Doritricin

Doritricin is a combination drug used to treat throat and mouth conditions. Its main components include:

1. Benzalkonium Chloride: It is an antiseptic that has antimicrobial properties. It helps reduce the growth of bacteria and microorganisms in the throat and mouth.
2. Benzocaine: This is a local anesthetic that helps reduce pain and discomfort in the throat. It blocks the transmission of nerve impulses, which temporarily numbs the area of application.
3. Tyrothricin: This is an antibiotic that is used to fight bacterial infections. In combination with the antiseptic and analgesic effects of benzalkonium chloride and benzocaine, tyrothricin helps fight throat infections caused by bacteria.

Doritricin is usually presented in the form of lozenges and sore throat. It is used for the symptomatic treatment of various throat diseases, such as sore throat, pharyngitis and laryngitis.

Indications Dorithricin

1. Sore throat (acute tonsillitis) - inflammation of the tonsils, accompanied by sore throat and difficulty swallowing.
2. Pharingitis is an inflammation of the pharyngeal mucosa, which causes sore throat, redness and swelling.
3. Laryngitis is an inflammation of the larynx, manifested by hoarseness, sore throat and sometimes cough.
4. Stomatitis is an inflammation of the oral mucosa, accompanied by the formation of ulcers and pain.
5. Gingivitis is inflammation of the gums, accompanied by redness, swelling and pain.

Release form

Doritricin is available in the form of lozenges. The drug contains active substances: benzalkonium chloride, benzocaine and tyrothricin.

Pharmacodynamics

1. Benzalkonium chloride

Mechanism of action: Benzalkonium chloride is a quaternary ammonium compound that acts as an antiseptic. It destroys the cell membrane of bacteria, which leads to leakage of cell contents and death of bacteria.

Action spectrum:

• Gram-positive bacteria
• Gram-negative bacteria
• Some viruses and fungi

2. Benzocaine

Mechanism of action: Benzocaine is a local anesthetic that reduces pain. It blocks nerve impulses by stabilizing the cell membranes of neurons, which prevents the occurrence and transmission of pain signals.

Effects:

• Pain relief for sore throat
• Reducing discomfort and pain when swallowing

3. Tyrothricin

Mechanism of action: Tyrothricin is a mixture of polypeptide antibiotics (gramidin and tyrocidin) that destroy the cell membranes of bacteria, causing their death. Tyrothricin disrupts membrane functions, causing the release of ions and other important molecules from the cell.

Action spectrum:

• Gram-positive bacteria such as Streptococcus spp. And Staphylococcus spp.
• Some gram-negative bacteria
• Some anaerobic bacteria

Synergism of action

The combination of these three components in Dorithricin provides a complex effect:

• Antiseptic effect due to benzalkonium chloride, which destroys or inhibits the growth of pathogenic microorganisms.
• The analgesic effect of benzocaine quickly reduces pain and discomfort in the throat.
• The antibacterial effect of tyrothricin ensures the destruction of bacteria sensitive to it, which helps to eliminate the infection more quickly.

Pharmacokinetics

1. Benzalkonium chloride:

   • Absorption: Benzalkonium chloride is used as an antiseptic and usually acts locally. It is poorly absorbed through mucous membranes.
   • Distribution: Since benzalkonium chloride is poorly absorbed, its systemic distribution is limited.
   • Metabolism and Elimination: When applied topically, benzalkonium chloride undergoes virtually no systemic metabolism and is excreted primarily in superficial secretions.

2. Benzocaine:

   • Absorption: Benzocaine is a local anesthetic that acts by blocking sodium channels in neurons. It is also poorly absorbed through mucous membranes when applied topically.
   • Distribution: When applied topically, benzocaine remains primarily at the site of application and is not distributed systemically.
   • Metabolism: Benzocaine is metabolized by esterases in tissues and plasma to para-aminobenzoic acid (PABA) and ethanol.
   • Elimination: Benzocaine metabolites are excreted in the urine.

3. Tyrothricin:

   • Absorption: Tyrothricin is an antibiotic that also acts topically. It is poorly absorbed through mucous membranes.
   • Distribution: Tyrothricin remains at the site of application and exerts its effect directly on pathogenic microorganisms.
   • Metabolism and Elimination: Since tyrothricin is poorly absorbed, its systemic metabolism and elimination are negligible.

Dosing and administration

Method of application:

• Tablets are intended for resorption in the oral cavity.
• The tablet must be dissolved slowly, without chewing or swallowing whole, to ensure long-term contact effects of the active substances on the mucous membrane of the mouth and throat.

Dosage:

• Adults and children over 6 years of age are recommended to dissolve 1 tablet every 2-3 hours.
• The maximum daily dose should not exceed 6-8 tablets.

Duration of treatment:

• The course of treatment is usually 5-7 days, but can be adjusted by the doctor depending on the patient’s condition and the severity of the disease.

Special instructions:

• The drug should not be taken by children under 6 years of age due to the risk of aspiration.
• If symptoms persist for more than 5 days or a fever occurs, you should consult your doctor.

Use Dorithricin during pregnancy

The use of drugs during pregnancy requires special care, as many drugs can affect fetal development. Let's look at the components of the drug Doritricin and their effect on pregnancy:

1. Benzalkonium chloride:

   • This is an antiseptic that is used to kill bacteria and prevent their growth.
   • Human and animal studies on the effects of benzalkonium chloride on pregnancy are limited. Its topical use is generally considered safe, but individual reactions are possible.

