Ex tempore. Preparation of combined ointments: Preobrazhensky ointment. Antiseptic Complex nasal ointment - review. Complex ointment with protargol from the common cold

Against viruses, antibiotic treatment is useless, which is why an antiviral nasal ointment is used. Viruses are non-cellular life forms and only show signs of life when they enter the host.

Features of using ointment for the nose

The use of antiviral nasal ointments has a number of advantages and disadvantages due to the use of such a dosage form of the drug.

The main benefits are:

1. Due to the consistency, the drug will not be able to drain down the throat, but will act at the site of application.
2. The tool will not be able to get into the auditory canals and provoke them inflammatory process.
3. The basis of ointments always contains components that are able to nourish and moisturize the nasal mucosa, avoiding its drying out.
4. The special base allows the ointment to remain on the mucosa much longer than drops, and therefore the effect of the ointment becomes longer, which increases the effectiveness of the product.

Despite the obvious advantages, the use of antiviral ointment also has certain disadvantages:

1. The impossibility of complete treatment of the entire surface of the nasal mucosa, which leads to the fact that the agent acts only at the site of application.
2. The use of cotton swabs to apply ointment to the mucous membrane in the depth of the nasal passages is not recommended - this can lead to injury.
3. Excessively oily texture long time not be removed from the nose even after the end of the action of the medicinal component - this can become a breeding ground for pathogenic microorganisms.

Prevention and treatment of influenza

Flu - viral disease, which may cause fatal outcome in case of infection of a person with excessively weakened immunity and in the absence of proper treatment. Therefore, in the season of exacerbation of the disease, in order to avoid infection, preventive measures can be taken.

To prevent infection with the influenza virus, oxolinic ointment and ointments containing viferon are used.

These ointments should be applied to the nasal mucosa before leaving the house. When using these agents, the viruses that settle on the mucosa cannot enter the body and cause infection.

Often you should not use these funds - this is due to the peculiarities of the active components of the ointment. So, for example, oxolinic ointment contains tetraoxo-tetrahydronaphthalene, which has a drying effect. Vaseline, which is part of the composition, does not have a moisturizing effect - it simply retains moisture at the site of application.

If you abuse the use of such an ointment, you can dry out the nasal mucosa, which can lead to a decrease in its natural protective properties.

Fighting herpes

Absolutely anyone can become a carrier of the herpes virus, but not everyone can manifest the disease. This is due to the individual susceptibility of the organism to the virus.

Often the nose becomes the site of localization of the virus. Such vesicles usually differ from the vesicles on the lips - they are covered with a denser shell, itching is more pronounced and appearance look like small abscesses.

Also, herpes can be localized near the nose - such rashes will not differ much in appearance from a rash on the lips.

In general, when nasal herpes occurs, specialized treatment may not be required if the immune system is strong enough. However, medications can be used to speed up healing and achieve remission more quickly.

If we influence the place of localization on early stages diseases, there is a chance to suppress the disease for another initial stage.

For drying, zinc ointment can be used.

Treatment is carried out using ointments based on acyclovir:

• Zovirax;
• Acyclovir;
• Panavir.

To soften and accelerate healing, sea buckthorn and rosehip oils can be used, which also have an excellent antiseptic effect.

Treatment of runny nose and colds

To cure inflammation of the mucous membranes of the nose, ointments are used in addition to complex treatment. The local effect of the ointment directly at the site of the localization of the disease helps to achieve therapeutic effect faster.

For the treatment of the common cold can be used:

1. Antiviral agents that are made on the basis of interferon, for example, Viferon ointment.
2. It is also possible to use oxolinic ointment for the treatment of the common cold.
3. In addition to antiviral ointments for a cold, antiseptic, combined and homeopathic remedies can be used.

Antiseptics include:

• Vishnevsky ointment;
• tetracycline ointment;
• Betadine.

Ointments have a combined effect:

• Levomekol;
• Pinosol;
• zinc ointment.

Homeopathic preparations usually do not contain active medicinal components and are used to relieve symptoms:

• balm "Asterisk";
• ointment "Doctor MOM";
• ointment "Brionia".

Such ointments are used only on the skin - it is not recommended to apply them to the mucous membrane, as they can cause a burn.

Overview of antivirals

Most often, antiviral ointments are used for the nose, which have combined action and are effective in the treatment of not only viral, but also bacterial diseases.

Complex nasal ointment

This is an ointment that is made directly in the pharmacy.

It usually contains:

• diphenhydramine;
• novocaine;
• menthol;
• Levomycetin.

The basis for such an ointment is most often vaseline. It is highly effective in the event of frontal sinusitis or sinusitis.

However, this ointment has one significant drawback - it must be stored only in the refrigerator and no more than 10 days.

Application of complex ointment:

• does not provoke addiction;
• causes constriction of the vessels of the nasal mucosa;
• relieves the feeling of congestion;
• the ointment does not dry out the mucous membrane.

According to the instructions for use, a complex ointment in the nose should be applied two to three times a day (depending on the concentration active ingredients and disease severity). After applying the ointment to the nasal membrane, the effect appears within a few minutes.

Effective ointment of Preobrazhensky

As part of the Preobrazhensky ointment a large number of active ingredients:

• streptocide;
• sulfadimezin;
• ephedrine hydrochloride;
• norsulfazole;
• camphor and eucalyptus oils.

This makes it a fairly effective treatment for viral infections.

• has a vasoconstrictive effect;
• helps relieve the symptoms of a runny nose;
• acts as a powerful antiseptic.

Contraindications to the use of ointment are:

• hypertonic disease;
• heart damage;
• hyperthyroidism;
• sleep disorders;
• atherosclerosis.

With an overdose of active ingredients, increased nervous excitement, circulatory disorders are observed.

Means based on interferon

Viferon is one of the most popular ointments with interferon in the composition. Extremely effective in the treatment of viral and microbial diseases. Active ingredients also help restore and strengthen local immunity.

Proven drug Levomekol

Popular combined remedy which contains methyluracil and chloramphenicol. It has a pronounced healing and antimicrobial effect. The ointment is effective in diseases of a viral nature.

Cannot be applied:

• children under 6 years old;
• pregnant women;
• lactating women.

This is due to the presence of chloramphenicol in the composition.

