Drugs that coat the intestinal mucosa. Enveloping agents for the treatment of the stomach and their use. Astringents, coatings, adsorbents and irritants
With increased stomach acidity and other irritating factors, the most rapid analgesic effect is provided by enveloping agents. However, their functions do not end there.
Enveloping drugs and their scope of application
Enveloping agents contain components that, when interacting with water, form colloidal compositions and suspensions. These can be either natural or chemical substances, but all of them are designed to reduce the sensitivity of nerve endings and thereby protect them from aggressive influences. The following diseases are indicated:
- heartburn;
- gastritis;
- enteritis;
- colitis;
- ulcers;
- chemical burns of the mucous membrane and others.
Externally, enveloping agents are used to protect the skin and other tissues in case of burns, frostbite, and wounds. Sometimes enveloping components are also added to medications to reduce their aggressiveness.
Coating agents for the stomach and intestines
Enveloping agents and drugs to protect the digestive tract are practically not absorbed and therefore do not enter the blood. This feature allows the use of both natural medicines and synthetic analogues. Almost all folk remedies contain starch, or starchy substances. Here is a short list of herbal components that have an enveloping effect:
- flax seeds;
- liquorice root;
- potato starch;
- corn starch;
- comfrey;
- oats and oatmeal.
All these enveloping agents are good for gastritis and even ulcers - they almost instantly relieve pain and inflammation. Having oatmeal with water for breakfast is useful not only for those who are watching their weight, but also for those who care about their stomach health.
Since the medicine enters the intestines later than the stomach, it makes sense to resort to pharmaceutical drugs. Today there is no shortage of enveloping agents. Here is a short list of the most popular medications:
In addition to their direct protective and analgesic effect, enveloping drugs have an antiemetic and antidiarrheal effect. This occurs due to the fact that such drugs reduce the reflex function of the nerve endings of the mucous membrane.
Enveloping drugs are drugs that cover the mucous membranes and tissues, forming a viscous film over them that protects sensitive nerve endings from irritation.
Starch mucus (MucilagoAmyli) It is a colloidal solution of starch in hot water. To prepare mucus, use wheat ( Amylum Tritici), corn ( Amylum Maydis), rice ( Amylum Oryzae) or potato ( Amylum Solani) starch.
Used internally in the treatment of gastroduodenitis (reduces pain, belching) and in the form of enemas for proctitis, sigmoiditis, Crohn's disease. Sometimes starch mucus is prescribed together with drugs that have an irritating effect on the gastrointestinal mucosa.
NE: not described.
FV: mucus 2% extemporaneously prepared.
Flax seed mucilage (MucilagosemenisLini) Flax seeds infused in hot water ( Linum usitatissimum L. ). Used orally in the treatment of gastroduodenitis (¼-½ cup) 4-6 times a day, as well as together with medications that irritate the gastrointestinal tract.
NE: not described.
FV: mucus 1:30 extemporaneous preparation.
Polyvinox (Polyvinox, Vinylin, Schostakowski Balsam) It is a viscous syrupy liquid with a specific smell and taste. Upon contact with wound defects, it forms an adhesive film over them.
Promotes cleansing, regeneration and epithelization of wounds, while it creates conditions unfavorable for the proliferation of microorganisms.
Reduces the secretion, acidity and proteolytic activity of gastric juice.
Application and dosage regimen:
Externally in the treatment of boils, carbuncles, trophic ulcers, purulent wounds, burns and frostbites, mastitis, they are used in pure form (perse), as well as in the form of a 20% oil solution or 3-5% ointment (with the addition of 0.75% silver nitrate) .
Orally for stomach and duodenal ulcers, gastritis on the first day, 3 capsules or 1 teaspoon at night, 5-6 hours after the last meal, then 5 capsules or 1 dessert spoon daily for 15-20 days.
Rectally through a rectoscope, 25-40 ml for 3-9 days for dysentery, colitis, Crohn's disease.
NE: drug hypersensitivity.
F 
B: balm in bottles of 100.0 and capsules of 1.4 g. Products for oral administration should contain no more than 8% moisture, while for external use it is allowed to use balm with a moisture content of up to 15%.
Sucralfate (Sucralfate, Venter, Alcucral) MD: In an acidic environment, at pH<4,0 распадается на ионы алюминия и сульфат сахарозы. Ионы алюминия денатурируют белки слизи и нейтрализуют соляную кислоту. Сульфат сахарозы соединяется с белками некротизированных тканей и, спонтанно полимеризуясь, образует плотную пленку полигликозилированных протеинов, которая является барьером для воздействия агрессивных факторов на слизистую оболочку ЖКТ.
