Chlorhexidine is a disinfectant and antiseptic used for skin disinfection prior to surgery and to sterilize surgical instruments. It can be used both to disinfect the patient's skin and the hands of health care providers. It is also used to clean wounds, prevent dental plaque, treat yeast infections, and keep urine catheters from blocking. It is used as a liquid or powder.
Side effects may include skin irritation, tooth discoloration, and allergic reactions. This can cause eye problems if direct contact occurs. Use in pregnancy seems safe. Chlorhexidine may be mixed in alcohols, water, or surfactant solutions. It is effective against various microorganisms, but does not inactivate spores.
Chlorhexidine began to be used in the 1950s. It's in the List of Essential Medicines of the World Health Organization, the most effective and safe drugs needed in the health system. Chlorhexidine is available on the table. The cost of wholesale in developing countries is around 2.20 to 4.10 USD per liter of 5% solution. In the United Kingdom this amount costs the NHS around Ã, £ 4.80.
Video Chlorhexidine
Usage
Chlorhexidine is used in disinfectants (skin and hand disinfection), cosmetics (additives for creams, toothpastes, deodorants, and antiperspirants), and pharmaceutical products (preservatives in eye drops, active substances in wound dressings and mouthwash antiseptics).
In endodontics, chlorhexidine is used for root canal irrigation and as intracanal dressing, but has been replaced by the use of sodium hypochlorite bleach in many developed countries.
Antiseptic
There is tentative evidence that it is more effective than povidone-iodine.
Chlorhexidine is active against Gram-positive and Gram-negative organisms, facultative anaerobes, aerobes, and yeasts. It is very effective against Gram-positive bacteria (in concentrations> = 1 Âμg/l). Significantly higher concentrations (10 to more than 73 μg/ml) are required for bacteria and Gram-negative fungi. Chlorhexidine is not effective against polio and adenovirus. The effectiveness of the herpes virus has not been firmly established.
Chlorhexidine, like other cation-active compounds, remains in the skin. It is often combined with alcohol (ethanol and isopropyl alcohol).
Dental use
The use of chlorhexidine-based mouthwash in combination with normal dental care may help reduce plaque buildup and improve mild gingivitis. Such mouthwashes also have a number of side effects including damage to the lining of the mouth, tooth discoloration, tartar buildup, and taste disorders. Extrinsic dye staining occurs when chlorhexidine rinse has been used for 4 weeks or longer.
A mouthwash containing chlorhexidine that stains teeth less than a classical solution has been developed, many containing chelated zinc.
Using chlorhexidine as a supplement for daily mechanical oral hygiene procedures for 4 to 6 weeks and 6 months led to a moderate reduction in gingivitis compared with placebo, control or oral hygiene alone.
Topic
Nepal is the first country in the world to use chlorhexidine to treat the umbilical cord of a newborn baby, and receive USAID Pioneer Prizes to reduce neonatal mortality. Chlorhexidine is very effective for poor countries like Nepal and its use grows in the world to treat the umbilical cord. The 2015 Cochrane review has yielded high-quality evidence that in community settings, skin care or cordhexidine cord can reduce the incidence of umbilical cephalitis by 50% as well as 12% neonatal mortality. Chlorhexidine gluconate is used as a skin cleanser for surgical scrubs, cleansers for skin wounds, for prep surgical skin preparation and hand germicide. Chlorhexidine eye drops have been used as a treatment for eyes affected by keratitis Acanthamoeba .
Maps Chlorhexidine
Side effects
Chlorhexidine does not meet current European specifications for hand disinfectants. Under the conditions of testing of European Standard EN 1499, no significant difference in efficacy was found between a 4% solution of chlorhexidine digikelonate and soap. In the US between 2007 and 2009, Hunter Holmes McGuire's Veterans Medical Center conducted a randomized trial of the group and concluded that the daily bath of patients in the intensive care unit with a bath towel saturated with chlorhexidine gluconate reduced the risk of hospital-acquired infection.
Whether prolonged exposure over the years may have a carcinogenic potential remains unclear. The Federal Drug Administration (FDA) in the United States recommends limiting the use of chlorhexidine gluconate to a maximum of six months.
Action mechanism
At physiological pH, chlorhexidine salt dissociates and releases positively charged chlorhexidine cations. The bactericidal effect is the result of binding of this cationic molecule to the cell wall of a negatively charged bacterium. At low chlorhexidine concentrations, this results in a bacteriostatic effect; at high concentrations, interference membranes produce cell death.
Chemistry
This is a cationic polybiguanide (bisbiguanide). It is used primarily as a salt (eg, dihydrochloride, diacetate, and digluconate).
Disabling
Chlorhexidine is turned off by forming insoluble salts with anionic compounds, including anionic surfactants commonly used as detergents in toothpastes and mouthwashes, anionic thickeners such as carbomers, and anionic emulsifiers such as acrylic/C10-30 alkyl acrylate crosspolymers, among many others. For this reason, chlorhexidine rinse should be used at least 30 minutes after other dental products. For best effectiveness, food, drink, smoking, and mouthwash should be avoided at least one hour after use. Many skin products, cleansers, and topical hand cleaners should also be avoided to prevent deactivation when chlorhexidine (as topical by itself or as a residue of a cleanser) is intended to remain in the skin.
Synthesis
This structure is based on two proguanil molecules, related to the hexamethylenediamine spacer.
Veterinary
In animals, chlorhexidine is used for topical wound disinfection, and for managing skin infections. Chlorhexidine-based disinfectant products are used in the dairy farm industry.
Post-surgical respiratory problems have been associated with the use of chlorhexidine products in cats. Chlorhexidine is ototoxic; if inserted into the ear canal that has a ruptured eardrum, it can cause deafness.
See also
- Polyaminopropyl biguanide
- Polyhexanide
- Triclosan
References
External links
- FDA Professional Drug Information
Source of the article : Wikipedia
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