Advantages and disadvantages compared to other forms of medication

First you need to say that an experienced and competent doctor will prescribe an ointment for sinusitis. Here's the thing, aerosols and drops are much more convenient to use. Moreover, the effectiveness of the ointment is much inferior to these forms, although their composition may be the same. Some say that ointments can be bought cheaper, but the difference in price is so small that this fact should not be taken into account at all.

The first step is to understand the shortcomings, because their number makes the scales lean in their direction.

We list the main disadvantages of this form:

1. Most of the ointments produced are very greasy in consistency. Therefore, when applied to the skin, they close the ciliated epithelium, thereby delaying harmful secretions in the nose. But this factor is not something terrible, since few people will be able to smear the entire surface of the nasal cavity with ointment.
2. Ointment will not be able to treat the entire inflamed area. After applying ointment to your finger, try to insert it into your nose as deeply as possible, most likely it will be very inconvenient and ineffective, and even more so in the case of children. Of course, you can use cotton buds to get to the right places, but most likely it will be unpleasant and even painful.
3. You can prepare a mixture based on essential oils, but they are contraindicated in children and pregnant women.
4. Complex ointments are very effective, but it is very difficult to prepare them at home. This is due to the composition, the right ingredients are difficult to get.

Now we can talk about positive aspects, or even about the side, because of the positive you can find only one. Due to its composition and properties, the ointment cannot enter the throat or stomach. Because of this, ointments are popular in the treatment of children. There is even an opinion that the use of an ointment as an antiviral agent can prevent the agent from entering the ear cavity.

Needless to say, complex ointments against viruses cannot be used. They can, only when treating a patient in a hospital, and the drug is applied using the right device, these procedures give good effect.

Not taking into account the very large distribution of antiviral ointments, not everyone has the desired effect. That's why the best option will - use medicines in the form of drops or sprays. Since their treatment will give much great results. It is allowed to use complex ointments only after consulting a doctor in a hospital, only in this case you can see good results.

Help of folk remedies for this pathology

Since ancient times, sinusitis has been treated with laundry soap, which was considered almost a real source of life.

Many recipes have been invented that have been passed down through many generations, capable of curing a large number of diseases. One of these diseases is sinusitis, it is very common and quite difficult to treat.

Laundry soap ointment. It helps people very effectively in the treatment of sinusitis, consider the recipe, all the ingredients described must be taken in the same amount:

• onion juice;
• beet;
• dark laundry soap;
• propolis tincture;
• unrefined oil.

All this in a water bath must be boiled and mixed. The recipe couldn't be easier. For even more efficiency, you can enter about 3 drops of squeezed radish, then screw tampons with ointment into your nose for 10 minutes. This procedure should be done for 5 days.

Ointment from laundry soap with onions.

Required Ingredients:

• soap;
• baking soda.

It is required to mix all the components and apply to the inflamed area or dip the turundas from the nose for 15 minutes.

Ointment with celandine and aloe, based on laundry soap. Highly effective remedy from sinusitis, helps to heal in as soon as possible, recipe:

• aloe juice;
• celandine juice;
• laundry soap;
• black radish juice.

All components must be mixed with a blender, boiled and left to infuse for a day. After that, it is required to soak the turundas with ointment and insert into nasal cavity for 20 minutes. Treatment should continue for about a week.

Treatment with ointment for crusts in the nose

To date, doctors cannot give an exact answer why a crust forms in the nose. For a simple reason, this problem is very little studied. Many disagree, some believe that the problem lies due to congenital defects in the nasal cavity. It is believed that the cause may be an increased width of the nostrils and poorly developed paranasal sinuses, as a result of which crusts can form.

This problem is usually treated with special ointments and oils, which have the function of softening the crust, this helps it to lag behind and peel off. But such drugs in no case can contain corticosteroids, or substances that will irritate the nasal mucosa or dry it. Most perfect option- this is sea buckthorn or even apricot oil. You can drip your nose with them, or you can moisten cotton swabs in oil and insert them into the nasal openings, and walk with them for at least half an hour.

If the cause of the appearance of crusts in the nasal cavity is a dry mucous membrane, the ointments will be very effective way treatment. Experts advise using the "Rescuer" or "Flemming" ointment. At the same time, it is necessary to additional actions, for example, wash the nose, and smear the mucosa with ointment before going to bed and after waking up. In just a week you will feel positive result, crusts will most likely leave you, and your breath will become pleasant and clean.

In addition, a new injection containing aloe extract can help with the problem of crusts in the nose. You need to use it for a month, 1 milliliter daily.

Ointment for blackheads on nose

The best remedy for acne and pimples on the nose is - Ichthyol ointment. In the process of treating all the hated black dots and inflammation on the skin, the main thing is to stop the spread harmful bacteria to healthy areas.

This ointment is very affordable and is not in short supply in pharmacies, it is also a proven remedy that has healing and antiseptic properties. In addition, it has an anti-inflammatory effect for some bacterial groups and fungi. The mother consists of medical vaseline and ichthyol - a product of the distillation of shale rocks. Ointment can be used in the following cases:

In addition to the common nasal drops and aerosols, ointments for the common cold can also be used in the treatment.

They are used both as a therapy and preventive purpose and are of particular relevance in the cold season, when the prevalence of colds is very high.

With the seeming ease of such treatment, one should not forget that the choice of ointment for adults and children depends on many factors and requires an individual approach.

How to smear the nose with a cold?

1. antiviral- are widely used for prevention, especially during epidemic outbreaks;
2. antiseptic- are used in the treatment of bacterial infections;
3. combined- provide general therapeutic effect, applied in a complex effect;
4. homeopathic– based on natural ingredients, used as part of complex treatment diseases.

The causes of rhinitis are infection or the body's reaction to an allergen. They can be pet hair, flowering plants, household dust. Before using this or that remedy, you need to determine the cause of the disease.

What ointments from the common cold can be used for children?

Many parents believe that it is ointments that can help in the treatment of a runny nose, since they have a thick consistency and do not get into the throat, which often causes discomfort in a small child.

However, one should listen to the opinion of experts who say that not all of them can be recommended for children.

Balm will be safe for children from 2 years old Golden Star(Asterisk), Evamenol, Fleming and Thuja ointments. They are based on petroleum jelly and herbal extracts.

After agreement with the doctor, it is possible to use oxolinic and ichthyol ointments, Viferona. It should be noted that the listed drugs will be truly effective only as part of complex therapy.