Enveloping effect – the polymer formed in the acidic environment of the stomach protects ulcerative defects by firmly covering them for 6 hours. Sucralfate practically does not interact with normal mucous membranes.
The antacid (acid-neutralizing) effect is insignificantly expressed; in terms of its strength, sucralfate is noticeably inferior to traditional products based on aluminum hydroxide. An essential feature of the antacid effect of sucralfate is its controllability. Since the release of free aluminum occurs only in an environment with an acidity pH of less than 4.0, sucralfate is not able to neutralize a pH of more than 4.0.
Gastrocytoprotective effect - associated with the ability of polyglycosylated mucus proteins formed when taking sucralfate to inactivate pepsin and bile acids.
Adsorbent action. In the intestine, a gel-like film of sucralfate absorbs bile acids, waste products of microorganisms. In addition, when aluminum reacts with phosphate ions, insoluble aluminum phosphate is formed.
Application and dosage regimen. Sucralfate is used in the treatment of gastric and duodenal ulcers, including symptomatic, stress, steroid ulcers, ulcerative-erosive lesions caused by the use of NSAIDs, as well as gastroesophageal reflux disease (retrograde reflux of bile into the lumen of the stomach or gastric juice into the esophagus). Usually it is taken 500-1000 mg 4 times a day 30-40 minutes before meals and at night, or 1000-2000 mg 2 times a day in the morning and evening. The course of treatment ranges from 6 to 12 weeks.
Sucralfate is sometimes used in patients with hyperphosphatemia caused by hemodialysis in end-stage chronic renal failure.
From the gastrointestinal tract, dry mouth and stool disorders are noted.
Despite the fact that the systemic absorption of aluminum from sucralfate is only 0.02%, it can sometimes have a neurotoxic effect in sensitive patients in the form of dizziness, drowsiness, headache and back pain.
It should be remembered that sucralfate forms insoluble complexes with fluoroquinolones, tetracyclines, theophylline and phenytoin, therefore its administration is incompatible with the oral administration of these drugs. On the contrary, antisecretory drugs (H 2 -blockers of histamine receptors, H + /K + -ATPase blockers) reduce the activity of sucralfate by increasing the pH of gastric juice.
FV: tablets of 500 and 1000 mg, granules of 1000 mg in sachets, gel 1000 mg in 5 ml sachets
Diosmectite (Diosmectit, Smecta) Diosmectite molecules have a discoid-crystalline structure - an aluminum octahedron in the center is surrounded by silicon tetrahedra on the sides. The molecules are combined into layers 1 nm thick, which, in turn, form scaly particles 1-2 microns in size. Inside the aluminum octahedra, some of the atoms are replaced by iron or magnesium; such a replacement leads to the appearance of an excess negative charge inside the layer and an excess positive charge between them.
MD: Diosmectite molecules have a very high adsorption capacity and fluidity, this is due to a combination of several factors:
The surface area of 1 g of the substance is 100 m2, which allows it to establish multiple nonionic bonds with mucus macromolecules;
Due to the presence of an excess positive charge, diosmectite sorbs small molecules in them;
Simple ions are sorbed by diosmectite inside the crystal lattice due to the excess negative charge.
Enveloping effect. Due to this effect, diosmectite acquires the ability to stabilize the mucous barrier of the gastrointestinal tract, prolonging the life of mucus and increasing its resistance to the action of acid protons.
Adsorbent action. Diosmectite molecules bind and neutralize toxigenic bacteria (V.cholerae, E.coli), rotaviruses, bile salts, undigested sugars. As a result, excessive secretion of fluid into the intestinal lumen under the influence of toxins or high osmotic environment stops and water absorption processes are normalized.
Indications for use and dosage regimen. Diosmectite is used for:
Symptomatic treatment of acute and chronic diarrhea (including in children). In terms of antidiarrheal effectiveness, diosmectite is comparable to opiates.
Symptomatic relief of pain in inflammatory diseases of the gastrointestinal tract (esophagitis, gastroduodenitis, enterocolitis).
Take 3 sachets per day orally on an empty stomach, dissolving their contents in 1 glass of water (for acute diarrhea, the dose can be doubled). In pediatric practice, for children under 3 years of age, 1 sachet is used per year of life; in older children, diosmectite is used in the same doses as in adults.
