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Pawitra Pulbutr M.Sc. In Pharm (Pharmacology) วัตถุประสงค์เชิงพฤติกรรม • มีความเข้าใจและอธิบายถึงกลไกการออกฤทธิ์และความเป็ นพิษของสารเคมีท่เี ป็ น Antiseptics และ Disinfectants • มีความเข้าใจและอธิบายถึงข้อดีและข้อเสียของสารเคมีท่เี ป็ น Antiseptics และ Disinfectants WORDS Sterilization การทาให้ปลอดเชื้อ • destroy microorganism including spores Disinfection การทาลายการติดเชื้อ • reduce or eradicate microorganism Disinfectants • chemicals that inhibit or kill micoorganism • use with non-living surface Antiseptics • chemicals that inhibit or kill microorganism • less toxic • use with living surface Properties of good antiseptics & disinfectants • active to all microorganisms • rapid & long action • water soluble & stable • tolerate to soap & organic material • non-toxic • less systemic absorption, non-allergenic • well penetrate • no colored, good smell • cheap NO antiseptics & disinfectants!! Alcohol • rapid evaporation…no residual action • can not penetrate organic material • may cause irritation & dryness • USE • antiseptic before injection • disinfectants Chlorhexidine • has residual action • tolerated to organic material • destroy by anionic & non-ionic surfactants • less irritation to skin • USE • chlorhexidine digluconate 2%, 4% • pre-operation … skin cleaning • infant bathing Halogen • iodine • chlorine • oxidize sulhydryl (SH) into S-S • denature protein • protein dysfunction & precipitation Iodine • active to bacteria, fungi, protozoa, virus , spore • tincture of iodine USP • 2% iodine + 2.4 % sodium iodide in alc. • Most potent antiseptics • irritation & hypersensitivity Iodophor • cpx of iodine + surface active agents • iodine + polyvinyl pyrrolidine • = povidone iodine (betadine®) • as active as iodine • less irritation & hypersensitivity • not staining • USE • wound antiseptic Chlorine • water soluble into hypochlorus, HOCL • active to bacteria, virus, protozoa, fungi, spore • destroy by organic material Chlorophor..slow release HOCL • sodium hypochlorite • chloramine Phenol Phenolic compounds • toxic….NO longer use • carcinogenesis • hyperbilirubinemia in neonates Phenolic agents • o-phenylphenol, o-benzyl-p-chlorophenol, ptertiary amylphenol • mixture of phenolic derivative • cresol, xylenol Phenolic compounds • cell membrane / cell wall disturbance • precipitation of protein • inactivate enz. • Active to bacteria, fungi, virus • No effect to spore • USE • disinfectants to hard surface..in lab/ hospital • not use in nursery…hyperbilirubinemia Hexachlorophene • active to most gm+ bacteria • hexachlorophene 3% in soap • USE • antiseptic in pre-operation • infant bathing …. • May accumulate..cause heart & brain abnormal •...cerebral edema , convulsion in premature infants Quaternary ammonium compound • cationic surface active detergents • benzalkonium chloride • cetylpyridine chloride • benzethonium chloride • inactivate enzyme • denaturation of protein • active to bacteria(+), fungi, lipophillic virus • sporistatic Aldehydes • formaldehyde, glutaraldehyde • alkylation protein / nucleic acid • active to bacteria, fungi, virus, spore • USE • disinfectants in medical equipments Hydrogen peroxide Release hydroxyl radical …cell membrane disturbance • hydrogen peroxide 3% & 6% • USE • disinfectants…respirator, soft contact lenses • wound antiseptics…catalase/ peroxidase...O2 gas + H2O • vapor phase hydrogen peroxide (VPHP) • USE • gaseous sterilant…less toxic than ethylene oxide, formaldehyde Mercury salts • thiomerosal (merthiolate) • thiomerosal 0.001-0.004%…preservative in vaccine • tincture merthiolate 0.1%…pre-operation antiseptics • merbromin (mercurochrome) ยาแดง Silver salts • silver nitrate • used as eye drop to prevent gonococcal ophthalmitis in newborns • silver sulfadiazine • burn wound