Attention

It is undesirable to use ointments based on petroleum jelly and herbs for treatment infants. Uncontrolled use without prior consultation with a doctor can lead to disruption of the mucous membranes of the nasal cavity.

There is no ointment designed specifically for babies. In the treatment of acute respiratory viral infections for children, Vishnevsky, Levomekol and tetracycline ointments are not used.

What are the contraindications

The safest drugs are those belonging to homeopathic group. Almost the only contraindication to their use is individual intolerance to the components. Antiseptic ointments prohibited for use in:

1. children under 6 years old;
2. pregnant and lactating women;
3. persons with chronic diseases liver and kidneys;
4. allergy sufferers.

Ointments are not used if the runny nose is accompanied by profuse ones. Since such symptoms may indicate the development of sinusitis, the treatment of which must necessarily be complex.

Antiviral and antiseptic

Antivirals are effective in reducing the likelihood of infection during SARS epidemics. It is most effective at the initial stage of the disease, they are able to remove individual particles of viruses from the affected cells.

Antiseptic with antibiotic properties are used for bacterial infections, which are characterized persistent rhinitis, inflammation of the mucous membranes, pain.

Tetracycline ointment

Antimicrobial drug, antibiotic, destroys pathogenic microorganisms. It has good efficiency and strong action.

For this reason, the ointment is recommended to be applied no more than three times a day for a week. If rhinitis is caused by viruses or fungi, the use of tetracycline ointment is ineffective. It is also not applied in the presence of blood crusts in the nasal cavity.

Prolonged use of the ointment adversely affects the work internal organs. The medicine is not recommended for pregnant and lactating women, children under the age of 6 years.

Viferon

It is indicated for use in order to prevent the disease or at the first signs of its manifestation. Available in the form of an ointment or gel. The main advantage is that it can be used expectant mothers and infants.
Source: website

The nasal passages are lubricated several times a day until the signs of a cold disappear completely. Main component drugs, interferon, effectively affect invading viruses even before they begin their destructive activity.

Oxolinic ointment

The most famous nasal ointment in the nose from a runny nose, used mainly for the prevention of influenza or SARS.

It has few contraindications, but is highly undesirable for children under 2 years of age. The agent is applied to the nasal mucosa 1-2 times a day for 3 weeks.

In some cases, a burning sensation is possible. This indicates the hypersensitivity of the body to the components of the drug.

Many experts note the lack of proven data on the effectiveness of oxolin. The medicine can help reduce the spread of infection in combination therapy.

Vishnevsky ointment

Main components - Castor oil and Birch tar. In some cases, it can be used for sinusitis. Treatment of SARS with this tool possible only in a hospital under the supervision of a doctor.

Use at home is not recommended due to increased risk allergic reactions.

homeopathic

The drugs in this group are based on natural ingredients, have an immunomodulatory effect. Ointments to order natural basis can be purchased at every pharmacy.

Doctor Mom

It is used to facilitate breathing with nasal congestion and severe SARS. The composition contains menthol, camphor, eucalyptus and turpentine oils.

Fleming's ointment

Assign for colds and sinusitis. Well tolerated by patients, side effects in the form of itching, burning or skin rashes rarely occur.

For treatment, processed turundas are administered. You can also lubricate both nostrils twice a day for two weeks. The drug can be used during pregnancy, it does not affect the development of the fetus and the condition of the expectant mother.

Star

A well-known aromatic balm from Vietnam, which was used in Soviet times. It contains natural essential oils, which have a beneficial effect on the condition of the upper respiratory tract and activate immune system, forcing the body to actively resist the disease.

An asterisk is not used. It should also not be applied to mucous membranes, as this may cause severe irritation and even a burn.

Combined

Medicines with combined composition eliminate nasal congestion due to the antibacterial activity of the components.

Levomekol

Prescribed if the causative agent of the disease is an infection bacterial origin. For accurate diagnosis analysis results are required.

Introduced into the nasal passages cotton swabs drug-impregnated. Therapeutic effect possible when the processed tampons are in the nose for at least four hours.

Only a doctor can prescribe Levomekol to children and expectant mothers. In case of an overdose or hypersensitivity of the body, burning, itching, swelling on the skin, rash are possible.

Pinosol

The main secret of popularity is its naturalness. Pinosol contains pine, eucalyptus and mint oils. They kill pathogens.

May be prescribed to relieve symptoms acute rhinitis and complicated by the formation of crusts. The nasal passages are carefully treated with Pinosol applied to a cotton swab.

Evamenol

Menthol and eucalyptus in the composition have a distracting, anti-inflammatory and antiseptic effect. The course of treatment should not exceed 5-10 days, during which the nasal passages are treated 2-3 times a day. If during this time the desired effect does not occur, more effective drugs are required.

Among the contraindications - hypersensitivity to components and childhood up to 2 years. Evamenol is quite safe for pregnant women. The ointment is quite cheap, which also contributes to its popularity.

Other ointments

Sunoref

When ARVI becomes chronic, Sunoref will help to cope with the problem. It has an anti-inflammatory and disinfecting effect.

Ingredients included - Eucalyptus oil, camphor, streptocide, ephedrine. The latter belongs to substances with narcotic effect, that's why this medicine can be bought at a pharmacy only on prescription. Not recommended for hypertension and individual intolerance.

Anemone

It is possible to prescribe a remedy for rhinitis, which is accompanied by abundant liquid secretions. For application use cotton swabs or sticks. The recommended course of treatment is two weeks with application twice a day. Possible allergic reactions Therefore, it is not prescribed to patients under 18 years of age and nursing mothers.

Synthomycin

First of all, it helps with burns and abrasions, but it is also possible to prescribe for getting rid of the symptoms of acute respiratory viral infections and with exacerbations of sinusitis and sinusitis that occur. Relieves the feeling of congestion and dryness in the upper respiratory tract.

It can not be prescribed for liver diseases, disorders in the work of the hematopoietic organs. Because the we are talking about the antibiotic, its appointment to pregnant women should be separately discussed with the doctor.

Boromenthol

The main ingredients of the product - menthol, boric acid and petroleum jelly, have effective impact at various diseases upper respiratory tract. The drug is prescribed as an additional to eliminate inflammation. Enough two or three times a day. Not recommended for children under five years of age.

with propolis

Famous bee product effective in the treatment of many diseases. It also helps with the first symptoms of a cold and its complications. Propolis is also useful because, in addition to its anti-inflammatory effect, it helps to strengthen the immune system.