NE: There are isolated reports of constipation occurring when taking diosmectite, which can easily be eliminated by reducing the dosage of the drug.
FV: powder in sachets of 3.0 for the preparation of a suspension.
Diseases of the digestive system associated with damage to the mucous membrane of the stomach and intestines in the form of erosions and ulcers develop under the influence of aggressive factors with insufficient protective properties. Enveloping agents for the stomach are a large group of medications that create a protective film on the mucous membrane of the organ.
Enveloping drugs are high-molecular compounds that form colloidal solutions or emulsions upon contact with water. A thin film is created that protects the nerve endings of the mucous membranes from the irritating effects of aggressive substances that make up the gastric juice. This provides an analgesic and anti-inflammatory effect.
Most coating substances have adsorbent and antacid properties. Drugs that coat the gastric mucosa are divided into two groups.
Products based on natural ingredients:
Synthetic chemical compounds:
- preparations based on colloidal bismuth;
- products containing aluminum;
- combination medications.
Mechanism of action
Normally, to protect the mucous membrane, a special mucus is synthesized in the stomach - mucin. This is an insoluble organic substance designed to protect the gastric epithelium from the aggressive acidic environment of gastric juice. Impaired mucus production leads to exposure of the mucous membrane and the formation of erosions and ulcers on it.
Enveloping drugs for the stomach and intestines increase the viability of epithelial cells of the digestive tract mucosa by influencing prostaglandins. Due to the active substances included in the preparations (aluminum oxide, bismuth salts, magnesium oxide), under the influence of hydrochloric acid, a durable polymer layer is formed, connected to protein exudates, which acts as a protective barrier.
Therapeutic effect of enveloping substances:
- They bind pepsin and bile acids that enter the stomach during reflux.
- They produce a cytoprotective effect due to stimulation of endogenous prostaglandins.
- Improves blood supply to the mucous membrane.
Indications
Enveloping drugs are used for inflammatory and ulcerative lesions of the stomach and intestines:
- heartburn;
- acute gastritis;
- chronic hyperacid gastritis;
- peptic ulcer of the stomach and duodenum;
- pancreatitis;
- enterocolitis;
- poisoning
Medicines
Colloidal bismuth preparations
Colloidal bismuth compounds, when combined with gastric hydrochloric acid, form a glycoprotein-bismuth complex, which settles mainly in the area of eroded and ulcerated areas of the mucosa. The protective barrier does not allow hydrochloric acid, pepsin, or food to reach the damaged areas, and the mucous membrane is restored faster.
A feature of bismuth preparations is their low bioavailability. During a course of treatment after a month, the concentration of bismuth in the blood plasma barely reaches 50 mcg/l. It takes 8 weeks to completely remove bismuth compounds from the body.
- De-nol;
- Vetrisol;
- Bizmat;
- Bisnall.
Side effects: headache, dizziness, alternating constipation and diarrhea. The stool is dark due to the formation of bismuth sulfide in the intestines.
Sucralfate is a complex aluminum-containing disaccharide that is not absorbed when taken orally. Polymerization occurs in the acidic environment of the stomach.
The resulting substance tightly combines with the proteins of the gastric mucosa, especially in the area of erosions and ulcers. The protective layer in the organ lasts up to 8 hours.
Side effects: dry mouth, stomach discomfort, nausea, stool disorders, local allergic reaction - hyperemia and itching of the skin.
Contraindications:
- children under 4 years old;
- pregnancy period;
- renal dysfunction.
Preparations containing aluminum
Phosphalugel– colloidal aluminum phosphate has an antacid, enveloping, sorbing and analgesic effect. The drug, neutralizing excess hydrochloric acid, preserves the environment in the stomach necessary for digesting food. Envelops the walls of the stomach, reduces pain, accelerates epithelial repair.
Contraindications: Alzheimer's disease, hypophosphatemia, severe kidney pathologies.
Side effects: nausea, vomiting, constipation, allergic reactions.
Almagel has similar pharmacological properties to Phosphalugel: antacid, enveloping, sorbing. By binding and eliminating damaging substances, aluminum and magnesium hydroxide cover the surface of the gastric mucosa with a film. The drug contains the substance benzocaine, which has a pronounced analgesic effect.
Main contraindications: Alzheimer's disease, kidney failure, children under 10 years of age, low levels of phosphorus in the blood.
