Iodine - instructions for use, dose, side effects, contraindications

Elementary iodine has pronounced antimicrobial properties. For preparations of elemental iodine, a pronounced local irritant effect on tissues is characteristic, and cauterizing effect in high concentrations. Local action is due to the ability of elementary iodine to precipitate tissue proteins. Preparations, eliminating the elementary iodine, have a much less pronounced irritant effect, and iodides have locally irritating properties only at very high concentrations.

The nature of the resorptive action of preparations of elemental iodine and iodides is the same. The most pronounced effect with resorptive action iodine preparations have on the functions of the thyroid gland. With iodine deficiency, iodides contribute to the restoration of impaired thyroid hormone synthesis. With normal iodine content in the environment, iodides inhibit the synthesis of thyroid hormones,decreases the sensitivity of the thyroid gland to thyroid-stimulating hormone pituitary gland and its pituitary secretion is blocked. Protection of the thyroid gland from radioactive training: iodine absorption by ingestion prevents the ingestion of radioactive isotopes of iodine by the gland.

The effect of iodine preparations on metabolism is manifested by the intensification of dissimilation processes. With atherosclerosis, they cause a slight decrease in the concentration of cholesterol and beta-lipoproteins in the blood; in addition, increase the fibrinolytic and lipoproteinase activity of blood serum and slow the rate of blood clotting.

Accumulating in syphilitic scales, iodine promotes their softening and resorption. However, the accumulation of iodine in tuberculosis foci leads to an intensification of the inflammatory process in them. Isolation of iodine excretory glands is accompanied by irritation of glandular tissue and increased secretion. This is due to expectorant action and stimulation of lactation (in small doses). However, in large doses of iodine preparations can cause suppression of lactation.

Pharmacokinetics:When exposed to skin or mucous membranes, 30% turns into iodides, and the rest into active iodine. Partially absorbed. The absorbed part penetrates into tissues and organs, is selectively absorbed by the thyroid gland. It is allocated mainly by the kidneys, intestines, sweat and mammary glands.

Indications:

For external use: infectious and inflammatory skin lesions, trauma, wounds, myalgia.

Disinfection of the operating field, pre- and postoperative treatment of the operating field - twice the skin with a sterile gauze swab dipped in solution. Total processing time - 4-6 minutes; injection, puncture, catheterization, treatment of the edges of wounds, fingers of the surgeon.

For topical application: chronic tonsillitis, atrophic rhinitis, purulent otitis media, trophic and varicose ulcers, wounds, infected burns, fresh thermal and chemical burns of I-II degree.

Endemic goiter (prevention).

For oral administration: prevention and treatment of atherosclerosis, tertiary syphilis.

ICD-10

IX.I70-I79.I70 Atherosclerosis

IX.I80-I89.I83.2 Varicose veins of the lower extremities with ulcer and inflammation

X.J30-J39.J31 Chronic rhinitis, nasopharyngitis and pharyngitis

X.J30-J39.J35.0 Chronic tonsillitis

XIII.M70-M79.M79.1 Myalgia

XIX.T08-T14.T14.0 Superficial injury of unspecified area of the body

XIX.T08-T14.T14.1 Open wound of unspecified area of the body

XIX.T20-T32.T30 Thermal and chemical burns, unspecified

Contraindications:

Hypersensitivity to iodine. For oral administration - pulmonary tuberculosis, nephritis, nephrosis, adenomas (including thyroid gland), furunculosis, acne, chronic pyoderma, hemorrhagic diathesis, urticaria, pregnancy, children under 5 years.

Vaginally during and before childbirth (transient hypothyroidism was found in newborns after vaginal use in mothers of a typical iodine solution during labor).

Carefully:Lactation period.

Pregnancy and lactation:

The category of recommendations is not defined. Not recommended topically and inwardly - the risk of hypothyroidism and goiter in a child. Can be used regularly if iodine supplementation is required.

Penetrates into milk with topical use or ingestion and can cause hypothyroidism and goiter in a child. Nevertheless, lactating women need iodine, their need is 200 mcg per day.

Dosing and Administration:

With external use of iodine, the damaged skin is treated.

For oral administration, the dose is set individually, depending on the indications and age of the patient.

Locally used for washing lacunae and supratonsillar spaces - 4-5 procedures at intervals of 2-3 days, for irrigation of the nasopharynx - 2-3 times a week for 2-3 months, for instillation in the ear and rinsing - for 2-4 weeks; In surgical practice and with burns, moistened napkins are applied to the affected surface as needed.

Skin disinfection - 2% alcohol solution is comparable with 2% chlorhexidine solution in 70% isopropyl alcohol; 0.7% iodine solution in 74% isopropyl alcohol - inferior to 2% chlorhexidine in 70% isopropyl alcohol; iodine solution is superior to povidone iodine (for disinfection of the skin in front of venipuncture in order to take blood for blood culture).

Side effects:

For external use: rarely - skin irritation; with prolonged use on extensive wound surfaces - iodism (rhinitis, urticaria, Quincke's edema, salivation, lacrimation, acne).

Ingestion: skin allergic reactions, tachycardia, nervousness, sleep disorders, excessive sweating, diarrhea (in patients older than 40 years).

Overdose:

When concentrated solutions get inside - severe burns of the digestive tract of the esophagus (with the subsequent development of strictures), hemolysis, hemoglobinuria; The lethal dose is about 3 g.

If you accidentally swallow unconcentrated solutions: abdominal pain, anuria, diarrhea with blood, severe thirst, fever, nausea, vomiting, metallic taste in the mouth. Shock, tachycardia, metabolic acidosis, renal failure. A fatal outcome is possible due to vascular insufficiency, epiglottis edema and asphyxia, aspiration pneumonia or pulmonary edema.

Treatment (if patient is conscious) - take milk every 15 minutes or a starch / flour solution (at the rate of 15 mg of starch or flour for 500 ml of water) to absorb unboiled iodine. You can also use Activated carbon and sodium thiosulfate (usually 1% solution) inside to transfer iodine to less toxic iodides. Gastric lavage is not recommended, as there is no certainty that even sufficiently weak iodine solutions can not cause a burn of the esophagus. To maintain the basic functions of the body - oxygen therapy, antihistamines, epinephrine and corticosteroids - with anaphylactic shock.

Interaction:

Acetone - the formation of a highly irritant mixture.

Means with antithyroid effect (lithium) - strengthening of hypothyroid and strugogenic influence, monitoring of thyroid function is necessary.

Alkaline or acidic environment, the presence of fat, pus, blood - the weakening of antiseptic activity.

Essential oils, ammonia solutions, white sedimentary mercury (an explosive mixture is formed), salts of bismuth, copper, iron, lead, mercury, potassium chlorate and other oxidizers, inorganic acids, strychnine hydrochloride, quinine and other alkaloid salts are incompatible.

Special instructions:

With prolonged use, the phenomena of iodism are possible.

To improve solubility, the preparation often contains potassium iodide, in this regard, with overdoses, the development of potassium intoxication is possible (anxiety, irregular heartbeat, numbness, tingling, tingling or pain, weakness in the hands and feet, unexplained fatigue, sensation of heavy legs).

Very slightly soluble in water (1: 5000), soluble in 10 parts of 95% ethanol, soluble in aqueous solutions of iodides (K+ and Na+).

Can change tests to determine the function of the thyroid gland.

When combined with a yellow mercury ointment, it is possible to form mercuric iodide in a tear fluid, which has a cauterizing effect.

Instructions

Iodine (Iodum)