Ointments that relieve inflammation

In a complex therapy of inflammatory processes that develop in various diseases of the skin and subcutaneous tissue, joints and muscles, nerve endings, individual ENT organs, this or that ointment that removes inflammation is often used.

According to its pharmacological effect, all external anti-inflammatory drugs are divided into etiotropic (that is, purposefully acting on the cause of inflammation) and pathogenetic, the purpose of which is the removal of inflammatory symptoms due to a violation of their biochemical mechanism.

[1], [2]

Indications of the ointments that relieve inflammation

An ointment that removes inflammation by affecting its etiology must contain antibacterial (antiviral or fungicidal) substances. Thus, indications for the use of ointments with antibiotics active against gram-positive and gram-negative aerobic and anaerobic bacteria include: infected wounds and burns; trophic ulcers and pyoderma (pustular lesions of the skin); erysipelas and streptococcal lesions of the epidermis (ecthimus); ophthalmic infections with blepharitis or conjunctivitis, as well as inflammation, localized in the nasal cavity or the auricles.

Indications for the use of ointments that remove inflammation by pathogenetic effects - non-steroidal anti-inflammatory drugs (NSAIDs) and glucocorticosteroid drugs (SCS) - apply to an extremely extensive list of diseases. Nonsteroid ointments help cope with inflammation and pain in rheumatoid and deforming arthrosis, osteoarthrosis and osteoarthritis, osteochondrosis and gout; with inflammation of the muscles (myositis) and peripheral nerves (neuritis).

A containing GCS ointments that relieve skin inflammation are prescribed at usual, contact and atopic dermatitis, eczema, psoriasis, vulgar pemphigus, exudative erythema and other dermatological diseases.

[3], [4], [5]

Release form

Here are some names for ointments that remove inflammation, breaking the list into groups - in accordance with the recommendations for their use.

Ointment from purulent inflammation in wounds, burns, folliculitis, phlegmon, etc.: Baneocin, Levomekol, Vishnevsky ointment, Inflarax, Oflokain; with furuncles and hydradenitis (inflammation of sweat glands) at the stage of shedding ichthyol ointment is well strained , and after eruption of the abscess, erythromycin or tetracycline ointment.

Ointments that relieve skin inflammation: Fluorocort (Triamcinolone, Triacort, Polcortolone, Cinacort and other trade names), Celestoderm-B, Kortomycetin, Gyoxysone, etc.

Effective ointment from erysipelas - Baneocin and erythromycin ointment.

Ointment relieving inflammation of the joints and inflammation of the muscles (myositis): Diclofenac (Diclofenacol, Dicloran, Voltaren), Indomethacin, Ibuprofen (Dolgit, Deep Relief and other trade names), Ketoprofen (Ketonal, Bystrumgel), Piroxicam, etc. , how these ointments act, what their contraindications and side effects are, read in the article - Ointment for pain in the joints, as well as in the publication - Treatment of muscle pain

Ointment that removes swelling and inflammation: preparations of the NSAID group, as well as heparin ointment.

The ointment prescribed by neuropathologists with inflammation of the nerve most often also refers to non-steroidal anti-inflammatory drugs (Diclofenac, Ibuprofen, etc.).

The most recommended ophthalmic ointment for inflammation of the eyelids (blepharitis or meibomite) is ointment Sulfacyl-sodium (10%), ditetracycline ophthalmic ointment, erythromycin ophthalmic ointment (0.5%) or Dexa-Gentamicin.

Experts in the complex treatment of external otitis media and inflammations localized in the external auditory canal (for example, furuncle), as well as uncomplicated perichondritis of the auricle or mastoiditis (inflammation of the mastoid process) use an ear wax for inflammation of the ear with an antibiotic: Bactrocar (Mupirocin), Levomekol, tetracycline ointment or Oflockin. And with dermatitis of the external auditory canal - the above mentioned ointments with corticosteroids.

Ointment from inflammation in the nose (for example, caused by the boil) - these are the same ointments containing antibiotics.

[6], [7], [8]

Pharmacodynamics

Let's start with the fact that Baneocin ointments, Levomekol, Bactroban (Mupirocin), Inflarax, Oflokain, Sulfacyl-sodium ointment, erythromycin and tetracycline ointment are antibacterial preparations. The composition of Baneocin contains antibiotics neomycin and bacitracin; in Levomecol ointments - levomycetin (chloramphenicol), in Bactroban - mupirocin, in Inflarax - amikacin, in Oflokaine - fluoroquinolone antibiotic ofloxacin.