The cooled product is crushed, mixed with butter and peach oil and mix thoroughly. Lubricated with the resulting mixture, turundas are placed for 5-10 minutes alternately in one and the other nostril. A remedy with propolis for the common cold is not used for patients prone to allergic reactions.

It is not necessary to rely on ointments as a panacea to completely get rid of the common cold. Many patients, as well as young and inexperienced mothers, tend to exaggerate them. positive action. But the competent and timely use of ointments in combination with other drugs gives a positive and lasting effect.

Drops- liquid dosage form, intended for internal or external use, dosed in drops. As dispersed systems, drops are true solutions, colloidal solutions, suspensions, emulsions.

Drops are classified according to the method of application:

For internal use;

For outdoor use.

Drops for internal use (Guttae pro usu interno)most often they are solutions of medicinal substances in water, tinctures, extracts and other liquids. The advantage of drops for internal use over potions is the high concentration of active ingredients. Therefore, drops are sometimes called concentrated potions.

Drop recipes for internal use containing substances on lists A and B are subject to mandatory dose checks (see Chapter 7, Doses).

Drops for external use (for instillation into the eyes, ears, nose).

The Global Fund has a general article only about eye drops.

Rice. 18.1.Dissolution device

Rice. 18.2.Mortar and pestle glass for dissolving

Drops for the nose, ears must meet the requirements for liquid dosage forms.

In addition, the quality of drops for external use, nose and ear drops characterize the following main indicators:

Compliance with the anatomical and physiological features of the route of administration;

Conformity physical and chemical properties medicinal substances.

18.1. REQUIREMENTS OF REGULATORY DOCUMENTATION FOR DROPS:

Safe level of microbial contamination for drops (no more than 1000 bacteria and 100 yeasts and molds in 1 ml of drops for external use, no more than 100 microorganisms in 1 ml (g) for oral administration);

Sterility of eye drops;

Compatibility of medicinal and excipients that make up the drops;

The accuracy of the concentration of medicinal substances and the volume (mass) of drops - in accordance with the requirements of the order of the Ministry of Health? 305;

Stability chemical and physical;

No mechanical inclusions.

In addition, the quality of the prepared drops is evaluated in the same way as other dosage forms, i.e. check the documentation (recipe, written control passport, copy of the recipe), design, packaging, color, smell.

18.2. ADVANTAGE OF DROPS OVER OTHER DOSAGE FORMS:

Higher bioavailability in comparison with powders, tablets;

Compactness, portability in comparison with medicines;

Ease of manufacture;

Ease of use.

18.3. DISADVANTAGES OF DROP

FOR INTERNAL USE

The need to maintain the required level of stability (physico-chemical, microbiological), since drops are used in conditions of frequently opened packaging;

The need for careful analysis chemical compatibility due to the higher concentration of medicinal substances compared to potions;

The short duration of the therapeutic effect of drops for external use. To prolong the action of medicinal substances used externally, it is recommended to introduce synthetic polymers into the drops: 1% methylcellulose or hydroxypropyl methylcellulose.

18.4. DROPS PRODUCTION TECHNOLOGY FOR INTERNAL AND EXTERNAL USE

Process steps

1. Preparatory, including the following operations:

Determining the total volume or mass;

Calculation of a sample of a substance, or the volume of a concentrated solution;

Checking doses of substances of lists A and B (only for enteral solutions);

Calculation of the mass or volume of the solvent;

Decor reverse side written control passports;

Preparation of the workplace, medicines and materials.

2. Dissolution and straining (filtering for eye drops).

3. Introduction to the composition of liquid medicines. Control of absence of mechanical inclusions.

4. Packaging, capping.

5. Registration; filling in the written control passport.

6. Quality control.

Rule 1

If the total volume of drops does not exceed 30 ml, then the dissolution is carried out in half the amount of solvent. The dissolution is carried out in a stand pre-rinsed with purified water.

The resulting solution is filtered through a cotton swab, previously washed with purified water. The rest of the solvent is used to wash the stand, where the dissolution and washing of the filter were carried out. With this method of manufacture, there is no decrease in the concentration of medicinal substances and the volume of drops.

Rule 2

When prescribing in drops of substances of lists A or B in an amount of less than 0.05 g, pre-prepared concentrated solutions these substances.

Features of the preparation of drops - solutions of medicinal substances in tinctures, extracts and other herbal preparations

Rule 3

In the manufacture of drops containing water-alcohol liquids, it is necessary to take into account the solubility of medicinal substances, as well as the composition of the liquids included in the prescription.

Example 1

Rp.: Sol. Ephedrini hydrochloridi 2% - 10 ml Sol. Adrenalini hydrochloridi 1:1000 gts. XX M.D.S. 4 drops in the nose 3 times a day.

In a stand, 0.2 g of ephedrine hydrochloride is dissolved in 5 ml of purified water. The solution is filtered through a cotton swab, previously washed with water, into a dark glass bottle. The remaining amount (5 ml) of water is filtered through the same swab. A 0.1% solution of epinephrine hydrochloride is measured directly into the vial with a pipette in an amount corresponding to 20 drops in a standard dropmer. The bottle is sealed and labeled "External" and a warning label "Keep in a cool place."

Example 2

Rp.: Mentholi 0.4 Natrii bromidi 1.0 Adonisidi 6 ml Tinct. Convallariae

Tinct. Leonuri Ana 15ml

M.D.S. 15 drops 2 times a day.

In the manufacture of drops of this type, it is necessary to take into account the solubility of medicinal substances, as well as the composition of the liquids included in the prescription. GF X found: adonizide contains 20% ethanol; tinctures of lily of the valley and motherwort are prepared in 70% ethanol; menthol is soluble in water in a ratio of 1:1800, in ethanol in a ratio of 1:1 (90%) and 1:2.5 (70%), 1.0 g of sodium bromide is soluble in 1.5 ml of water and 3.5 ml 70% ethanol.

15 ml of lily of the valley tincture and motherwort tincture are measured with a pipette into the vial, and 0.4 g of menthol is dissolved in a mixture of tinctures. Pipette 6 ml of adonizide into a small stand and dissolve 1.0 g of sodium bromide in them. The resulting solution is transferred into a vial (if necessary, pre-filter). Issued according to general rules.

