Active Ingredient in Disinfectants & antiseptics (others)

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

2 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.

3 Contamination of an Operating Room Cleaning afterwards critical

4 Minimizing microbial population Hospitals very important 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

5 Sterilization Disinfection Antisepsis

6 Microbial Control Methods The role of Chlorhexidine Povidone iodine Acriflavinium Glutaraldehyde the Method Name Public Health Uses & of Laboratory Analysis Trade in infection Name control

7 Chlorhexidine Chlorhexidine is a cationic polybiguanide (bisbiguanide). It is used primarily as its salts (e.g., the dihydrochloride, diacetate and digluconate).

8 Method Analysis of Chlorhexidine Ultraviolet Spectrophtomtric method Aqueous acid at 245 nm Aqueous alkaline ph:10 at 232, 253 nm Limit conformity % Reference : Clarke s Analysis of Drugs and Poisons, 40 TH

9 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

10 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

11 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.

12 Method Analysis of Povidone Iodine Iodometric titration to determine uvailable content of Iodine Titrate sample with 0.02M Sodium thiosulphate Limite conformity of Iodine % w/v Referance : Briticsh Pharmacopeia

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

14 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.

15 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.

16 Method Analysis of Acriflavinium Ultraviolet Spectrophtomtric method Aqueous acid at 262 nm Limit conformity % Reference : Clarke s Analysis of Drugs and Poisons, 40 TH

17 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.

18 Glutaraldehyde Glutaraldehyde is a saturated dialdehyde

19 Referance : Indian Pharmacopeia Method Analysis of Glutaraldehyde ph meter Method Limite conformity % 0.1M NaOH Titration to ph:3. Acidified Glutaraldehyde by 10% hydroxyl amine.

20 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 does the solution become sporicidal.

21 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.

22 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

23 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.

24 HOW TO USE ACTIVATED CIDEX SOLUTION Disinfection Activate Clean Rinse Disposal Testing Instruments Solution Dry & Sterilization

25 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.

26 A 1. Clean Instruments B

27 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.

28 2. Activate solution

29 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.

30 3. Testing

31 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.

32 4. Disinfection / Sterilization

33 4. Disinfection / Sterilization

34 4. Disinfection / Sterilization A B

35 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.

36 5. Rinse Instruments

37 5. Rinse Instruments

38 6. Dry High-level disinfected or sterilized Dry Disinfected or sterilized stored in a manner to minimize recontamination.

39 6. Dry

40 7. Disposal

41 7. Disposal

42 The role of the Public Health Laboratory in infection control Assay of active ingredient of antiseptic & disinfectant chemicals. Antimicrobial activity of antiseptic & disinfectant chemicals. Sterility test of drugs, medical supplies and surgical equipment's.

43 Antiseptic & Disinfectant Samples

44 Conformity of Samples

45 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.

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