Acetarsol + Boric acid + Dextrose + Sulfanilamide - instructions for use, dose, side effects, contraindications

Clinical and pharmacological group: & nbsp

Included in the formulation

АТХ:

G.01.A.B Arsenic compounds

J.01.E.B Sulfonilamides of short action

Pharmacodynamics:

The drug with antiprotozoal, antibacterial, antiseptic and anti-inflammatory action for topical application.

Acetarsol contains about 27% arsenic. Due to its ability to block sulfhydryl enzyme systems, it breaks the metabolic processes of the protozoa (including trichomonads, amoebae), and some spirochetes.

Acetarsol is practically insoluble in water, but soluble in alkaline medium. Therefore, to prevent the resorption of the drug (and possible intoxication with arsenic), it is necessary to maintain the acidic environment of the vagina. Dextrose, which is part of the drug, is a nutrient substrate for lactobacilli normal vaginal microflora. Lactobacilli decompose dextrose to form lactic acid, providing an acidic environment of the vagina. Boric acid also supports the acidic environment of the vagina.

Sulfanilamide is a structural analogue of para-aminobenzoic acid, necessary for microorganisms for the synthesis of dihydrofolic acid. The drug causes a competitive blockade of dihydropteroate synthetase of bacteria: a disruption of synthesisdihydropteroic acid (precursor of tetrahydrofolic acid - cofactor of purine synthesis). The synthesis is violated deoxyribonucleic acid and, consequently, the growth and multiplication of bacteria. Thus, only microorganisms that are forced to synthesize folic acid themselves are sensitive to its action.

Pharmacokinetics:

In case of intravaginal application, the systemic action of acetazol is not manifested.

Boric acid is absorbed through the mucous membranes. Penetrates into many organs and tissues and can accumulate in them. It is withdrawn slowly (with repeated injections cumulates). About 50% is excreted in the urine in 12 hours, the remainder - within 5-7 days. Has an irritant effect on the mucous membranes.

Sulfanilamide with local application is absorbed slightly. Passes through histohematological, including blood-brain, placental barriers. In the liver, acetylated with a loss of antibacterial properties. It is excreted mainly (90-95%) by the kidneys.

Dextrose molecules are utilized in the energy supply process.

Indications:

Trichomonas colpitis.

ICD-10

I.A50-A64.A59.0 Urogenital trichomoniasis

XIV.N70-N77.N76 Other inflammatory diseases of the vagina and vulva

Contraindications:

Hypersensitivity, hepatic insufficiency, chronic renal failure, diabetes, hemorrhagic vasculitis, tuberculosis, heart and gastrointestinal disease, pregnancy.

Carefully:

When using acetazol, as well as other drugs of arsenic, you can not exclude the development of jaundice and hepatitis.

Efficacy and safety when used in children have not been studied.

Pregnancy and lactation:

Category of recommendations Food and Drug Administration (US Food and Drug Administration) not determined.

When pregnancy is contraindicated. Adequate and well-controlled studies on humans and animals have not been conducted. There is no information on the penetration into breast milk.

Dosing and Administration:

Intravaginal - 1 suppository (contains 300 mg of acetarSol, 300 mg of boric acid, 300 mg of dextrose, 300 mg of streptocid) once a day for 10 days. The suppository is administered in the patient's prone position.

Side effects:

Jaundice, hepatitis, polyneuritis, vomiting, diarrhea, fever, dermatitis, allergic reactions.

Overdose:

Cases of overdose when applying suppositories according to the instructions are not marked.

Symptoms of acute intoxication (accidental ingestion) boronic acid: nausea, vomiting, diarrhea, gastralgia, disruption of cardiovascular system stimulation or depression of the central nervous system, hyperpyrexia, erythematous rash with desquamation subsequent (possibly fatal within 5-7 days), impaired kidney function and liver (including jaundice), circulatory collapse, shock, including fatal.

Treatment: symptomatic. Blood transfusion, hemo- and peritoneal dialysis.

Symptoms of intoxication with dextrose: hyperglycemia, glucosuria, disturbance of water-electrolyte balance.

Treatment: stop the injection of glucose solution, introduce insulin; symptomatic therapy.

Symptoms of intoxication sulfonamides (in case of accidental ingestion): nausea, vomiting, confusion, fainting, intestinal colic, dizziness, headache, drowsiness, depression, blurred vision, fever, hematuria, crystalluria; with prolonged overdose - thrombocytopenia, leukopenia, megaloblastic anemia, jaundice.

Treatment: cancellation of the drug, gastric lavage (within 2 hours after taking an excessive dose), urine acidification (to increase the excretion of sulfanilamide), abundant drinking, intramuscularly - 5-15 mg per day of calcium folinate (eliminates the effect of sulfanilamide on the bone marrow); forced diuresis, if necessary - hemodialysis.

Interaction:

Drug interaction of the drug has not been described to date.

It is known that myelotoxic drugs increase the hematotoxicity of sulfanilamide (ingestion).

Special instructions:

There is no information on the penetration of the drug into breast milk.

Efficacy and safety of use in children have not been studied.

Instructions

Acetarsol + Boric acid + Dextrose + Sulfanilamide (Acetarsolum + Acidum boricum + Dextrosum + Sulfanilamidum)