Packing, labeling and analysis of the quality of drops are carried out in accordance with the requirements of the pharmacopeia and orders of the Ministry of Health of the Russian Federation for solutions.

18.5. DROP EXAMPLES

FOR INTERNAL USE

(ORDER of the Ministry of Health of the USSR? 223 OF 12.08.1991)

cardiac

1. Menthol solution with nitroglycerin Rp.: Sol. Mentholi spirituosae 3% - 9 ml Nitroglycerini spirituosae 1% - 1 ml

M.D.S. Inside, 1-2 drops per piece of sugar under the tongue.

Action and indications: has a reflex expansion of the coronary vessels of the heart.

Used to relieve angina attacks.

Contraindications:

2. Tinctures of valerian and lily of the valley with validol Rp.: T-rae Valerianae

T-rae Convallariae ana 10 ml Validoli 2.0

M.D.S. Inside, 20-30 drops 3 times a day. Action and indications: used as sedative with neurosis of the cardiovascular system.

3. Valerian and lily of the valley tinctures with sodium bromide Rp.: T-rae Valerianae

T-rae Convallariae ana 10 ml Natrii bromidi 4.0

M.D.S. Inside, 20 drops 2 times a day.

Action and indications: renders sedative action used in neurosis of the heart.

4. Motherwort and hawthorn tinctures with sodium bromide Rp.: T-rae Leonuri

T-rae Crataegi ana 15 ml Natrii bromidi 4.0

M.D.S. Inside, 15-20 drops 2-3 times a day. Action and indications: has a sedative effect, is used for functional disorders cardiac activity.

5. Votchal drops Rp.: T-rae Valerianae

T-rae Convallariae ana 10 ml

Validoli 2.0

So1 Nitroglycerini spirituosae 1% - 1 ml

Action and indications: has a sedative and vasodilating action, is used for cardiovascular neurosis, angina pectoris with tachycardia.

Contraindications: elevated intracranial pressure, hemorrhage in the brain.

6. Valerian, motherwort and belladonna tinctures with menthol Rp.: T-rae Valerianae

T-rae Leonuri ana 10 ml T-rae Belladonnae 5 ml Mentholi 0.2

M.D.S. Inside, 20-25 drops 2-3 times a day.

Action and indications: has a sedative effect and increases blood circulation in coronary vessels hearts; used for heart neuroses, angina pectoris with bradycardia.

7. Lily of the valley and valerian tinctures with hawthorn and menthol extract

Rp.: T-rae Convallariae T-rae Valerianae ana 20 ml

Extr. Crataegi fluidi 10 ml Mentholi 0.1

M.D.S. Inside, 15-20 drops 2-3 times a day.

Action and indications: has a sedative effect and enhances blood circulation in the coronary vessels of the heart, is used for functional disorders of cardiac activity.

18.6. NASAL DROPS

Nasal drops- liquid dosage form intended for instillation into the nasal cavity. They are aqueous or oily solutions or suspensions and gels of medicinal substances.

The inner surface of the nasal cavity is rich blood vessels Therefore, intranasal application of drugs is practically bioequivalent to the injection route of administration.

Benefits of intranasal administration Drugs are: the gradual entry of drugs into the bloodstream and the absence of drug interaction with blood elements. Therefore, intranasal dosage forms of insulin, glucagon, progesterone, propranolol and painkillers are promising.

Disadvantages of intranasal dosage forms are:

Destruction of many drugs by enzymes of the nasal mucosa;

Loss of drugs due to the reverse (pushing) action of the ciliated epithelium of the nasal cavity;

Violation of the function of the ciliated epithelium;

The possibility of swallowing the drug; as a result, when administered nasally, the drug can be ingested, which is accompanied by a violation of the dosage.

Rule 1

Doses of substances in lists A and B in nasal drops are usually not checked, since they are prescribed for local action and in small quantities. However, it is recommended to take into account the possibility of absorption of medicinal substances through the mucous membrane, as well as ingestion of drops flowing into the mouth, and, consequently, their general and toxic effects.

Rule 2

Before dispensing solutions of potent nasal drugs, pipettes or aerosols must be calibrated.

Nasal pipette calibration algorithm:

1. The pipette and solution that the patient will use are subject to calibration;

2. The number of drops in 1.0 ml of the solution prescribed by the doctor is determined by weighing the mass of 20 drops three times;

3. Recalculate the number of drops per 1 dose, taking into account the fact that the doctor prescribes the dose in standard drops (20 drops of an aqueous solution in 1.0 ml).

Example 1

Rp.: Dimedroli 0.05 Ephedrini hydrochloridi Novocaini ana 0.1

Solutionis Natrii chloridi 0.9% -10 ml AI.D.S. 2 drops in the nose 3 times a day.

When calibrating an empirical pipette, it was found that 1.0 ml of the dosing solution contains 10 drops. If we take into account that dosing with a standard dropmer of 1.0 ml of an aqueous solution is equivalent to 20 drops, then the pipette coefficient is 0.5, and the patient is recommended to instill 1 drop 3 times a day.

Atomizer or inhaler calibration algorithm:

1. Weigh the aerosol can or inhaler.

2. Perform 10 sprays per plastic bag.

3. Re-weigh the aerosol can or inhaler, divide the difference in weight by 10; getting the mass of one spray.

4. Calculate single dose LS by multiplying the mass of one spray by the concentration of the substance, dividing by 100%.

5. Compare the single dose with the prescribed dose and the highest single dose.

Requirements for nasal drops

The main requirement for nasal drops is the compliance of the composition with the anatomical and physiological features of the route of administration, i.e. drops should not slow down the transport function of the ciliated epithelium.

The mucous membrane of the upper and lower divisions respiratory tract is covered with ciliated epithelium. The main structural

an element of the epithelium are ciliated cylindrical cells. 3-25 cilia 6-10 microns long and less than 0.3 microns in diameter depart from each such cell. The cilia make coordinated movements, producing blows and pushes on the secret covering them (8-12 blows in 1 s). The movement of the ciliated epithelium in the nasal cavity is directed towards the nasopharynx, and from the lower respiratory tract - upwards. Thus, the airways are cleared.

