Medical encyclopedia - irritants. Irritants Types of action of irritants

Irritants are medicinal substances that cause irritation of sensitive nerve endings when applied topically. Irritants belong to different classes of chemical compounds. They tend to be highly lipoid soluble, allowing them to penetrate the epidermis and superficial layers and reach sensitive nerve endings.

When irritants are applied to the skin and mucous membranes, a local reaction is observed in the form of hyperemia and swelling, as well as reflexes characteristic of irritation of this receptor field. The therapeutic effect of irritants is explained by the occurrence of reflexes that lead to changes in the activity of some nerve centers (respiratory, vasomotor) or the state of internal organs (changes in blood supply, metabolism). The action of irritants can accelerate the resolution of the inflammatory process and reduce the pain associated with this process (distracting effect). Thus, for example, the action of mustard plasters (see) with and (see) with myositis is explained. Irritants, acting on the mucous membranes of the upper respiratory tract, excite the respiratory and vasomotor centers (see Ammonia). With irritation of the oral mucosa, an expansion of the coronary vessels occurs with (see Validol, Menthol). Under the action of bitterness (see) on the oral cavity, the excitability of the "food center" reflexively increases. Irritation of the gastric mucosa leads to excitation of the vomiting center, which, depending on the intensity of exposure, causes an expectorant or emetic effect (see Expectorants).

Irritants (Dermerethistica) - medicinal substances that, when applied locally, cause irritation of sensitive nerve endings and reflexes characteristic of irritation of this receptor field. Under the influence of irritating agents, a local reaction develops on the skin, consisting of three components (“triple reaction”): bright hyperemia and swelling at the site of direct exposure to irritating agents and a rim of more moderate hyperemia surrounding this place. The first two components of this reaction depend on the expansion of the capillaries and the increase in their permeability, which is explained by the action of histamine on the capillaries, which is released from the cells when irritating agents act on them. The third component is due to the axon reflex. This reflex is carried out within the sensitive axon as a result of the propagation of impulses arising from irritation of the receptors to the vasodilating branches extending from the sensitive nerve fibers to the arterioles of the skin.

In the past, irritants have been used that cause a more intense local reaction with blistering, suppuration, and even necrosis (eg Spanish flies). Such irritants are now practically out of use. However, such a reaction can also occur under the influence of currently used irritants of moderate strength; this happens with excessive duration of their exposure to the skin.

Irritants are used for inflammatory diseases of the internal organs, as well as for myositis, neuritis, arthralgia, etc. (see mustard plasters, ammonia, turpentine). Under the influence of irritants, the resolution of the inflammatory process is accelerated and the pain associated with this process is weakened. The therapeutic effect of irritants is explained by segmental trophic reflexes from the skin to underlying tissues and internal organs. According to L. A. Orbeli, these are axon reflexes that spread within the ramifications of sympathetic nerve fibers. It is possible, however, that these reflexes are closed in the spinal cord, and their afferent link is sensory nerve fibers, and the efferent link is sympathetic fibers originating in the lateral horns of the spinal cord. Since the trophic cutaneo-visceral reflexes are segmental in nature, irritants should be applied to the Ged's zones, corresponding to the localization of the inflammatory process. When exposed to irritating agents on extensive skin surfaces, impulses arising in sensitive nerve endings propagate to the suprasegmental parts of the central nervous system, in particular to the respiratory and vasomotor centers of the medulla oblongata. This is the basis for the use of mustard wraps for vascular and respiratory failure. Reflexes to the respiratory and vasomotor centers also occur when sensitive receptors in the nasal mucosa are irritated. Ammonia is used as a means to irritate these receptors.

Some irritants have a selective effect on receptors that perceive the sensation of cold (see Validol, Menthol). Under the influence of such irritants, reflexes of the same nature arise as under the influence of cold. Therefore, application to the skin or mucous membranes of such irritants causes vasoconstriction. The therapeutic effect of such irritants in angina attacks is probably the result of the expansion of the coronary vessels as a result of irritation of cold receptors in the oral mucosa.