The pharmacodynamics of bactericidal and bacteriostatic antimicrobial agents is based on their ability to penetrate bacterial cell membranes and bind to ribosomes, resulting in the cessation (or significant slowing down) of protein synthesis in microbial cells.

In addition, in levomecol ointments there is methyluracil - a substance with regenerating qualities, which contributes to the improvement of trophic tissue of inflamed tissues.

A multicomponent ointment from purulent inflammations of Inflarax also contains an antiseptic of benzalkonium chloride, an NSAID of the sulfonanilide group of nimesulide (suppressing the production of mediators of the inflammatory reaction of prostaglandins and reducing the permeability of the walls of the blood and lymphatic vessels) and local anesthetic of lidocaine hydrochloride. Ophthalmine ointment besides antibiotic, too, contains lidocaine, which provides an additional analgesic effect due to inhibition of transmission of painful impulses.

Erythromycin ointment against erysipelas is an antibiotic of the macrolide group erythromycin, which is active against many bacteria, including beta-hemolytic group A streptococcus, which causes erysipelas of the skin.

Ointment from the inflammation of the eyelids Dexa-Gentamicin is a drug of combined pharmacological action containing an aminoglycoside antibiotic gentamicin and a synthetic corticosteroid dexamethasone. Sulfacyl-sodium ointment refers to sulfonamides, and its action is based on a violation of the cycle of production of folic acid and its derivatives by bacteria, without which the formation of nucleic acids in microorganism cells is impossible.

Ointments that remove skin inflammation and itching - Fluorocort, Kortomycetin, Gyioxisone, etc. - are hormonal, since their action is provided by glucocorticosteroids: in ointment, Fluorocort is a fluorinated GCS triamcinolone, in Cortomycetin and Gyioxysone - hydrocortisone. Steroids activate the synthesis of lipomodulin and inhibit the enzyme phospholipase, which prevents the production of the same inflammatory mediators in the mast cells of damaged tissues.

In this case, the ointments Kortomycetin and Gyioxisone are combined agents: the first contains the antibiotic levomiyetin, and in the second - oxytetracycline. This is what makes it possible to apply them, if the inflammation of the epidermis with dermatitis or eczema acquires an infected character.

[9], [10], [11], [12]

Pharmacokinetics

Pharmacokinetics of ointments Baneocin, Levomekol, Inflarax, Sulfacyl-sodium, erythromycin and tetracycline ointments, as well as Kortomycetin and Gyioxysone

In the instructions to the drugs is not explained.

Ingredients of the drug Bactroban can penetrate into the bloodstream only through the damaged epidermis and then are transformed and removed from the body with urine. Ointment from purulent inflammation of Oflokain has a similar factakokinetics.

Dexa-Gentamycin, more precisely, the antibiotic gentamicin sulfate does not penetrate into the blood, provided the integrity of the tissues on which this ointment is applied from the inflammation of the eyelids.

Active substance of ointment Fluorocorte triamcinolone is absorbed by skin cells and enters the systemic circulation; the metabolism of triamcinolone occurs in the liver, the elimination of metabolites is carried out by the kidneys.

[13], [14]

Dosing and administration

Ointments Baneocin and Bactroban are recommended to be applied two to three times a day; duration of treatment - one week.

Levomekol and erythromycin ointment are used up to 4-5 times a day (for a maximum of 10 days).

Inflarax applied twice a day (with burns three times a week), you can impose on the inflamed area gauze napkin with ointment. The standard course of treatment is 5-7 days.

Ointment from suppurative inflammations Oflokain should be applied once a day (with ulcers and wounds) - with the imposition of a sterile bandage; when treating burn injuries - every other day.

Tetracycline ointment and Kortomycetin are applied no more than twice a day, it is possible under the bandage (with its change every 12 hours).

Dexa-Gentamicin is used up to three times during the day; the use of this remedy should not exceed three weeks.

Fluorocort should be applied no more than three times during the day; the maximum allowable dose is 15 g per day (for adult patients), and when applying a dressing - 10 g. For children and the elderly, the ointment can not be applied under the bandage, and the duration of treatment should not be more than five days.