2. Benzocaine:

   • This is a local anesthetic that is used for pain relief.
   • Animal studies have shown no significant risk to the fetus, but there is insufficient data on use in pregnant women. In general, topical benzocaine is considered safe in small doses, but overuse should be avoided.

3. Tyrothricin:

   • It is an antibiotic used topically to treat bacterial infections.
   • Research on its safety in pregnancy is limited, so use of this substance should be based on a risk-benefit assessment.

General recommendations:

• Consultation with a Doctor: Before using any drug, including Dorithricin, during pregnancy, consult a doctor. The doctor will be able to assess the risks and benefits of using the drug in your particular case.
• Avoiding self-medication: Never self-medicate, especially during pregnancy. Even drugs that seem harmless can have unwanted effects.
• Use of minimum doses: If your doctor has approved the use of the drug, strictly follow his recommendations and do not exceed the recommended dose.

Alternative methods:

• In some cases, safe home remedies such as salt gargling or herbal infusions can be used to relieve symptoms after discussing them with your doctor.

Contraindications

1. Allergy to components of the drug: People with a known hypersensitivity or allergy to any of the components of Dorithricin (benzalkonium chloride, benzocaine, tyrothricin) should avoid its use.
2. Children: Dorithricin is not recommended for children under 6 years of age because they may accidentally swallow the tablet or have trouble swallowing it.
3. Methemoglobinemia: Patients with hereditary or idiopathic methemoglobinemia should avoid the use of benzocaine as it may cause increased levels of methemoglobin in the blood.
4. Severe damage to the mucous membrane of the mouth and throat: Use of the drug may be contraindicated in patients with severe damage to the mucous membrane of the mouth and throat, such as open wounds or ulcers.
5. Pregnancy and breastfeeding: The safety of Dorithricin during pregnancy and breastfeeding has not been established, so its use should only be done when clearly necessary and under the supervision of a physician.
6. Kidney and liver problems: People with severely impaired kidney or liver function should use Dorithricin with caution and under medical supervision.

Side effects Dorithricin

1. Allergic reactions:

   • Hives (redness and itching of the skin)
   • Swelling of the mucous membrane of the mouth and throat
   • Anaphylactic shock (very rare but serious side effect)

2. Local reactions:

   • Irritation of the mucous membranes of the mouth and throat
   • Burning or tingling at the application site

3. Side effects associated with benzocaine:

   • Methemoglobinemia (a rare condition in which the blood's ability to carry oxygen is reduced)

4. Side effects associated with tyrothricin:

   • Possible development of bacterial resistance with long-term use

Overdose

Overdose symptoms

Benzalkonium chloride:

• Irritation of mucous membranes
• Burning and pain in the throat or stomach
• Nausea and vomiting
• In severe cases: respiratory depression, heart rhythm disturbances

Benzocaine:

• Systemic toxic reactions, especially in children
• Methemoglobinemia (a potentially dangerous condition in which the oxygen capacity of the blood is reduced)
• Symptoms of methemoglobinemia include: blue skin, lips and nails (cyanosis), dizziness, shortness of breath, fatigue, rapid heartbeat
• Allergic reactions (urticaria, angioedema, anaphylactic shock)

Tyrothricin:

• Systemic toxicity is unlikely due to topical application, but local allergic reactions and irritation are possible

Measures in case of overdose

1. Immediate help:

   • Stop using the drug.
   • If the drug is accidentally swallowed, give the victim enough water or milk to dilute the stomach contents.
   • Do not induce vomiting unless advised by a medical professional.

2. Seek medical help:

   • Consult a doctor or call emergency services immediately.
   • In case of severe symptoms such as difficulty breathing, severe pain, cyanosis or loss of consciousness, call an ambulance.

3. Treatment of symptoms:

   • For methemoglobinemia: your doctor may prescribe intravenous methylene blue.
   • For allergic reactions: it is possible to use antihistamines or adrenaline in case of anaphylactic shock.
   • For systemic toxicity: supportive care, monitoring vital organ functions, oxygen therapy if necessary.

Prevention

• Carefully follow the recommended dosage and instructions for use.
• Keep the drug out of the reach of children.
• Do not use the drug for longer than the recommended period or in larger quantities than prescribed.

Interactions with other drugs

1. Benzalkonium chloride:

• Combination with anionic substances (e.g. Soaps): Anionic substances may reduce the effectiveness of benzalkonium chloride as an antiseptic.
• Other antiseptics and disinfectants: Combined use may enhance or, conversely, weaken the antiseptic effect.

2. Benzocaine:

• Other local anesthetics: Concomitant use with other local anesthetics (eg, lidocaine) may enhance the local anesthetic effect and increase the risk of toxic reactions.
• Sulfonamides: Benzocaine is metabolized to para-aminobenzoic acid (PABA), which may inhibit the action of sulfonamide antibiotics.
• Drugs that cause methemoglobinemia: Concomitant use with drugs that can cause methemoglobinemia (eg, nitrates, sulfonamides) may increase the risk of this pathology.

3. Tyrothricin:

• Other topical antibiotics: Concomitant use may enhance the antibacterial effect, but may also increase the risk of developing resistance or allergic reactions.
• Systemic antibiotics: Interaction is unlikely due to the minimal systemic absorption of tyrothricin, but it is theoretically possible to increase or decrease the effect of systemic antibiotics.