Pharmacological properties
Pharmacodynamics. Gentacept is a combined antimicrobial drug of prolonged action for topical use, containing the aminoglycoside gentamicin sulfate, an organic silicon sorbent - polymethylsiloxane (methoxane) and a coordination compound of zinc with tryptophan. Gentamycin sulfate is a broad-spectrum antibiotic with a bactericidal effect, active against pathogenic gram-positive microorganisms - staphylococcus aureus, streptococcus spp., mycobacterium spp. and gram-negative microorganisms - pseudomonas aeruginosa, aerobacter aeruginosa, escherichia coli, proteus spp., klebsiella spp., serratia spp., shigella spp., salmonella spp., citrobacter spp., providenta spp., yeryenia spp. Polymethylsiloxane provides sorption and detoxification properties and, together with zinc tryptophan, potentiates the antibacterial effects of the antibiotic and maintains the antimicrobial concentration of the antibiotic in the wound at a therapeutic level for 8 days. Application therapy with Gentasept reduces the number of microorganisms in the wound to a minimum level (102-103 in 1 g) for 2-3 days, accelerates the transition from the hydration phase to the dehydration phase, prevents the development of possible purulent-septic complications. Due to its sorption properties, the drug absorbs toxic waste products of microorganisms, low-molecular toxic metabolites of tissues (pyruvic and lactic acids, peroxide compounds, amino acid oxidation products, polypeptides, lipids, etc.), fibrin dehydration products. The mechanism of action of Gentasept is associated not only with the inhibition of protein synthesis of microorganisms, but also with the disruption of the lipid layer of the cell wall due to the formation of complexes. Gentasept reduces the manifestations of local and general intoxication due to its antibacterial properties, draining and anti-edematous action, normalization of microcirculation, gas exchange, and pH of the wound environment. This helps to cleanse wounds of exudation and tissue breakdown products, eliminate local inflammatory reactions, stimulate the growth of granulation tissue, improve the healing process, and prevent the formation of keloid scars. Gentasept also cleanses burn wounds, reduces inflammatory reactions, reduces the area of deep burns, prevents tissue destruction, accelerates the formation of granulation tissue in deep burns and epithelialization in superficial burns, and promotes high-quality preparation of wounds for autodermoplasty.
Pharmacokinetics. The pharmacokinetics of the drug have not been studied, since Gentacept is a drug for non-systemic use, acts only superficially and has no resorptive effect.
Indication
Treatment of wounds infected with pathogens sensitive to the drug:
infected surgical wounds (postoperative suppurations, phlegmons, abscesses); traumatic infected wounds of various localization and genesis; trophic ulcers arising against the background of chronic venous insufficiency, obliterating atherosclerosis, thrombophlebitis of the subcutaneous veins of the lower extremities; burns of II and III A-III B degrees; various forms of erysipelas; bedsores; wounds in patients with various diseases in which regenerative processes are reduced (diabetes mellitus, immunodeficiency, radiation injury); prevention of sepsis in widespread purulent processes; prevention of the formation of keloid scars.
Application
Gentasept is used topically at all stages of the wound process until complete wound healing. In the initial stage (day 1-5), the dressings are changed 1-2 times a day, after the inflammatory processes have subsided, the wound has been cleansed of purulent-necrotic masses, granulations have appeared and the wound has become epithelialized - once every 1-2 days. Gentasept is applied to the wound surface through a dropper plug (hole in the plug), removing the cap, after thorough surgical treatment, washing the wound with antiseptic solutions with mandatory subsequent drying in such a way that it evenly (0.5-1 mm) covers the wound surface. In case of large lesions, for example, burns, a single application of 8-12 g of the drug is possible. After applying Gentasept, the wound is drained according to general rules and a bandage is applied. In case of significant wound tissue defects, loose tamponade with gauze napkins is allowed. If there is abundant discharge from the wound, Gentacept is partially removed along with the discharge. In this case, when changing the dressing, the wound is dried with gauze swabs and the drug is additionally applied in a single dose without any other manipulations in the wound.
For the treatment of burns, Gentasept is applied to the burned surface both in the first 5-6 days and during the period of sequestration of the burn scab (up to 15 days). In this case, the drug is fixed on the wound using an aseptic bandage. During dressings, Gentasept should be completely removed from the surface of burn wounds using antiseptics or special wound shampoos. The drug can be used on any part of the body of a burn patient.
If it is impossible to perform surgical treatment of the wound in full, Gentasept is applied to the wound surface in a dose of 0.5-4 g, depending on the area of the lesion, and a bandage is applied for a period not exceeding 24 hours.
Contraindication
Hypersensitivity to gentamicin sulfate and other components included in Gentasept.
Side effects
When using Gentasept, side effects are possible due to the presence of gentamicin sulfate in the drug.
Allergic reactions in the form of erythema, urticaria, contact dermatitis, and itching are possible.
Gentasept can be applied to the wound surface only after thorough surgical treatment. The drug prevents the adhesion of bandages and the occurrence of pain when removing them. When applied topically, the drug does not have a local irritating effect, however, Gentasept should not be allowed to get into the eyes.
Use during pregnancy and breastfeeding. There are no data on the use of the drug during pregnancy and breastfeeding. If it is necessary to use Gentacept during pregnancy or breastfeeding, the doctor should give recommendations on the appropriateness of its use, taking into account the benefit/risk ratio.
Children. Gentasept can be used to treat children of all age groups, as it is a non-systemic drug, acts only superficially and has no resorptive effect.
The ability to influence the reaction speed when driving vehicles or working with other mechanisms. Does not affect.
Interactions
Not studied, but possible enhancement of the effect when used topically with antibiotics that have a bactericidal effect.
Overdose
In case of overdose, allergic reactions are possible, requiring discontinuation of the drug and desensitization therapy.
Storage conditions
At a temperature not exceeding 25 °C.