Irritants are found in various classes of chemical compounds. As a rule, irritants are distinguished by a common physicochemical feature - solubility in lipoids, which allows them to penetrate the epidermis and the surface layers of the epithelium and reach sensitive nerve endings. Good solubility in lipoids is distinguished, in particular, by essential oils widely used as irritants.

Irritating agents that have a selective effect on certain receptors of the digestive tract have a wide practical application. The reflexes that arise in this case depend on the localization of the receptors on which the given irritating agent acts. When the receptors of the oral cavity, which perceive the sensation of bitter taste, are irritated, a reflex increase in the excitability of the “food center” occurs (see Bitterness). Irritation of receptors in the gastric mucosa leads to reflex excitation of the vomiting center, which, depending on the intensity of irritation, causes expectorant or emetic effects (see Expectorants). Irritation of receptors in the intestinal mucosa leads to a reflex increase in its peristalsis (see Laxatives).

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. Dichlorodiethyl 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),

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.

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,

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

Irritants I 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, formic acid, dichloroethyl sulfide (yperite), trichlorotriethylamine, methyl salicylate, nicotinic acid derivatives (for example, β-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; a synonym for volatile); 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. Dichlorodiethyl sulfide is part of the Psoriasin ointment, trichlorotriethylamine is part of the Antipsoriaticum ointment, β-butoxyethyl ester 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, glycosides, saponins, and others have irritating properties. To those used as R. s. 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, thymol, chloral hydrate, cinnamon alcohol, spermaceti and petroleum jelly ; "Camphomene" (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 capsicum are used, the active ingredient of which is the alkaloid capsancin. In addition, capsicum tincture is part of the frostbite ointment (Unguentum contra congelationem), capsitrinum (Capsitrinum), pepper-ammonia liniment (Linimentum Capsici ammoniatum), pepper-camphor liniment (Linimentum Carsici camphralum), and capsicum extract - in the composition of pepper patch (Emplastrum Capsici). Of the products of plant origin, birch tar and preparations that contain it (for example, balsamic 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 the bronchial glands belong to expectorants (Expectorants) of the reflex type of action; drugs that cause a laxative effect - to laxatives (Laxatives); drugs that simulate - to choleretic agents (choleretic agents); stimulants - to bitterness (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 tissues, 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. When ammonia vapor is inhaled, a reflex of the respiratory center occurs due to irritation of the receptors of the upper respiratory tract. In addition, ammonia vapors can probably affect 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 skin afferent, and the efferent link is the sympathetic nerves emanating from the corresponding segments of the spinal cord. It is possible that some visceral skin may also have axon reflexes. In the mechanism of trophic effects of R. of page. the release of biologically active substances (for example, histamine), which occurs when the skin is irritated, also plays a certain role. 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 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 corresponding to the Zakharyin - Geda zones (Zakharyin - Geda zones). It is also possible that the weakening of pain under the influence of R. s. occurs due to the activation of antinociceptive systems of the c.n.s. (systems that regulate the perception of pain) and enhance the production of so-called endogenous opioid peptides, i.e. due to mechanisms similar to the mechanisms of the analgesic effect of some types of reflexology, such as acupuncture.

As various R. with. (for example, formic alcohol, preparations of menthol, turpentine, methyl salicylate, finalgon ointment) are widely used for arthralgia, myalgia, neuralgia, etc.

1. Small medical encyclopedia. - M.: Medical Encyclopedia. 1991-96 2. First aid. - M.: Great Russian Encyclopedia. 1994 3. Encyclopedic dictionary of medical terms. - M.: Soviet Encyclopedia. - 1982-1984.

See what "Irritants" are in other dictionaries:

Irritant drugs are drugs whose pharmacological action is mainly due to the excitatory effect on the endings of the afferent nerves of the skin and mucous membranes. Contents 1 Examples 1.1 Annoying ... Wikipedia

IRRITANTS- belong to the oldest drug groups. Since, according to the ideas of old medicine, irritation of the skin could lead to the distraction of the “painful onset” from the internal organs outwards, R. s. got… …

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- (irritantia; synonymous with distractions) drugs that have a local irritant effect on the skin and mucous membranes; are used in the treatment of inflammatory processes, as well as to relieve pain (oil ... ... Big Medical Dictionary