Side effects: nausea, vomiting, constipation, allergies.
Combination drugs
Vikalin contains bismuth subnitrate, sodium bicarbonate, rutin, magnesium carbonate, active flavonoids of calamus and buckthorn. This composition provides anti-inflammatory, bactericidal, reparative, antispasmodic effects of the drug.
Side effects: nausea, vomiting, headache, allergic reactions: rash, urticaria.
Contraindicated in case of poor blood clotting, children under 18 years of age, hypoacid gastritis, renal failure, enteritis and colitis, during pregnancy and lactation.
Vikair– a combined drug: bismuth subnitrate forms a protective film, sodium bicarbonate and magnesium carbonate reduce the acidity of gastric secretions, the active component of calamus acts as an antispasmodic - relieves pain and muscle spasms.
Contraindications: hypoacid gastritis, kidney pathology, children under 18 years of age, pregnant and lactating women, enterocolitis.
Natural antacids
Licorice root syrup contains glycyrrhizic acid. This glycoside, when combined with water, foams and forms a gel. In the stomach, it stimulates the production of prostaglandins, promotes
healing of ulcerative defects.
Flax-seed. The mucus released when boiling the seeds covers the inflamed gastric mucosa, relieves pain, prevents eroded areas from coming into contact with the acidic contents of gastric juice, and accelerates the scarring of ulcers.
Starch According to its chemical composition, it belongs to polysaccharides. Starch swells in water, forming a colloidal solution - a paste. This property is used in the treatment of stomach inflammation caused by insufficient production of protective mucus by glandular cells - mucin. Starch has an analgesic and enveloping effect. In addition, it normalizes the process of gas formation and prevents flatulence.
Oats. The active components of the cereal have a healing effect on ulcerative defects, reduce the inflammatory process, and promote accelerated cell regeneration. For severe pain and spasms, oatmeal decoction relieves pain.
Comfrey. The mucus formed by decoction of the root contains a healing flavonoid - allantoin, which stimulates the development of new cells. Once in the stomach, it has an enveloping, healing and anti-inflammatory effect.
Traditional medicine recipes
Natural coating agents are used together with other medicines used in the treatment of stomach diseases.
Flax seeds
Pour 50 g of flax seeds into a liter of hot water. Put on fire, bring to a boil, stirring constantly. The result will be a decoction reminiscent of jelly. Strain and drink a cup 3 times a day between meals.
Pour a large spoonful of seeds crushed in a blender with a cup of boiling water. Leave to infuse for 8 hours. Do not strain, drink with seed particles every evening before bed.
Licorice root
Dry fry 2 small spoons of crushed root, add half a liter of boiling water, leave for 8 hours. After straining, drink 30 drops three times a day half an hour before meals.
Dilute a large spoonful of plant material with a glass of water.
Simmer in a water bath for 20 minutes. After 2 hours, squeeze out and strain. Take the decoction by spoon 4 times a day.
Starch
Add 2 large tablespoons of starch per liter of liquid. Place on the fire and, constantly stirring the mixture with a spoon, bring to a boil. After cooling, drink a cup before eating. It is not recommended to add jam or berries to jelly when treating ulcers and gastritis.
To quickly relieve heartburn, place a spoonful of dry starch in your mouth and gradually wash it down with warm water.
Oats
Pour a glass of whole grains with a liter of cold boiled water. For fermentation, place the solution in a warm place for 12 hours. Then boil the mixture for 30 minutes. After straining, the healing decoction is ready. Drink half a cup 30 minutes before meals until all symptoms disappear.
Pour a glass of oats into a container with a liter of water. Cook, stirring occasionally for 4 hours. When boiling, add liquid to the original volume. The broth will acquire the consistency of jelly. Grind the boiled grains until the broth becomes homogeneous. Drink 2-3 glasses a day for a long period.
If you have high acidity, the patient should start the day with oatmeal. The enveloping properties of this dish will protect the walls of the stomach throughout the day.
Comfrey root
Brew a teaspoon of powdered root in a glass of boiling water. Leave for 3-4 hours. Take a spoon 5 times a day half an hour before meals.
Grind the dry root into a fine powder, pour a tablespoon into a cup with 50 g of honey, and thoroughly grind the mixture until smooth. Leave for 2 weeks. Take a coffee spoon half an hour before meals for 14 days.
Gastric ulcer is a serious chronic disease that occurs cyclically with remissions and exacerbations. In each period, treatment tactics are different. It is the doctor’s prerogative to select medications that are most suitable for a given phase of the disease, and it is the patient’s job to strictly follow all the doctor’s instructions.
