Topical Antiseptics and Potassium Permanganate

Study Notes

Medications applied directly to skin or mucous membranes
Typically low-viscosity solutions, containing dissolved powder, alcohol, or sometimes oil
Reduce infection risk (sepsis, putrefaction) by killing or inhibiting microorganisms
Some solutions can dry skin when alcohol is used

Chemical compound with formula KMnO4
Also known as permanganate of potash or Condy's crystals
Strong oxidizing agent with disinfectant, deodorizing, and astringent properties
Dissolves in water to form a deep purple solution
Uses in dermatological conditions: treating infected eczema, blisters, cleansing wounds (especially weeping ones or abscesses), and fungal infections (athlete's foot)
Concentrations:
- 1:100 or 1% for fungal infections (athlete's foot)
- 1:1000 for wet soaks on blistering wounds (20-30 minutes)
- 1:10000 for dry weeping sores and eczema
Precautions:
- Can burn the skin
- Not suitable for dry skin
- Temporary skin staining that disappears within 48 hours
- Can stain clothes and requires acetic acid for removal

Antiseptic
Named for its violet color
Antifungal and antibacterial activity
Used in dermatological conditions
Concentrations: 0.5-2%
Used as a histological stain in Gram's method for classifying bacteria
Uses:
- Fungal infections (skin, oral thrush, vaginal thrush, especially in HIV-positive patients)
- Superficial bacterial skin infections (eczema, boils, chronic leg ulcers, including those caused by MRSA)
Oral hairy leukoplakia: treats white patches on the tongue associated with weakened immune systems and HIV-positive individuals.
Precautions:
- Can irritate mucous membranes (nausea, vomiting, diarrhea, abdominal pain)
- Can cause necrotic skin reactions (blackened skin)
- Staining of skin and clothes is permanent if applied to ulcers

Antiseptic and disinfectant
Available in solid, solution, and tincture forms
Iodine preparations:
- Povidone iodine (200 mg pessaries, 100 mg/g ointment) - antiseptic solution
- Tincture of iodine (2% iodine, 2.4% potassium iodide, 50% ethanol) - external use
- Weak iodine (2% iodine, 2.4% potassium iodide) - external use
- Strong iodine (Lugol's solution) (5% iodine, 10% potassium iodide) - internal use
Color variations based on solvent (dark violet in non-polar solvents like hexane, brown or orange in polar solvents)
Uses:
- Topical antiseptics
- Treating thyroid diseases (orally)
- Radiological contrast media (X-rays, CT scans, cholecystograms)
- Dietary intake (iodized salt)
Precautions:
- Ingestion causes corrosive effects (glottis edema, asphyxia, pulmonary edema, aspiration pneumonia)
- Eye exposure causes ocular burns
- Inhalation causes severe lung irritation (pulmonary edema)

Used in medicine mostly due to its sterile properties
Types:
- 0.91% NaCl (normal saline)
- 0.45% NaCl (half-normal saline)
- 0.22% NaCl (quarter-normal saline)
Uses:
- IV drip for dehydrated patients
- Providing nutrients
- Intravenous infusion
- Cleaning wounds
- Cleaning contact lenses
- Nasal irrigation
Precautions:
- Rapid intravenous infusion can cause metabolic acidosis

Solution of sugar (glucose or dextrose) in water
Used as a volume expander and for parenteral nutrition
Types:
- D5W (5% dextrose in water)
- D5NS (5% dextrose in normal saline)
Uses:
- Maintaining balance between starvation and hyperglycemia during and after surgeries

Alcohol extracts or solutions of non-volatile substances
Alcohol stabilizes the chemicals; water dilutes for safe concentrations
Iodine tincture: disinfectant with 2-7% Iodine + Potassium Iodide. Potassium Iodide & water increase iodine solubility.
Spirits (high alcohol concentration): used for flavoring and medicinally
Preparation Methods: simple solution, distillation, maceration

Clear aqueous solutions saturated with volatile oils (rose, peppermint, etc.) or aromatic substances (camphor)
Flavored with volatile substances
Uses:
- Perfumes
- Flavoring agents
- Eye drops (refreshing, stimulating, e.g., camphor water)
- Astringent and after-shave lotions