Drugs, the therapeutic use of which is based on their ability to irritate the sensitive nerve endings of the skin and mucous membranes. In R.'s group with. include substances of different origin and chemical structure: ... ... Great Soviet Encyclopedia

- (Asria, Irritantia) medicinal substances that have a strong irritant effect at the application site. Other R. the means accepted inside and got to blood irritate only certain bodies. The results of their application are... Encyclopedic Dictionary F.A. Brockhaus and I.A. Efron

Those who increase the amount of urine should directly or indirectly increase the work of the kidney tissue. Since the normal activity of the latter depends mainly on the state of the kidney tissue itself, the composition of the blood and the conditions of blood circulation in ... ... Encyclopedic Dictionary F.A. Brockhaus and I.A. Efron

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ANESTHETIC DRUGS- ANESTHETIC DRUGS, Apae sthetica (from Greek a negative part, aisthesis feeling), substances that suppress sensitivity. Usually, this implies substances that can prevent the sensation of pain during surgery. or other honey. intervention in... Big Medical Encyclopedia

6.1. Irritant action: definition.

Irritants

Irritating is the local action of chemicals on receptor formations in integumentary tissues, leading to the launch of excessive protective and adaptive reactions, which causes a complete loss of capacity (purposeful conscious behavioral activity).

Irritant action is irritation of the mucous membranes of the eyes (conjunctiva), mucous membranes of the upper respiratory tract, in high concentrations - irritation of the skin. It is quite obvious that such an action is inherent in a large number of chemical compounds. Almost all strong-smelling or "aggressive" substances (acids and alkalis) when inhaled cause irritation of mucous membranes and skin. Among the whole variety of substances that have an irritant effect, one can conditionally single out a group of those that selectively act on the receptor apparatus of the reflexogenic zones (i.e., damage to other organs and tissues occurs when exposed to doses that are hundreds to thousands of times higher than the doses causing irritation). Such substances are referred to in toxicology as irritants.

So, irritant substances (irritants) are a group of substances that selectively act on the receptor apparatus of protective and adaptive reflexes, i.e. substances that cause such a pronounced irritation of the mucous and integumentary tissues, which leads to a complete loss of legal capacity.

The most sensitive to irritation are the integumentary tissues, in which the density of nerve endings is highest, where they are more accessible to the action of chemicals. This is, first of all, the conjunctiva of the eyes, the mucous membrane of the respiratory tract.

Receptor formations in integumentary tissues of various localizations have structural features. This causes differences in the sensitivity of receptors to various substances. On this basis, irritant substances are divided into three groups:

tear-acting substances (lachrymators) - substances that cause primary irritation of the conjunctiva of the eyes (halogenated ketones and nitriles);

sternites ("sneezing" substances) - substances that selectively act on the mucous membranes of the upper respiratory tract (arsenic organic compounds);

3) irritating substances of mixed action - have the same irritating effect on the conjunctiva and on the upper respiratory tract, and at high concentrations - on the skin.

Causes of (mass) damage by irritating substances:

The vast majority of hazardous chemicals are irritants, i.e. in the event of foci of chemical damage as a result of an accident at chemical industry facilities, first of all, the damage will be characterized by powerful irritation of the integumentary tissues and upper respiratory tract.

Substances of an irritating effect are supplied to law enforcement agencies in almost every state. These are the so-called "police gases". They are used to disperse unsanctioned demonstrations, mass violations of law and order, when there is a threat of violent actions from organized armed groups, and so on. An analysis of media reports allows us to conclude that in the modern world, in the last 5-7 years, police irritants are used 150-190 times a year (worldwide).

The armies of countries possessing chemical weapons are armed with irritating poisonous substances, which are designed to temporarily incapacitate enemy personnel. Red pepper extract - capsaicin - in fact one of the first OB. The fact of its use was established in the Navy of Ancient China. The irritating agent group was widely used during the First World War. One of the weapons used at that time - adamsite - is still in service with most armies. Very widely irritating agents were used in the 50s. XX in France during the war in Korea, in the 60-70s. during the US war in Vietnam.

