Indications for use:

Hypertension, edema in CHF; Spironolactone (an aldosterone antagonist) is also used for hyperaldosteronism.

Side: dyspeptic symptoms, azotemia, cramps in the lower extremities, hyperkalemia.

Osmotic diuretics

Mannitol (mannitol)

Designed for intravenous drip injection in a volume of 200-400 ml. Mannitol is filtered through the endothelium of the capillaries of the renal glomeruli and maintains a high osmotic pressure in the lumen of the nephron tubules. The drug is not reabsorbed and therefore retains water in all parts of the nephron, especially in the proximal tubules, resulting in a significant increase in urine volume. In addition to the diuretic effect, mannitol has a dehydrating effect by increasing the osmotic pressure of blood plasma.

Indications for use:Pulmonary edema, cerebral edema; Acute poisoning (for forced diuresis); Acute attack of glaucoma

NB! In case of impaired renal excretory function, mannitol is ineffective and contraindicated!

Side effects:

Dry mouth, tachycardia, nausea, vomiting, convulsive reactions are possible.

Carbonic anhydrase inhibitors

Indications for use:• After suffering strokes, brain injuries, neuroinfections, neurosurgical interventions • Intracranial hypertension • Internal hydrocephalus • Some forms of epilepsy, cerebral palsy • Chronic alcoholism • Open-angle glaucoma • Prevention and relief of mountain (high-altitude) sickness

Dorzolamide (Trusopt) is used topically in the form of eye drops for open-angle glaucoma.

Side effects:• Metabolic acidosis (for its prevention after 4-5 days of administration - a break of 2-3 days) • Increased blood glucose levels • Moderate hypokalemia and hypomagnesemia

• Diarrhea. • Teratogenic effect (contraindicated in pregnancy).

four). Dyes. Detergents. Oxidizing agents. Acids and alkalis. Classification. Mechanism of action. Indications for use. Side effects. Contraindications Comparative evaluation of drugs.

Dyes:Brilliant green, methylene blue, ethacridine lactate

Detergents:Zerigel, roccal

Oxidants:Potassium permanganate, hydrogen peroxide solution

Acids and alkalis:Boric acid, salicylic xylot; ammonia solution, sodium bicarbonate.

Detergents (roccal, cerigel) - cationic soaps with detergent and antiseptic properties.

Mechanism of action: violation of the structure of the cell membrane, denaturation of proteins and inhibition of enzymes of the microbial cell.

Indications: treatment of the surgeon's hands, sterilization of instruments.

Side effects: they do not cause irritation of tissues in usual concentrations.

Cannot be combined with anionic soaps as their activity decreases.

Oxidants

Hydrogen peroxide

Mechanism of action:upon contact with tissues, it decomposes with the release of molecular oxygen, which is released in the form of bubbles from the wound, mechanically cleans it. It also has a deodorant and hemostatic effect.

Indications: used for the primary treatment of superficial contaminated wounds, cleansing wounds from pus and blood clots, stopping capillary bleeding (including nasal), for rinsing the mouth and throat).

Potassium permanganate

Mechanism of action:in the presence of organic substances, it splits off atomic oxygen, the antiseptic effect of atomic oxygen is more pronounced than molecular one; provides antimicrobial and deodorizing effects, and the resulting manganese oxide is an astringent.

Indications: it is used for treating wounds, rinsing the mouth and throat, 0.02-0.1% solution is used for washing and douching for gynecological and urological inflammatory diseases, as well as for washing the stomach in case of poisoning.

Acids and alkalis.

Boric acid, salicylic acid.

Mechanism of action: the antimicrobial properties of acids are due to the specific action of molecules and the ability to change the pH of the medium towards the acidic side. This shift is unfavorable for the development of many microorganisms.

Indications: Boric acid (2-4% solution) is used to rinse the mouth and throat, wash the eyes; 2% alcohol solution is used in the form of ear drops for otitis media, for treating affected skin areas with pyoderma, diaper rash; 5% ointment - for the treatment of head lice. Boric acid is a part of combined ointments, liniment, pastes.

Salicylic acid in the form of an ointment, paste, alcohol solution, as well as in combination preparations is used as an antiseptic, irritant and keratolytic agent for infected lesions, fungal skin diseases.

Ammonia solution and sodium bicarbonate solution.

Indications:10% ammonia solution (ammonia) - as an ambulance to stimulate breathing and remove from fainting. Sodium bicarbonate has good detergent properties, it is used for rinsing the mouth and throat with tonsillitis, washing the eyes, sterilizing instruments.

Dyes.

Mechanism of action: have some selectivity of action against certain microorganisms. They not only denature the proteins of microorganisms, but even in low concentrations bind to DNA and quickly lead to the death of bacteria.

Side: non-irritating to tissues, non-toxic in the concentrations used.

Indications: brilliant green in the form of 1-2% alcohol (or water) solution is used for lubrication with pustular skin lesions (pyoderma, folliculitis), with small skin cuts, infectious diseases of the eyelids (blepharitis).

Methylene blue is used for washing with cystitis, urethritis. This drug is an antidote for cyanide poisoning, since in certain doses it is able to convert hemoglobin into methemoglobin, which binds to cyanide and forms non-toxic cyanmethemoglobin.