Doritricin

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

1. Benzalkonium chloride: This 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 relieve pain and discomfort in the throat. It blocks the transmission of nerve impulses, which temporarily numbs the area.
3. Tyrothricin: This is an antibiotic that is used to fight bacterial infections. When combined with the antiseptic and analgesic effects of benzalkonium chloride and benzocaine, tyrothricin helps fight throat infections caused by bacteria.

Doritricin is usually presented as lozenges and throat pain relievers. It is used for the symptomatic treatment of various throat diseases such as tonsillitis, pharyngitis and laryngitis.

Indications Doritricina

1. Angina (acute tonsillitis) is an inflammation of the tonsils, accompanied by a sore throat and difficulty swallowing.
2. Pharyngitis is an inflammation of the mucous membrane of the pharynx, which causes a sore throat, redness and swelling.
3. Laryngitis is an inflammation of the larynx, which causes hoarseness, sore throat and sometimes coughing.
4. Stomatitis is an inflammation of the oral mucosa, accompanied by the formation of ulcers and pain.
5. Gingivitis is an inflammation of the gums, accompanied by redness, swelling and pain.

Release form

Doritricin is available as lozenges. The drug contains the following active ingredients: 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 disrupts the bacterial cell membrane, causing the cell contents to leak out and the bacteria to die.

Spectrum of action:

• 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 generation 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 bacterial cell membranes, causing their death. Tyrothricin disrupts membrane function, causing the release of ions and other important molecules from the cell.

Spectrum of action:

• 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 Doritricin provides a comprehensive effect:

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

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 through 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 predominantly at the site of application and is not distributed systemically.
   • Metabolism: Benzocaine is metabolized by esterases in tissues and blood 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 locally. 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: Because tyrothricin is poorly absorbed, its systemic metabolism and elimination are negligible.

Dosing and administration

Directions for use:

• The tablets are intended to be dissolved in the mouth.
• The tablet must be dissolved slowly, without chewing or swallowing whole, to ensure prolonged contact 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 given to children under 6 years of age due to the risk of aspiration.
• If symptoms persist for more than 5 days or if fever occurs, consult a doctor.

Use Doritricina during pregnancy

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

1. Benzalkonium chloride:

   • It 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:

   • It is a local anesthetic that is used to relieve pain.
   • Animal studies have not shown significant risk to the fetus, but there is insufficient data on use in pregnant women. Topical benzocaine is generally considered safe in small doses, but excessive use should be avoided.

3. Tyrothricin:

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

General recommendations:

• Consult with your doctor: Before using any medication, including Doritricin, during pregnancy, you should consult with your doctor. Your doctor will be able to assess the risks and benefits of using the medication in your particular case.
• Avoid Self-Medication: Never self-medicate, especially during pregnancy. Even medications that seem harmless can have unwanted effects.
• Use of minimal 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 gargling with salt water or herbal teas may be used to relieve symptoms after discussing them with your doctor.

Contraindications

1. Allergy to components of the drug: People with known hypersensitivity or allergy to any of the components of Dorithricin (benzalkonium chloride, benzocaine, tyrothricin) should avoid its use.
2. Paediatrics: Doritricin is not recommended for use in children under 6 years of age as they may accidentally swallow the tablet or be unable to dissolve it.
3. Methemoglobinemia: Patients with hereditary or idiopathic methemoglobinemia should avoid the use of benzocaine as it may cause an increase in blood methemoglobin levels.
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 Doritricin during pregnancy and breastfeeding has not been established, so its use should be carried out only in case of obvious need and under the supervision of a physician.
6. Kidney and Liver Problems: People with severe kidney or liver problems should use Doritricin with caution and under medical supervision.

Side effects Doritricina

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 membrane 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

Symptoms of overdose

Benzalkonium chloride:

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

Benzocaine:

• Systemic toxic reactions, especially in children
• Methemoglobinemia (a potentially dangerous condition in which the oxygen-carrying 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, Quincke's edema, 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 assistance:

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

2. Seek medical attention:

   • Seek immediate medical attention or call emergency services.
   • 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.
   • In case of allergic reactions: it is possible to use antihistamines or adrenaline in case of anaphylactic shock.
   • In case of systemic toxicity: supportive care, monitoring of vital organ functions, oxygen therapy if necessary.

Prevention

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

Interactions with other drugs

1. Benzalkonium chloride:

• Concomitant use with anionic substances (eg, 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: Co-administration may enhance the antibacterial effect, but may also increase the risk of developing resistance or allergic reactions.
• Systemic antibiotics: Interaction is unlikely due to minimal systemic absorption of tyrothricin, but an increase or decrease in the effect of systemic antibiotics is theoretically possible.