The transport function of the ciliated epithelium is slowed down by:

1. Solutions:

Silver nitrate;

cocaine hydrochloride;

Boric acid - above 1% concentration;

Sodium bicarbonate - above 3%;

Ephedrine hydrochloride - above 1-2%, etc.;

2. Solutions with a pH value up to 6.4 and more than 9.0.

3. Solutions with osmotic pressure up to 0.3 and more than 4% NaC1.

Nasal drops technology

The manufacturing technology of nasal drops consists of the same stages as drops for internal use.

Rule 3

For the preparation of nasal drops, sterile solvents are used: purified water, isotonic buffer solutions, oils, etc.

The following are used as stabilizers, preservatives, prolongators and other excipients: sodium chloride, sodium sulfate, sodium nitrate, sodium metabisulfite, sodium thiosulfate, mono- and disubstituted sodium phosphate salts, boric acid, sorbic acid, nipagin, nipazole, benzalkonium bromide, derivatives cellulose, etc. Solutions are packaged manually or semi-automatically into vials. Cork with lids, roll up with caps.

Containers and materials for packing drops

Pharmacy uses vials, stoppers and caps for packing drops (Fig. 18.3), as well as devices with a built-in dispenser (Fig. 18.4).

Rice. 18.3.Bottles made of a glass tube (drota) brand NS, rubber stoppers AB and aluminum caps K1 for packaging solutions

Rice. 18.4.Dropper bottles made of glass or polypropylene

The dropper bottle consists of a bottle (glass or polypropylene) with a solution and a cap combined with a pipette. The patient removes the cap, places the tip of the dropper bottle into the nostril, instills the drug solution. When using a spray gun, when you press the pear, the solution is fed into the spray nozzle. solution evenly and thin layer irrigates the mucous membrane of the nasal cavity. The quality control of drops is carried out in accordance with the requirements of the pharmacopoeia and orders M3 of the Russian Federation.

Examples of prescriptions for nasal drops (orders of the Ministry of Health? 214, part 5, tab. 7; ? 223)

1. Rp.: Furacilini 0.002 Dimedroli 0.05 Ephedrini hydrochloride Novocaini ana 0.1

Solutionis Natrii chloridi 0.9% - 10 ml

In 5 ml of a 0.02% solution of furacilin, diphenhydramine, ephedrine hydrochloride and novocaine are dissolved. The solution is filtered through a cotton swab, previously washed with a solution of furacilin.

2. Drops of Preobrazhensky Rp.: Ephedrini hydrochloride Acidi borici ana 0.3 Norsulfasoli

Streptocidiana 0.5

Dimedroli 0.03

Olei Eucalypti gts. X Olei Persicorum 20.0

M.D.S. 3 drops in the nose 2 times a day.

Solid medicinal substances carefully crushed in a mortar with approximately half of their mass of peach oil, add the rest of the peach oil while stirring, transfer the suspension into a dry bottle, add 10 drops of eucalyptus oil.

3. Mezaton solution 1; 2; ten%

Rp.: Sol. Mesatoni 1% (2; 10%) - 10 ml

Action and indications: adrenomimetic agent.

4. Ephedrine hydrochloride solution 3%

Rp.: Sol.Ephedrini hydrochloridi 3% - 10 ml

M.D.S. 1-2 drops in the conjunctival sac.

Action and indications: adrenomimetic agent.

5. Collargol solution 1; 2; 3; 5%

Rp.: Sol. Collargoli 1% (2; 3; 5%) - 10 ml M.D.S. 2-3 drops in the nose 3 times a day.

Action and indications: astringent, antiseptic and anti-inflammatory agent.

6. Protargol solution 1; 2; 3%

Rp.: Sol. Protargoli 1% (2; 3%) - 10 ml

M.D.S. 2-3 drops in the nose 3 times a day.

7. Citral oil solution 1% Rp.: Citrali 0.1; 01. Olivarum 10.0 M.D.S. 2 drops in the nose 3 times a day.

8. Furacilin solution with diphenhydramine Rp.: Sol. Furacilini 0.02% - 10 ml Dimedroli 0.1

M.D.S. 2 drops in the nose 3 times a day.

Action and indications: antibacterial and antihistamine.

9. Oil drops with ephedrine, diphenhydramine, streptocide and sulfadimesine.

Rp.: Ephedrini hydrochloridi 0.15

Dimedroli 0.05

Streptocidi

Sulfadimezini ana 0.5 Olei. Helianthi 20.0

M.D.S. 2 drops in the nose 3 times a day.

Action and indications: antibacterial, antihistamine and vasoconstrictor.

Application

How to properly instill drops in the nose (Fig. 18.5).

1. Clear your nostrils.

2. Wash your hands with soap and warm water.

3. Lie on the bed with your head thrown back (let your head hang over the edge of the bed or place a small pillow under your shoulders).

Please note: when instilling drops into the child’s nose, place him with his back on your knees. The head should be tilted back.

4. Dial a small amount of drug into a pipette.

5. Breathe through your mouth.

6. Insert the tip of the pipette into your nostril to a depth of 5-10 mm. Try not to touch the nasal mucosa with the pipette.

7. Count the prescribed number of drops.

8. Continue to lie down for approximately 5 minutes for complete absorption of the drug.

9. Wash the pipette, place it in the package.

How to use the dropper bottle

(Fig. 18.6).

1. Clear your nostrils.

2. Wash your hands with soap and warm water.

3. Keep your head upright.

Rice. 18.5.The correct position when instilling drops in the nose

Rice. 18.6.Using a dropper bottle

4. Close one nostril with one finger.

5. With your mouth closed, insert the dropper tip into your open nostril. Exhale through the nostril, squeeze the container quickly and firmly.

6. Hold your breath for a few seconds and then exhale through your mouth.

7. Repeat the procedure for the other nostril, if prescribed by a doctor.

8. Rinse tip hot water and screw on the lid. 9. Wash your hands

18.7. EAR DROPS

In the form of ear drops, aqueous, non-aqueous and combined solutions are used. The technology is identical to the technology for making eye and nasal drops.

Examples of prescriptions for ear drops (order of the Ministry of Health of the USSR? 223 of 12.08.1991)

1. Rp.: Sol. Dimexidi 20% - 20 ml

M.D.S. On a moistened turunda, inject into ear canal 2-3 times a day (with acute inflammation external auditory canal).

Dissolve 4 g of dimexide in 10 ml of water, the volume of the solution is adjusted with water to 20 ml.