On the affected area Gyoxysone Ointment is recommended to be applied one to three times during the day.

In the instructions for the described drugs, it is noted that their overdose is unlikely or that there is no evidence of an overdose of the drug.

[19], [20],

Use of the ointments that relieve inflammation during pregnancy

Among the ointments presented in the review during pregnancy, only Levomekol can be used.

Bactroban ointment is used in pregnancy only if the intended benefit for the mother is much higher than the likely threat to the fetus. Dexa-Gentamycin is not allowed to use in the first trimester of pregnancy, and at later dates this ointment can be prescribed by an ophthalmologist only when assessing the correlation between benefit and harm.

Ointments Baneocin, Inflarax, Oflokain, tetracycline ointment are not used for the treatment of pregnant and lactating women.

When used by pregnant women, any steroid ointment that removes inflammation - including Fluorocort, Cortomycetin and Gyioxysone - can cause systemic side effects, so SCS is not prescribed for such patients.

Contraindications

It should be considered what contraindications to use has a specific anti-inflammatory ointment.

Baneocin is contraindicated for hypersensitivity to aminoglycoside antibiotics, for poor kidney function, for allergies, for open damage to the external auditory canal;

Tetracycline ointment is not used for fungal infections, as well as for patients younger than 10 years;

Ointment Inflarax is contraindicated in the presence of mycoses, eczema, neurodermatitis and children younger than two years;

Ointment from inflammation of the eyelids Dexa-Gentamicin is contraindicated in herpesvirus and

Fungal lesions of the eyes, acute purulent diseases with corneal damage, increased intraocular pressure (glaucoma) and patients under 18 years old.

Hormonal ointments that remove skin inflammation and itching (Fluorocort, Tselestoderm-B, etc.) are not used for bacterial, viral and fungal skin lesions, skin tuberculosis, syphilis and oncological diseases.

Among the contraindications combined drugs Kortomitsetin and Gyoksizon also noted viral and fungal dermatological diseases and cutaneous tuberculosis.

[15], [16], [17], [18]

Side effects of the ointments that relieve inflammation

The most frequent side effects of Levomekol, Bactroban, Inflarax, Oflocaine, erythromycin and tetracycline ointment are allergic reactions in the form of rashes, itching and flaking of the skin at the site of application.

When applying Baneocin ointment to large areas of the skin, systemic side effects can occur, in particular, hearing impairment, muscle innervation, development of superinfection.

The use of ointment from the inflammation of the eyelids Dexa-Gentamicin and Sulfacyl-sodium can also cause burning, and Dexa-Gentamycin - secondary glaucoma and steroid cataract.

Fluorocort, Cortomycetin, Gyoxysone and all local remedies with SCS have the same side effects: redness and itching of the skin, atrophy of the skin at the site of application; long-term use of these funds can trigger a decline in the functions of the hypothalamic-pituitary-adrenal system, osteoporosis, metabolic disorders, including glucose and fat.

Interactions with other drugs

Reports on the interactions of ointments Levomecol, Bactroboq (Mupirocin), Baneocin, Oflokain, erythromycin and tetracycline ointments, as well as corticosteroid ointments with other drugs are absent.

Ointment from suppurative inflammations Inflarax, containing amikacin, can enhance the effect of other antibacterial agents for external use, especially with benzylpenicillin and antibiotics-cephalosporins; Nimesulide potentiates the effects of sulfonamide drugs and anticoagulants, and lidocaine - other local anesthetics.

Dexa-Gentamicin ointment is incompatible with atropine, heparin and sulfonamides.

[21], [22], [23]

Storage conditions

Store ointments Baneocin, Levomekol, Bactroban, erythromycin ointment, Inflarax, Oflocaine should be used at a temperature of + 25 ° C; tetracycline ointment, Dexa-Gentamicin, Sulfacil-sodium at a temperature of + 18-20 ° C; Fluorocort, Cortomycetin and Gyioxysone - at a temperature of + 8-15 ° C.

[24], [25], [26], [27]

Shelf life

The shelf life of tetracycline and erythromycin ointment, Levomecol, Sulfacil-sodium is 3 years; ointments Baneocin, Bactroban, Inflarax, Oflokain, Dexa-Gentamicin, Fluorocort, Kortomycetin, Gyioxysone - 24 months.

[28], [29], [30]