Rivanol

RIVANOL (Rivanol), an antiseptic of the acridine series, synthesized by Morgenroth in 1921 as the hydrochloride salt of diethoxy-diamino-acridine. Instead of the difficultly soluble hydrochloride of R., the lactic acid rivanol has been put on the market, NH₂ ^н^ч^ч^Ч/~^{CH₃CH(OH)COO-}'!

a fine crystalline yellow powder, gradually dissolving in cold water in the ratio of 1:15, in hot water - 1:9, in wine alcohol - 1:110. The bactericidal properties of R. are considerable, especially against pyogenic cocci - streptococci, staphylococci, and gonococci. According to Morgenroth, in a test tube R. kills streptococci in a concentration of 1:100,000; for the death of streptococci in an infected mouse, the solution of R. must be at a concentration of 1:40,000; when mice are infected with staphylococci, sterilization is achieved by the introduction of a solution of R. into the subcutaneous tissue at a concentration of 1:2,000, and it was found that in many cases animals could be saved from the development of sepsis if after their infection until the injection of R. 1-24 hours had passed. The dose of R. in treatment is established based on the following data: a 20-gram mouse tolerates with subcutaneous administration 0.0015 R. in a 1:200 solution, with intraperitoneal - 0.0008 at a concentration of 1:600 and with intravenous - 0.0003 in a 1:1,500 solution; the lethal dose for rabbits is 0.05 per 1 kg of body weight with intravenous administration and 0.1 with subcutaneous. Death occurs due to respiratory arrest. From tissues R. is absorbed slowly; solutions of R. of strength 1:1,000, 1:500 and even 1:400 (Axhausen) do not damage tissues; from stronger concentrations of R. tissues are irritated and infiltrates appear. In undiluted blood serum R. does not lose its bactericidal properties, therefore R. is recommended for intravenous administration in cases of sepsis. Leschke (E. Leschke), based on his personal observations, however, finds it difficult to confidently assert that recovery of septic patients followed due to treatment with R. The introduction of R. into the blood initially causes vasodilation and a fall in blood pressure. This phenomenon occurs the more sharply the larger amount of R. is introduced into the blood and the faster this is done. Kompanyants, who thoroughly studied the reaction of blood vessels to R., also points out that the stage of entry of R. into the blood is characterized by dilation (up to 30%) of blood vessels, after which however the vessels constrict (up to 27%), and the stage of exit of rivanol is characterized by even greater constriction. The vasoconstrictive effect of R. Kompanyants associates with the direct effect of R. on the peripheral neuromuscular apparatus of blood vessels, whereas with the toxic effect of this agent the phenomena depend on the effect of R. on the vasomotor center and heart. In medical practice R. is widely used at present as an antiseptic for external and internal administration, as well as for preventive purposes, noting the considerable disinfecting power of R., cessation of the painful process, healing of wounds by primary intention, acceleration of the formation of the demarcation line. For washing wounds and ulcers, both superficial and deep, R. is used in solutions of 1:1,000; solutions of R. of the same strength are also used for disinfecting the abdominal cavity by washing during laparotomies, the pleural cavity with abundant tuberculous pus. (Sidlyarevskaya-Zakharova), for douching the uterine cavity (in the amount of 10-20 cm³) after surgical intervention, as well as the vagina prophylactically before and after childbirth (Guzikovs, Rusin); for washing the cavity of a cyst and chitinous membranes after removal of liver echinococcus (Kogan), a solution of R. 1:400 is used, and for pouring into the cavity of a cyst, 100-500 cm³ of a solution of R. of strength 1:1,000 is taken; for rinsing the mouth, pharynx, throat, for washing the nose and ears, solutions of 1:1,000 are used; in ophthalmic practice, solutions of 1:500 gave (Melik-Gul-nazaryan) better results than a 1.5% solution of zinc sulfate. However, caution should be exercised with corneal ulcers due to irritation by R. It is manufactured at the Karpov factory in Moscow under the name acridide. Stains from R. on linen are removed with a strong solution of acetic acid.