Irritant substances are one of the most likely sabotage agents and substances used for terrorist purposes. For example, in one of the hypermarkets in St. Petersburg in 2006, an irritating substance was used, as a result of which about 90 people were injured. Exposure to irritants at "usual" effective concentrations is not expected to result in severe injury. The experience of using these substances shows that in the overwhelming majority of cases a reversible transient toxic reaction develops. However, each victim should strive to get out of the lesion as quickly as possible. This provokes panic, which can be accompanied by great sacrifices.

In some countries, irritants are sold for "individual" use as a means of self-defense.

Thus, the group of substances with an irritating effect is one of the most relevant for extreme toxicology, since their defeat in ° is possible both in peacetime emergencies and in combat operations.

6.2. Acute lesion pathogenesis

The “target structure” for irritants is the receptors of the reflexogenic zones of protective and adaptive reflexes. There are two mechanisms of action of chemicals on the receptor apparatus:

direct action on membrane structures: inhibition of SH-groups of structural proteins by arsines; the action of capsaicin on the ion channels of the electrically excitable membrane;

indirect action: activation of the formation in the integumentary tissues of "inflammatory mediators" (bradykinin, prostaglandins, serotonin, etc.), which secondarily excite the receptor apparatus.

As a result of excitation of the receptor apparatus, a powerful afferent flow arises, which is transmitted to the neurons of the gelatinous substance and the sensory nuclei of the spinal cord, the nuclei of the trigeminal and glossopharyngeal nerves. From the primary nerve centers, the signal enters the autonomic and motor nuclei located in the middle and medulla oblongata. Unconditioned reflexes are formed: cough, runny nose (rhinorrhea), sneezing, lacrimation, blepharospasm, etc. The physiological meaning of these reactions is clear - the body is trying to “wash away” the substance that caused powerful afferentation from the mucous membranes.

In addition to the cascade of protective-adaptive reactions, the action of irritants causes intense pain or its pathophysiological analogues (burning, itching). In the physiology of sensory systems, it is generally accepted that pain sensations can arise as a result of two processes: 1) excitation of special "pain receptors" - the nociceptive system, the presence of which in integumentary tissues remains a more or less probabilistic hypothesis today; 2) excessive (outrageous) excitation of any afferent channel is perceived as pain (for example, excessive impulses through a channel that transmits information about skin temperature when exposed to high temperatures is perceived as pain).

Thus, as a result of direct or indirect action of irritants on the receptor apparatus, protective and adaptive reflexes (lacrimation, cough, runny nose) and intense pain sensations arise. The action of irritants - the classic version reflex the action of poison.

The main clinical manifestations of acute damage by irritating substances in the vast majority of cases are quickly stopped without any residual effects. Such a rapid regression of clinical manifestations suggests that irritant damage is characterized by the development of the so-called "transient toxic reaction". The clinical picture of acute poisoning occurs under the action of large doses of irritating substances.

The danger of exposure to super-high doses of irritants lies in the following pathogenetic mechanisms. In 1870, Kretschmer described a reflex formed when the upper respiratory tract was irritated with ammonia: in an acute experiment, it was proved that the inhalation of ammonia in high concentrations causes reflex respiratory arrest (apnea). This reflex can also be induced in humans: when large doses of irritants are inhaled, death from primary reflex respiratory arrest is possible.

When exposed in high concentrations, irritants can lead to severe and persistent bronchospasm. The cause of the phenomenon is the activation of mast cells by irritants in the lung tissue, which throw in active substances that cause spasm of the smooth muscles of the bronchi.

With prolonged inhalation of large doses of irritants (for example, if it is impossible to leave the infection zone), the affected person may develop toxic pulmonary edema (see section "Pulmonary toxicity").

6.3. RH irritating action: general characteristics.

"Police Gases"

The vast majority of irritating agents are solid crystalline substances that are practically insoluble in water.

The main properties of some irritating agents are presented in table 16.

Table 16

Properties of the main irritant agents

(according to N.V. Savateev, 1987)

For the use (for military or police purposes) of irritating substances, it is necessary to use special devices for dispersion: aerosol generators, smoke bombs, grenades, etc. When using "police gases", aerosols and fumes are quickly carried away by air currents (unstable focus).

The main manifestations of acute injury

The manifestations of lesions by various tear agents (chloroacetophenone, CS, CR) are basically similar.