2. Rp.: Natrii hydrocarbonatis 0.5 Glycerni 5.0

Aq. pur. 5ml

M.D.S. Bury in the ear canal 7-10 drops 3 times a day.

The solution is prepared by heating in a water bath at a temperature of 60-70? The combination of ethanol, glycerin and dimexide as a solvent increases the permeability of the eardrum for the liquid part of the exudate.

3. Rp.: Resorcini

Spiritus aethylici 96% - 3 ml

Glycerini 8.0

M.D.S. 8-10 drops in the external auditory canal 2-3 times a day.

Ephedrine hydrochloride (accounting), resorcinol and novocaine are dissolved in ethanol or in its mixture with glycerin and dimexide.

4. Rp.: Sol. ntidi borici spirituosae 1% (3%) - 10 ml

Action and indications:

5. Alcoholic solution of levomycetin 2; 2.5; 3; 5%

Rp.: Sol. Laevomycetini spirituosae 2% (2.5; 3; 5%) - 10 ml M.D.S. 5 drops in the ear 3 times a day.

Action and indications: how antibacterial agent with catarrhal and purulent otitis media.

6. Phenol solution 3% in glycerin

Rp.: Sol. Phenoli 3% in glycerini 20.0

M.D.S. 5 drops in the ear 3 times a day.

Action and indications: as an antiseptic for otitis.

7. Furacilin solution 0.02%

Rp.: Sol. Furacilini 0.02% - 10 ml

M.D.S. 10 drops in the ear 3 times a day.

Action and indications: as an antibacterial agent for catarrhal otitis media.

8. Furacilin alcohol solution 0.05%

Rp.: Sol. Furacilini spirituosae 0.05% - 10 ml M.D.S. 5 drops in the ear 3 times a day.

Action and indications: as an antibacterial agent for chronic suppurative otitis media.

test questions

1. What are the advantages and disadvantages of drops as a dosage form?

2. What are the main quality indicators of drops?

3. What are the features of checking the dose of substances of lists A and B in drops? Give examples.

4. What are the features of nasal drops quality assurance?

Tests

1. Drops - a liquid dosage form dosed with drops is intended for:

1. Internal application.

2. Parenteral application.

3. Outdoor application.

2. As dispersed drop systems are:

1. Solutions are true.

2. Colloidal solutions.

3. Suspensions.

4. Emulsions.

3. The advantage of drops for internal use over potions is:

1. low concentration active substances.

2. High concentration active substances.

4. Recipes for drops for internal use containing substances of lists A and B:

1. Not subject to dose verification.

2. Subject to mandatory dose verification.

5. Drops for the nose, ears must meet the requirements for:

1. Liquid dosage forms.

2. Eye drops.

3. Injectable solutions.

6. Eye drops:

1. Must be sterile.

2. May be non-sterile.

7. If the total volume of drops does not exceed 30 ml, then the dissolution is carried out:

1. Using all the solvent at once.

2. In half the amount of solvent.

8. When administered in drops of substances of lists A or B in an amount less than

0.05 g:

1. Concentrated solutions of these substances are not used.

2. Pre-prepared concentrated solutions of these substances are used.

9. Intranasal drug application is practically bioequivalent to:

1. Injection route of administration.

2. Enteral route of administration.

10. Doses of substances of lists A and B in nasal drops:

1. Usually they do not check.

2. Check necessarily.

11. Before dispensing solutions of potent drugs for nasal use, pipettes should be:

1. Sterilized.

2. Calibrated.

For some diseases of the nasal cavity, the doctor may prescribe a multicomponent ointment. This medicinal product is prepared in production department pharmacies only on order. The composition contains various components that have anti-inflammatory and bactericidal effects. Complex ointment for the nose helps to fight sinusitis and rhinitis of various etiologies. During treatment, it is very important to comply with the dosage and not exceed the indicated duration of therapy.

Advantages of ointments

A complex ointment in the nose with sinusitis and frontal sinusitis has a number of advantages over other forms of drugs:

1. Due to the thick consistency medicinal product well envelops the nasal mucosa and quickly has a therapeutic effect.
2. The possibility of getting the drug into the middle ear cavity and the development of complications is excluded.
3. The composition of the medication has special components that prevent excessive drying of the nasal mucosa and the appearance of dry crusts.

As part of multicomponent ointments, there are components that help to quickly stop the main signs of the disease. Due to the multicomponent ointment, you can achieve the following effect:

• Treat sinusitis without sinus piercing.
• Eliminate swelling and congestion of the nasal passages.
• Reduce inflammation.

The use of such drugs is especially justified in cases where the use of antibiotics should be abandoned. systemic action. Such a talker can be prescribed to pregnant women and small children.

The healing properties of the multicomponent composition are truly unique. It allows for a short time cure nasal diseases that occur with severe inflammation and the formation of purulent masses.

Types of medication

Multicomponent ointment is of several types. There are differences in the composition and method of application. Each type of medicine has its own contraindications and side effects. Unreal to find standard instruction on the use of a complex ointment in the nose, since depending on the substances included in its composition, the method of application and dose changes.

Quite often, the prescription contains antibacterial substances, but according to the doctor's prescription, a drug based on vegetable matter. Most often, cyclamen root is included in the composition.

Standard Recipe

Most often, patients are prescribed a classic talker made from the following components:

• vaseline oil.
• Novocain and Dimedrol.
• Levomycetin and Menthol.

Depending on the diagnosis and the sensitivity of bacteria to the action of antibiotics, Levomycetin can be replaced by Erythromycin. In this case, the composition will be as follows:

• Vaseline oil as a base.
• Erythromycin.
• Menthol and Lanolin.
• Lidocaine.

In certain cases, prescriptions may be supplemented with other components, the use of which must be agreed with the attending physician.

A complex ointment is made in a pharmacy only to order. Its preparation usually does not take much time.

Preobrazhensky's recipe

The appointment of Preobrazhensky ointment is advisable for sinusitis, frontal sinusitis and rhinitis allergic nature. The composition of such a drug includes a number of substances that have a pronounced therapeutic effect. The Preobrazhensky recipe contains:

• Norsulfazol - antibacterial drug a large spectrum of action, capable of inhibiting the growth and reproduction of pathogens.
• Ephedrine - Has a pronounced vasoconstrictor effect.
• Sulfadimezin is an antimicrobial drug.
• Streptocide is a broad-spectrum antibacterial agent.
• Eucalyptus oil and camphor - have strong anti-inflammatory and antimicrobial action. Well moisturize the nasal mucosa and prevent the formation of crusts.

