Dioxizole® [Dioxidine, lidocaine hydrochloride]

Pharmacological properties

dioxisole darnitsa is a combined topical drug, the active ingredients of which are dioxidine and lidocaine. the solution has a strong local anesthetic and moderate hyperosmolar effect, relieves wound and perifocal inflammation, stimulates the repair processes and activity of phagocytes in the wound.

Dioxidin has a pronounced antibacterial effect against gram-negative and gram-positive, aerobic and anaerobic, spore-forming and asporogenic microflora (Pseudomonas aeruginosa, staphylococci, streptococci, clostridia, bacteroids, peptococci, etc.) in the form of monocultures and microbial resistance to bacteria, including multi-bacterial resistance to microbial bacteria, other antibacterial drugs. The basis of its antibacterial action is the ability to damage the DNA of bacteria. As a result of this effect, the synthesis of bacterial nucleases slows down, the ultrastructure of the bacterial cell is disrupted, the cell membrane thickens and the membrane structure is disturbed. The cytostatic effect is due to the effect on the genome regions responsible for the synthesis of exoenzymes that determine virulence, which is associated with the ability of the drug to inhibit the development of resistance in microorganisms.

Lidocaine has a local anesthetic effect due to blockade of voltage-gated Na⁺-channels, which prevents the generation of impulses at the ends of the sensory nerves and the conduction of impulses along nerve fibers. When applied topically, it dilates blood vessels, has no local effect. The effect develops 1–5 minutes after application to the skin.

Pharmacokinetics When applied topically, dioxidine is practically not absorbed and does not have a locally irritating effect. It is not metabolized in the body, does not cumulate. It is allocated by kidneys.

The absorption rate of lidocaine and the amount of active substance that enters the bloodstream depends on the dose, type, size and condition of the surface on which the drug is applied (skin or mucous membrane), as well as the duration of exposure.

Lidocaine is well absorbed when applied to the mucous membrane and damaged skin and poorly when applied to healthy skin. Time to reach C_max in blood plasma - up to 1 hour. 40–80% of lidocaine binds to plasma proteins. It penetrates the blood-brain and placental barriers into breast milk. Metabolized in the liver. T_½ - 1.6 hours. It is excreted by the kidneys and with bile: 90–95% - in the form of metabolites, 10% - unchanged.

Indications

Local treatment of infected soft tissue wounds of various localization and genesis (limb stump after amputation, wounds after surgical treatment of purulent foci, pressure sores, trophic ulcers; purulent postoperative wounds and fistulas; paraproctitis, abscess; phlegmon of the maxillofacial region, etc.), treatment of burns of the II – IV degree, chronic and acute osteomyelitis, preparation of a wound for autodermoplasty, prevention of purulent-inflammatory processes in surgery and combustiology during various plastic surgeries.

Application

The drug is used in adults locally and for insertion into fistulas, wound cavities and pockets.

Topical application. Before starting the course of treatment, it is necessary to conduct a skin allergy test (on the inner surface of the forearm, subcutaneously) for tolerance to the drug. In case of a positive reaction, do not use a solution.

The drug should be used immediately after surgical treatment of wounds and burns, as well as later in the process of their treatment, previously cleaning the wound surface from exudate and necrotic tissue.Sterile dressings (gauze dressings or tampons) are richly saturated with r-rum and applied to superficial burns or inserted into deep wounds, after which sterile wipes are applied, which are fixed with a bandage or adhesive plaster. Dressings should be changed once every 7-14 days in the treatment of burns, once a day in the treatment of wounds.

Intracavitary administration (fistula, wound cavity and pockets). Before starting the course of treatment, conduct a test for tolerability of the drug, for which 8 ml is introduced into the purulent cavity. In the absence of adverse reactions for 3-6 hours (dizziness, chills, fever), start a course of treatment.

The drug is injected with a catheter using a syringe 1-2 times a day, followed by a sterile gauze dressing.

The dose and duration of treatment depend on the size of the damaged area, the severity of the disease, tolerance and are determined by the doctor. In this case, the daily dose of the solution for local use should not exceed 100 ml, with the introduction into the cavity - 50-60 ml. The course of treatment should not exceed 15 days.

Contraindications

Hypersensitivity to the drug. arterial hypotension, cardiogenic shock, av-block II-III degree, bradycardia, adrenal cortex insufficiency (including a history).

Side effects

On the part of the immune system, skin and subcutaneous tissue: hypersensitivity reactions, in particular itching, skin hyperemia, rash, urticaria, near-dermatitis dermatitis, edema, pain and burning sensation at the site of application, disappearing on their own after a few minutes and not requiring drug withdrawal.

With intracavitary administration of the drug or when doses are exceeded, systemic side effects may occur due to the presence of dioxidine in the preparation: headache, dyspeptic disorders, chills, fever, convulsions, hypersensitivity reactions, photosensitivity.

Systemic adverse reactions when using lidocaine as a local anesthetic are very rare. The reason for their occurrence may be the use of too high doses (more than 15 g) of lidocaine, rapid absorption of the drug, hypersensitivity, idiosyncrasy or reduced tolerance to lidocaine in some individuals. Systemic side effects can be manifested by excitation or depression of the central nervous system, inhibition of the cardiovascular system against the background of arterial hypotension, bradycardia and anaphylaxis, convulsions, tremors.

special instructions

The drug is used under medical supervision. before use, it is necessary to conduct a test for tolerability of the drug. in case of a positive reaction, do not use a solution. use the drug with caution in patients with impaired liver function and in patients with renal failure.

If adverse reactions occur, reduce the dose, prescribe antihistamines, and if necessary, discontinue use of the drug.

The drug is used mainly in the first phase of the wound process, as well as in the second - with granular wounds, with zones of necrosis and inflammation.

Use during pregnancy and lactation. The drug is contraindicated during pregnancy.

Children. The drug is not used in children.

The ability to influence the speed of reactions when driving vehicles or working with other mechanisms. During treatment, one should refrain from driving vehicles and potentially dangerous activities that require increased attention, as well as the speed of mental and motor reactions.

Interactions

Interactions of the solution of dioxisole-darnitsa with other drugs have not been identified, but it is not recommended to use it simultaneously with other ointments or creams.

Overdose

In case of an overdose, an increase in the side effects of the drug is possible.

Treatment: drug withdrawal, symptomatic therapy.

Storage conditions

In the original packaging at a temperature of 15-25 ° C.