When defeated mild degree a transient toxic reaction develops. The defeat is accompanied by a pronounced burning sensation in the eyes, sometimes a feeling of pain, blepharospasm (spasm of the muscles of the eyelid), rarely - photophobia. Upon leaving the contaminated atmosphere, the irritation phenomena persist for 2-4 minutes, and then stop.

With a more severe lesion - a lesion moderate severity - the phenomena of eye irritation are accompanied by pronounced manifestations of irritation of the respiratory tract: burning in the mouth, nasopharynx, in the chest, profuse rhinorrhea, salivation, painful dry cough. Sometimes the cough is so persistent that it provokes vomiting. In most cases, the signs of the lesion are reduced within 20-30 minutes after the cessation of the action of the irritant (exit from the focus).

Intolerable subjective sensations caused by the action of irritating substances on the mucous membranes of the eyes and respiratory tract are objectively expressed only in a small injection of the vessels of the mucous membrane of the pharynx, slight hyperemia of the larynx and nasal cavity, and an injection of the sclera.

With prolonged inhalation develops severe defeat, deeper parts of the respiratory tract are involved in the process. Subjectively, this is expressed by a feeling of suffocation. An intense “tearing” retrosternal pain develops, which in severity can be compared with a burn sensation, the pain radiates to the head and back. The pain is so excruciating that the affected are barely able to take a breath (“every breath causes incredible torment”). Severe irritation of the respiratory tract can lead to severe bronchospasm.

With prolonged exposure to lachrymators and sternites in high concentrations, lethal outcomes are possible. Cause of death usually is toxic pulmonary edema. Large doses of irritants can cause reflex respiratory and cardiac arrest.

Giving help. Medical protection measures

A modern (combined-arms or civil defense) filtering gas mask reliably protects the respiratory organs and eyes from the effects of irritating agents. If there is a threat of damage to AOHV, which have a pronounced irritating effect (chlorine, ammonia), gas masks with special filter elements should be used.

To provide first aid to the affected, a volatile anesthetic ficillin is used. It is available in an ampoule in a cotton-gauze braid. The role is crushed, the contents are impregnated with a cotton-gauze braid, which is placed under the helmet-mask of the gas mask of the affected. Evaporating, the local anesthetic enters the respiratory organs and stops the flow of afferent impulses.

Of historical interest is the precursor of ficillin - a complex of volatile anesthetics, which was part of the formulation of "anti-smoke mixture (PDS)".

After leaving the area of ​​infection, to reduce the effects of irritation, it is necessary to rinse the eyes and mouth with a 2% aqueous solution of soda, in the absence of clean water.

With persistent pain syndrome, the victim is sent to medical institutions for medical assistance. Various volatile anesthetics can be used, and with a painful intractable cough - up to narcotic analgesics.

Given the continuing threat of pulmonary edema, patients with severe forms of lesions, with intractable pain syndrome, should be under active medical supervision in a therapeutic hospital for at least 48 hours.

6.6. Medical and tactical characteristics of the lesion

When using an irritating agent, foci are created that can be systematized and described as follows:

According to the speed of action: the focus of the lesion with a fast-acting substance

the lesion develops almost instantly, already in a few seconds - minutes from the moment of exposure to the substance.

According to the resistance of infection: most combat agents form a focus of unstable infection - damaging concentrations of the substance persist for no more than 1 hour (10-20-30 minutes, depending on weather conditions).

The exception is combat agents of irritating action, which create foci of sufficiently persistent infection. So, in Vietnam, the US Army used two recipes: CS-1 and CS-2. RecipeCS -1 infected the area for about 2 weeks, and CS-2 - a more resistant formulation in which each particle of crystalline CS is covered with a water-repellent silicone film, caused infection of the area for up to a month (Myasnikov V.V., 1984).

According to the final effect of the lesion: the lesion by the incapacitant

Irritating agents are not designed to destroy enemy personnel, their tactical purpose is to temporarily disable the enemy.

Irritants stimulate the endings of the sensory nerves of the skin and mucous membranes.

Mustard essential oil, ethyl alcohol (20-40%), purified turpentine oil, pepper patch, 10% ammonia solution, menthol, etc. are used as irritants.