All components are placed in the medicine in a strictly defined amount. Both an excess of a single component and its deficiency reduce the effectiveness of the drug. Chatterbox has the following therapeutic effect:

• Reduces swelling and irritation of the nasal mucosa.
• Reduces the inflammatory process.
• It has a detrimental effect on pathogenic microorganisms.
• Reduces nasal congestion.
• Softens the nasal mucosa and prevents it from drying out.

This ointment is often prescribed for the treatment of children and women in position, as well as all those patients who, for some reason, are not recommended for systemic antibiotics. The viscous consistency of the drug allows you to effectively treat the nasal cavity. The medicine does not drain into the throat and has only a local effect.

Due to the optimally selected composition, the duration of the ointment is quite long. Therefore, there is no need to treat the nose frequently.

With silver

Sometimes, for diseases of the nose, it is advisable to use ointments with silver particles. Such a drug reduces the degree of inflammation and effectively fights microbes. Such a medicine is being prepared according to a standard prescription, only it is supplemented with protargol.

Diphenhydramine is often included in the composition. Its amount in the drug is so minimal that it does not have a systemic effect on the body. It is possible to use multicomponent ointments with Diphenhydramine even for the treatment of young children.

According to Simanovsky

Such a multicomponent drug is used to treat severe purulent processes in the nasal cavity. The drug is prepared exclusively according to the doctor's prescription in a pharmacy. Simanovsky's recipe contains the following components:

• cocaine hydrochloride.
• Menthol oil.
• Lanolin.
• Vaseline oil.
• zinc oxide.

Before using any complex means the nasal passages must be washed with a solution of Furacilin or a strong decoction medicinal herbs. To reduce nasal congestion drip vasoconstrictor drops, and then put cotton turundas smeared with ointment into the nasal passages.

Prepare complex compositions qualified specialist. It is not recommended to make such preparations on your own.

Features of treatment

A complex composition with antibacterial substances in the composition is often prescribed to those patients who are not recommended oral intake antibiotics:

• These medicines for the treatment of children can be used only as directed by a doctor. The composition of the drug and the duration of treatment may differ depending on the diagnosis and age of the child.
• Complex preparations often contain Diphenhydramine, but despite this, the drug does not affect the reaction rate and attention. During treatment, it is allowed to drive a car and work with complex mechanisms.
• These medicines do not interact with other medicines. Therefore, they can be prescribed as part of complex treatment.
• An expiration date is indicated on a nasal preparation made in a pharmacy. It is strictly forbidden to use the medication after the expiration date.
• There is no standard instruction for the use of these drugs. Therefore, you must strictly follow all the recommendations of your doctor.

Keep the drug in the refrigerator. Before use, the talker can be kept for about an hour at room temperature.

Side effects

Even if a multi-component nasal ointment is used in accordance with the prescriptions of the attending physician, there are big risk development side effects. When treating with a talker, you may experience:

• Nose bleed.
• Severe itching and burning in the nasal cavity.
• Irritation and excessive drying of mucous membranes.
• Peeling of the skin around the nostrils.

If there were any adverse reactions, treatment is stopped and a doctor is consulted.

With the help of complex ointments, you can quickly get rid of sinusitis and rhinitis of various etiologies. These drugs well envelop the mucosa and have a pronounced bactericidal and anti-inflammatory effect. Subtleties of use similar drugs explains the attending physician. The price of such drugs is quite acceptable, which only adds to their popularity.

With concomitant inflammation upper respiratory tract (which in most cases is the cause of otitis), it is very important to carry out appropriate treatment. Swollen nasal mucosa interferes with normal breathing and ventilation tympanic cavity through eustachian tube.

It makes it hard outflow a secret from the tympanic cavity through the tube, especially since with rhinitis there is also swelling of the mucous membrane of the nasopharynx, in particular, the mouths of the Eustachian tube. To mitigate these phenomena, it is recommended to lubricate the turbinates 3-4 times a day with a 1-2% solution of cocaine with adrenaline, which is an excellent vasoconstrictor: Sol. Cocaini hydrochlorici 1-2% 10.0; Sol. Adrenalini 1: 1,000 GT. x.

In addition, you can insert in the lower nasal passages, cotton swabs moistened with this solution for 3-5 minutes, and also apply an ointment of the following composition: Mentholi 0.1, Cocaini hydrochlorici 0.2; Sol. Adrenalini 1: 1,000 GT. x; Vaselli 10.0.
With good effect a 2-3% solution of ephedrine is also used in the form of nasal drops (4-5 drops) or lubrication.

With acute rhinitis good effect- gives a powder proposed by B. S. Preobrazhensky (Streptocidi albi; Sulfasoli; Sulfidini aa 2.0. M. f pulv. subtilis). The powder is blown into the nasal cavity using an insufflator; the patient may also sniff it up the nose, like a pinch of snuff, but not very forcefully. In the early days of acute rhinitis, an oral medication of the following composition often has a stopping effect:

Rp. Codcini pliosphorici
Papaverini hydrochlorici aa 0.015
Sacchari albi 0.2
M.f. p. D.t. d. N.XII

The patient should ban to draw mucus from the nose into the oral cavity, as well as blow your nose strongly or blow your nose, although not strongly, but simultaneously through both nostrils, as this leads to an increase in pressure in the nasopharynx, and possibly to the penetration of an infected secret from the nasal cavity through the Eustachian tube into drum cavity.

AT initial stage otitis media come to the fore, depending on the irritation of the twigs trigeminal nerve in the eardrum, due to pressure from the exudate; general state patient, the temperature rise recedes into the background. Anti-inflammatory therapy: heat in all forms (in particular, a warming compress), aspirin, pyramidon, salicylic drugs, sulfa drugs etc., in most cases, weakens the inflammatory process, and at the same time reduces the accumulation of exudate in the tympanic cavity and partly the pain.

Locally for pain relief apply drops poured into the external auditory canal. The most effective are 5% carbolic-glycerin drops with the addition of cocaine (3 or 5%); glycerin is applied dehydrated (Ac. carbolici 0.5; Cocaini hydrochlorici 0.3; Glycerini 10.0).