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Active Ingredient in Disinfectants & antiseptics (others) Chemist. Saleh A. El-Taweel Head of Drug Analysis Dept. Public Health Lab Ministry of Health

Antiseptics & Disinfectants - dnntest.iugaza.edu.psdnntest.iugaza.edu.ps/Portals/133/أ.صالح الطويل.pdf · Active Ingredient in Disinfectants & antiseptics (others) Chemist

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Active Ingredient in

Disinfectants & antiseptics

(others)

Chemist. Saleh A. El-Taweel

Head of Drug Analysis Dept.

Public Health Lab

Ministry of Health

Introduction

During patient treatment, surfaces in equipment and

treatment rooms are likely to become contaminated with

saliva or by aerosol containing blood, saliva, or both.

Laboratory studies have shown that microorganisms

may survive on environmental

surfaces for varying periods.

Assume that if a surface has had contact with saliva,

blood, or other potentially infectious materials,

it contains live microorganisms.

Contamination of an Operating Room

Cleaning

afterwards

critical

Hospitals

Danger of healthcare-associated infections

Reduce health care costs

Patients more susceptible to infection

Pathogens more likely found in hospital setting

Feces, urine, respiratory droplets, bodily secretions

Instruments must be sterilized to avoid introducing

infection to deep tissues

Minimizing microbial population

very important

Sterilization Disinfection Antisepsis

Microbial Control Methods

• Chlorhexidine

• Povidone iodine

• Acriflavinium

• Glutaraldehyde

Name

&

Trade

Name

Method

of

Analysis

Uses

The role of

the Public

Health

Laboratory

in infection

control

Chlorhexidine

Chlorhexidine is a cationic polybiguanide

(bisbiguanide). It is used primarily as its salts

(e.g., the dihydrochloride, diacetate and

digluconate).

Method Analysis of Chlorhexidine

Ultraviolet Spectrophtomtric method Aqueous acid at 245 nm

Aqueous alkaline pH:10 at 232, 253 nm

Limit conformity 95 – 105%

Reference : Clarke’s Analysis of Drugs and Poisons, 40TH

Uses of Chlorhexidine

Chlorhexidine is used as low-level disinfectants

(disinfection of the skin and hands),

Cosmetics (additive to creams, toothpaste,

deodorants & antiperspirants).

Pharmaceutical products (preservative in eye

drops, active substance in wound dressings and

antiseptic mouthwashes).

Preparing skin for surgery

Chlorhexidine

At moderate to high concentrations, it is

bactericidal for both gram-positive and

gram-negative bacteria but inactive against

spores

low toxicity, rapid action

Povidone iodine

Povidone-iodine (PVP-I), brand name Wokadine and

Betadine. It contains from 9.0% to 12.0% available

iodine.

This unique complex was discovered at the Industrial

Toxicology Laboratories in Philadelphia by H. A.

Shelanski and M. V. Shelanski

It was first sold in 1955, and has since become the

universally preferred iodine antiseptic.

Method Analysis of Povidone Iodine

Iodometric titration to determine uvailable content of Iodine

Titrate sample with 0.02M Sodium thiosulphate

Limite conformity of Iodine 0.85 – 1.20 % w/v

Referance : Briticsh Pharmacopeia

Uses of Povidone iodine

Povidone-iodine is an iodophore that is used as a low-level disinfectant & antiseptic

Uses of Povidone iodine

It’s mainly for the treatment of contaminated

wounds and pre-operative preparation of the skin

and mucous membranes as well as for the

disinfection of equipment.

Solutions of povidone-iodine gradually release

iodine to exert an effect against bacteria, fungi,

viruses, protozoa, cysts, and spores.

Acriflavinium chloride

Acriflavine It has the form of an orange or brown

powder.

Acriflavine was developed in 1912 by Paul Ehrlich, a

German medical researcher and was used during the

First World War against sleeping sickness.

Method Analysis of Acriflavinium

Ultraviolet Spectrophtomtric method Aqueous acid at 262 nm

Limit conformity 95 – 105%

Reference : Clarke’s Analysis of Drugs and Poisons, 40TH

Uses of acriflavinium chloride

Acriflavine is a topical antiseptic.

0.1% used for the treatment of wounds or burns &

for skin infection

Acriflavine is also used as treatment for external

fungal infections of aquarium fish.

Acriflavine has been shown to have anti-cancer

activity.

Glutaraldehyde

Glutaraldehyde is a saturated dialdehyde

Method Analysis of Glutaraldehyde

pH meter Method Limite conformity 90–110%

Referance : Indian Pharmacopeia

0.1M NaOH

Titration to pH:3.

