Pharmacological properties
Pharmacodynamics. The ointment has anti-inflammatory, analgesic and antimicrobial effects. Amikacin and benzalkonium chloride have a wide spectrum of antimicrobial activity against gram-positive and gram-negative microorganisms, including staphylococci, Pseudomonas aeruginosa and Escherichia coli. The mechanism of action is due to the ability to bind to ribosomes, which leads to irreversible inhibition of protein synthesis, to fix on the cytoplasmic membranes of bacteria, disrupting their permeability, while the cell loses potassium ions, amino acids, nucleotides. Nimesulide has anti-inflammatory (suppresses the inflammatory phase due to a decrease in the activity of inflammatory mediators, which contributes to a decrease in the permeability of the vascular wall) and analgesic effects (reduction of tissue edema is accompanied by a decrease in the severity of pain), and lidocaine has a local anesthetic effect (due to the membrane-stabilizing effect, the magnitude of the action potential decreases). The water-soluble base of the ointment - polyethylene oxide - enhances and prolongs its antibacterial and anti-inflammatory effect, has a pronounced and long-lasting osmotic effect. Thus, when using the ointment, perifocal edema is eliminated and the wound is cleansed of purulent-necrotic contents. Therapeutic activity persists for 20-24 hours.
Pharmacokinetics: Not studied.
Indication
In surgical practice, the drug is used to treat purulent wounds in the first (purulent-necrotic) phase of the wound process; postoperative complications (postoperative suppuration of wounds, phlegmon, fistula, abscess); for the prevention of suppuration of superficial and deep wounds; in combustiology - for the prevention and treatment of suppuration of burn wounds; in dermatology for the treatment of purulent-inflammatory skin diseases (pyoderma).
Application
The ointment is applied in a thin layer to the affected areas 1-2 times a day or sterile gauze napkins are impregnated with ointment and applied to the wound. The required amount of the drug is determined by the area of the wound surface and the degree of purulent exudation. The ointment should cover the entire affected area.
When treating purulent wounds and purulent-inflammatory skin diseases, the ointment is used daily.
When treating burns - daily or 2-3 times a week, depending on the amount of purulent discharge.
The duration of the course of treatment is determined individually depending on the effectiveness of the therapy and the size of the damage. Dressings with ointment are applied until the wound is completely cleansed of the purulent-necrotic process, but not more than 5-7 days.
Contraindication
Hypersensitivity to any of the components of the drug, psoriasis, eczema, fungal skin lesions. Children under 2 years of age.
Side effects
Allergic and local irritation phenomena (skin rashes, itching, peeling).
Special instructions
The drug should be applied only to damaged areas of the skin, preventing the ointment from getting on intact areas of the skin, in the eyes, and on the mucous membranes.
When using the ointment in children over 2 years of age, it is necessary to limit the duration of treatment (up to 3-4 days) and exclude actions that lead to increased resorption and absorption of the ointment (warming and occlusive dressings).
Use during pregnancy and breastfeeding. Women during pregnancy and breastfeeding should use the ointment taking into account the risk/benefit ratio.
Children. The drug is contraindicated in children under 2 years of age.
The ability to influence the reaction rate when driving vehicles or working with other mechanisms is unknown.
Interactions
When using the drug topically, its interaction with other drugs has not been established. It should be noted that when used in combination, amikacin may enhance (mutually) the effects of carbenicillin, benzylpenicillin, cephalosporins, nimesulide - sulfonamides and anticoagulants; lidocaine - novocaine and bupivacaine.
Overdose
Due to the insignificant penetration of the drug through the mucous membranes and skin, overdose is unlikely, but when applying the ointment to large areas of damage, when exceeding the recommended doses and with prolonged use of the ointment, systemic side effects characteristic of amikacin, nimesulide, lidocaine are possible. In this case, it is necessary to stop using the drug. Treatment is symptomatic.
Storage conditions
At a temperature of 2-25 °C.
