mechanism of action of irritating agents, from enveloping, astringent, adsorbing agents?
2. What are the combined preparations of menthol?
3. What is the peculiarity of the action of menthol preparations?
4. What is the essence of the distracting effect of irritants?
5. What precautions should be taken when using irritants?
Recommended literature:
Mandatory:
1. V.M. Vinogradov, E.B. Katkova, E.A. Mukhin "Pharmacology with a prescription", a textbook for pharmaceutical schools and colleges / edited by V.M. Vinogradova-4 ed.corr.- St. Petersburg: Spec. Lit., 2006-864s.: Ill.
Additional:
1. M.D. Gaevyj, P.A. Galenko-Yaroshevsky, V.I. Petrov, L.M. Gaeva "Pharmacology with the formulation": Textbook. - Rostov n / a: Publishing Center "Mart", 2006 - 480s.
2.M.D. Mashkovsky "Medications" - 16th ed., Revised. Corrected. And add.-M.: New wave: Publisher Umerenkov, 2010.- 1216 p.
3. Handbook VIDAL, Medicines in Russia: Handbook. M.: AstraPharmService, 2008 - 1520s.
4. Atlas of medicines. – M.: SIA International LTD. TF MIR: Eksmo Publishing House, 2008. - 992 p., ill.
5. N.I. Fedyukovich Reference book on medicines: at 2 pm Ch. P.. - Mn .: Interpressservis; Book House, 2008 - 544 p.
6.D.A.Kharkevich Pharmacology with a common formulation: A textbook for medical schools and colleges. - M,: GEOTAR - MED, 2008, - 408 p., ill.
Electronic resources:
1.Electronic library by discipline. Lecture on the topic "Irritants".
These are substances that, when applied topically, can excite sensitive nerve endings of the skin and mucous membranes, while there is vasodilation, improvement in tissue trophism at the site of drug application, suppression of pain impulses and the appearance of a "distracting" effect in case of pain in the joints, muscles, internal organs. The mechanism of the "distracting" action is associated with the suppression of the painful reflex by impulses resulting from exposure to an irritating substance.
These substances can also have a general effect on the body, for example, they stimulate the formation and release of enkephalins and endorphins, which are involved in the regulation of pain; stimulate the formation of other endogenous biologically active substances.
Irritants are used mainly externally for neuralgia, radiculitis, arthrosis, rheumatism, bruises, injuries, as well as for rhinitis, pharyngitis, tracheitis, etc.
Ammonia solution- a volatile liquid with a characteristic odor. It is used to excite respiration and remove patients from fainting, for which they bring a piece of cotton wool moistened with ammonia to the nose. There is a reflex stimulation of the respiratory center. Sometimes prescribed 5-10 drops in 100 ml of water when intoxicated. Has antimicrobial action.
mustard plasters- sheets of paper coated with mustard flour obtained from the cake of mustard sarepskaya. When wetted with warm water, there is a strong smell of mustard oil, which has an irritating effect. Used for diseases of the respiratory system, neuralgia, angina pectoris.
Menthol- the main component of peppermint essential oil. It has a strong characteristic odor and a cooling taste. Does not dissolve in water. It has an irritating, distracting, anesthetic, antimicrobial effect. Reflexively reduces vascular tone. They produce menthol oil 1% and 2%, alcohol solution of menthol 1% and 2%, menthol pencil, powder. Included in tablets Validol, Boromenthol ointments, Menovazin liquids, Gevkamen ointments, etc.
They are used for inflammatory diseases of the upper respiratory tract (lubrication, inhalation); neuralgia, joint pain (rubbing into the skin); migraines (rubbing in the temples); angina pectoris (tablets under the tongue).
Irritants used for joint and muscle pain include drugs Camphor(camphor alcohol, camphor oil), turpentine ointment, LS peppercorns o (tincture, pepper patch, Kapsitrin, Kapsin liniment, Nikoflex ointment); PM poisons of snakes and bees(Ointments "Viprosal", "Vipratox", "Apizartron").
Means that excite sensitive receptors and have a reflex effect also include expectorants, emetics, laxatives, bitterness, choleretic and other drugs, which will be discussed in the relevant sections.
| Drug name, synonyms, storage conditions | Release forms | Application methods |
| Procainum (Novocainum) | Powder, vial. 0.25%, 0.5% solution - 200 ml and 400 ml; Amp. 0.25%, 0.5%, 1%, 2% solution - 1 ml, 2 ml, 5 ml, 10 ml Suppositories 0.1 | Tissue injections (infiltration anesthesia) Injections along the nerve (conduction) Into the rectum |
| Benzocainum (Anaesthesinum) | Powder Tab. 0.3 Suppositories | In ointments, powders 1-2 tablets. 3-4 times a day Into the rectum |
| Lidocainum (Xylocainum) | Amp. 1%, 2%, 10% solution - 2 ml, 10 ml, 20 ml | Injections in layers into the tissue along the nerve, into a vein, muscle |
| Trimecainum (Mesocainum) | Amp. 2% solution - 1 ml, 2 ml, 5 ml, 10 ml | Injections in layers into the tissue, along the nerve, into the vein, muscle |
| Articainum (Ultracainum) | Amp. 1%, 2% solution - 5 ml Amp. 5% solution - 2 ml | For infiltration, conduction anesthesia For spinal anesthesia |
| Tanninum | Powder | For the preparation of solutions and ointments |
| xeroformium | Powder | In the form of ointments, powders |
| Infusum radicis Althaeae | Infusion 1:30 | 1-2 tables. spoon 3-4 times a day |
| Mucilago seminis Lini | Slime 1:30 | In potions |
| "Almagelum" | Flac. 170 ml | 1 table. spoon 3 times a day before meals and at bedtime |
| Carbo activatus (Carbolenum) | Powder Tab. 0.25; 0.5 | Inside, 2-3 tablets. (grinding) 3-4 times a day (for flatulence) 20-30g per 10-15l of water (for gastric lavage) |
| Belosorbum | Packages 23.0 | |
| Smecta | Packages 3.0 | Inside the contents of the package in the form of a suspension in water |
| Solutio Ammonii caustici | Amp. 10% solution - 1ml Flac. 10% - 10 ml, 40 ml | On cotton for inhalation |
| Mentholum | Powder | Rub in (2% alcohol solution or 10% oil solution) |
| Polyphepanum | Packs of 10.0 | 1 table. spoon 3 times a day in 1 glass of water |
test questions
1. What is the principle of action of anesthetic substances? Types of anesthesia.
2. How does the effect of local anesthetics change when injected into inflamed tissues and why?
3. What is the purpose of adding a solution of epinephrine hydrochloride to anesthetic substances?
4. What is the mechanism of action of astringents? Their application.
5. What is the mechanism of action of activated carbon in case of poisoning?
6. Local and reflex action of irritants. Their application.
7. Explain the mechanism of action of ammonia solution on respiration.