Acidified Glutaraldehyde

by 10% hydroxyl amine.

Glutaraldehyde

Glutaraldehyde has gained wide acceptance as a

high-level disinfectant and chemical sterilant.

Glutaral is non-corrosive towards most materials.

Aqueous solutions of glutaraldehyde are acidic

and generally in this state are not sporicidal.

Only when the solution is "activated" (made

alkaline) by use of alkalinating agents to pH 7.5–

8.5 does the solution become sporicidal.

Glutaraldehyde

Optimum activity between pH 7.5 and 8.5; such

solutions are chemically stable for about 14 days.

Solutions at lower pH values are more stable.

Once activated, these solutions have a shelf-life of

minimally 14 days because of the polymerization

of the glutaraldehyde molecules at alkaline pH

levels.

(aldehyde groups) of the glutaraldehyde molecules

that are responsible for its biocidal activity.

Disinfection & Sterilization of

Glutaraldehyde

immersion 10 to 20 min.

rapidly effective against

• Gram-positive

• Gram-negative

• Mycobacterium tuberculosis

• Some fungi

• Some viruses

(hepatitis B & HIV)

.

.

Disinfection

immersion up to 10 hrs.

slowly effective against

• Bacterial spores

.

.

.

.

.

.

. Sterilization

Uses and Administration

A 2% aqueous solution buffered to a pH 8

(activated glutaral; alkaline glutaral) may be used

for the sterilisation of endoscopic and dental

instruments, rubber or plastic equipment, and for

other equipment which cannot be sterilised by

heat.

Clean

Instruments

Rinse

Instruments Dry

Activate

Solution Testing

Disinfection

&

Sterilization

Disposal

HOW TO USE ACTIVATED CIDEX SOLUTION

1. Clean Instruments

Instruments must be cleaned since residual organic

matter will decrease the effectiveness of the CIDEX®

Solutions.

Clean (e.g., endoscopes) with detergent Solution

which are mild in pH, low foaming, and easily rinsed.

Rinse instrument with large amounts of fresh water.

Remove excess moisture. This will help prevent

rapidly diluting the CIDEX® Solution.

1. Clean Instruments A B

2. Activate solution

Prepare Active CIDEX® Solution :-

Add the activator to the container.

Shake well. Activated solution immediately

changes color.

Do not use activated solution beyond stated

14- or 28-day reuse life.

Record date of activation (mixing date) &

expiration date.

2. Activate solution

3. Testing

Do not rely solely on days in use.

CIDEX® Solutions must be tested prior

to each use with the Test Strip.

It is recommended that CIDEX®

Solutions be tested before each usage.

3. Testing

4. Disinfection / Sterilization

Immerse clean, dry instruments completely in the

CIDEX® Solution.

Fill all lumens.

Cover the CIDEX® Solution tray or bucket with a

secure lid to reduce exposure to glutaraldehyde

vapors which can be irritating,

Result in irritation to the respiratory tract and eyes, stinging sensation

in the nose and throat or difficulty breathing.

4. Disinfection / Sterilization

4. Disinfection / Sterilization

4. Disinfection / Sterilization

A B

5. Rinse Instruments

For devices that have been sterilized:

using sterile technique and rinse thoroughly with sterile water.

Following disinfection, aseptically:

rinse instruments thoroughly, flushing the channels with potable or

sterile water.

Be sure to repeat this procedure twice, for a total

of three rinses.

Each rinse should be a minimum of one minute in

duration, and a large volume of fresh water (e.g.,

two gallons) must be used for each rinse.

5. Rinse Instruments

5. Rinse Instruments

6. Dry

High-level disinfected or sterilized

Disinfected or sterilized stored in a manner to

minimize recontamination.

Dry

6. Dry

7. Disposal

7. Disposal

Assay of active ingredient of

antiseptic & disinfectant chemicals.

Sterility test of drugs, medical

supplies and surgical equipment's.

Antimicrobial activity of antiseptic &

disinfectant chemicals.

The role of the Public Health

Laboratory in infection control

Antiseptic & Disinfectant Samples

Conformity of Samples

Recommendations

Periodic mentoring on antiseptic & disinfectant products on

many status

Awareness lectures & instruction guidelines for stuff in the

sterilization & medical departments.

Practical training for technical stuff to good implantation for the

disinfectant and sterilization protocol.

Support facilities of drug analysis dep. to test types of antiseptic

& disinfectant products.