Irritant substances are used for inflammatory diseases of the respiratory tract, muscle and joint pain (myositis, neuritis, arthritis, etc.).

In this case, when exposed to healthy areas of the skin that have conjugated innervation with the affected organs or tissues, irritating substances have a so-called distraction - as a result, the sensation of pain is reduced. The distracting effect is explained by the interaction of excitation entering the central nervous system from the affected organs, and excitation coming from sensitive skin receptors when exposed to irritating substances. This reduces the perception of afferent impulses from pathologically altered organs and tissues.

In these cases, the use of irritants also improves the trophism of the organs and tissues involved in the pathological process. The trophic effect of irritating substances is explained by the activation of the sympathetic innervation of the affected organs and tissues during excitation of sensitive skin receptors. It is believed that excitation can spread from the skin receptors to the affected organs through the branching of postganglionic sympathetic fibers in the form of an axon reflex (bypassing the central nervous system). Trophic action can also be carried out by the usual skin-visceral reflex (through the central nervous system). A certain positive effect can be exerted by the release of biologically active substances (histamine, bradykini-naidr.) during skin irritation.

Mustard essential oil, which is released when using mustard plasters, has a distracting and trophic effect.

Mustard plasters - mustard paper coated with a thin layer of mustard seed powder, which contains a glycoside sinigrin and enzyme myrosin. Before use, mustard plasters are placed for a short time in warm water (about 38 ° C). This temperature is optimal for the enzymatic reaction, as a result of which, under the influence of myrosin, sinigrin is cleaved to form the active mustard irritant - essential mustard oil (allyl isothiocyanate). Mustard plasters are used for diseases of the respiratory system, angina pectoris, as well as for neuralgia, myalgia. When they are used, the feeling of pain decreases, and the trophism of the corresponding organs and tissues improves.

To obtain a distracting effect, other irritating agents are also used.

Alcohol compresses. For compresses, ethyl alcohol 40% is used, since it is at this concentration that alcohol has a pronounced irritant effect.

stinging effect (in children's practice, lower concentrations of alcohol are used - 20%).

The fruits of capsicum, containing the main irritating glycoside capsaicin, are used to prepare various preparations - tinctures of capsicum, pepper patch, creams and ointments - Nikoflex, Efkamon.

Turpentine oil (purified) is a product of the distillation of resin from Scots pine, contains a lipophilic substance of a terpene structure - α-pinene, which penetrates the epidermis and irritates sensitive nerve endings. It has a distracting and antiseptic effect. Included in the turpentine ointment. These drugs are used mainly as distractions for radiculitis, myositis, arthritis. The ointment "Finalgon" has a distracting effect.

Irritants, by stimulating the sensitive receptors of the mucous membranes, can have reflex action(excitation from sensitive receptors is transmitted through afferent fibers to the central nervous system, while the state of the corresponding nerve centers and the organs innervated by them changes). The reflex action of irritating substances is used when using a solution of ammonia, menthol.

Ammonia solution (ammonia, NH 4 OH) is used for reflex stimulation of the respiratory center during fainting. To do this, cotton wool moistened with an ammonia solution is brought to the patient's nose. Inhalation of ammonia vapor leads to excitation of the endings of the sensory nerves of the upper respiratory tract, as a result, the respiratory center is reflexively excited and the patient regains consciousness. However, inhalation of large amounts of ammonia vapor can cause a sharp decrease in heart rate, respiratory arrest.

Menthol, the main component of peppermint essential oil, is a terpene alcohol. It has a selective stimulating effect on cold receptors, causes a feeling of cold, replaced by local anesthesia. Irritation with menthol of Cold receptors in the oral cavity is accompanied by a reflex expansion of spasmodic coronary vessels. On the basis of menthol, the drug validol is produced (25% solution of menthol in the menthol ester of isovaleric acid), used for mild forms of angina pectoris, for cardiovascular neuroses.

Menthol is used for inflammatory diseases of the upper respiratory tract in the form of drops, inhalations, etc.

Menthol, as a distraction, is part of many combined preparations for external use - Menovazin, Boromenthol, Efkamon and others.