It is necessary to observe the doses of the prescribed gastric coating agents. Increased doses of the drug can lead to alkalization of gastric juice, which will cause a decrease in the digestive ability of the stomach.
Before using traditional medicine methods, consultation with a gastroenterologist is necessary.
Today, enveloping agents that create a barrier for the stomach and its mucous membrane from an aggressive environment are available in any pharmacy and are available without a prescription. To use drugs correctly, you need to know in what cases a particular drug is required and what are the indications for its use.
Very often, due to poor nutrition and abuse of alcohol and carbonated drinks, we create an increased level of acidity in the stomach, heartburn and pain in the upper abdomen occur, creating a favorable environment not only for gastritis, but also for peptic ulcers. In such cases, the body can no longer cope on its own; additional external help is required in the form of enveloping agents for the stomach, which will create a kind of protective layer on the mucous membrane and relieve the pain symptom.
Enveloping preparations contain chemicals that can interact with water and create colloidal solutions. They are distributed evenly over the entire surface of the stomach, thereby creating a protective film from further exposure to toxic substances and reducing the sensitivity threshold of nerve fibers. Thus, drugs in this group have the following properties:
- Enveloping effect.
- Stops an attack of nausea and vomiting.
- Analgesic effect.
- Antidiarrheal action.
- Antimicrobial and/or anti-inflammatory effect.
Medicines can also be used topically for various damage to the skin: injuries, frostbite, burns.
Enveloping agents exist in 2 generations: 1st generation - absorbable drugs, 2nd generation - non-absorbable. The former have a short-term effect; they interact with hydrochloric acid in the stomach and are partially absorbed into the general bloodstream. Such drugs include magnesium and calcium carbonate, burnt magnesia, Rennie. The advantage of the second group of drugs is their non-absorption property, that is, they do not enter the bloodstream, thereby remaining entirely in the stomach and intestines. Among them are Gastal, Maalox, Almagel.
At the moment, there are medicines, both herbal products and their synthesized analogues. Components of natural origin include starch and its derivatives, such as:
- Flax is a mucus protector, a breakdown of the stomach lining, and is used in the form of jelly, since the seeds release mucus in warm water. Also has antimicrobial and laxative properties.
- Liquorice root.
- Potato or corn starch - a frequently used product in the kitchen, upon contact with hot water turns into a colloidal mixture, which has an excellent enveloping effect. It is used not only internally, but also as enemas.
- Oats.
- Oatmeal or oatmeal is the healthiest breakfast product, cooked in water, it has a beneficial effect on the mucous membranes.
- Comfrey.
- White clay is available in powder form, dissolves in water and is used both internally and topically on the skin.
- Marshmallow root has a proven enveloping effect; brew it in boiling water and drink several servings a day before meals.
- Two-leaved lyubka.
- Spotted orchis contains both mucus and starch and is used as a decoction.
If it's nighttime and you don't have any medications on hand, you can use commonly used products like milk or baking soda as an antacid.
The most popular medications that provide a coating effect for the stomach are:
- White magnesia;
- Almagel;
- Phosphalugel;
- Sucralfate;
- Vikair;
- Aluminum hydroxide.
Important! Stomach and intestinal coating agents are often used in combination with antihistamines and antacids, as well as proton pump inhibitors. Their combined use provides a comprehensive approach to control the intensity and course of the disease. At the same time, modern drugs have almost no side effects, which explains their widespread use in medical practice.
Indications for the use of enveloping agents are the following diseases:
- For gastritis, both acute and chronic forms.
- Stomach and/or duodenal ulcers.
- Pancreatitis.
- Heartburn.
- Bloating.
- Poisoning.
- Enterite.
- Colitis.
- Burns of mucous membranes due to exposure to chemicals or toxic substances.
Almagel. Very often prescribed by doctors for gastritis or peptic ulcers, it is available in several forms, and another antacid, Maalox, has similar properties. The dosage of the drug is prescribed by the attending physician. Since these products contain aluminum, it is necessary to stop using them during pregnancy and breastfeeding; aluminum has a teratogenic effect on the fetus and placenta. Almagel ensures an increase in the pH of the contents in the stomach cavity and creates a protective film. The advantage of the drug is the absence of side effects of flatulence in patients. It is used for acute and chronic inflammation of the stomach, both for therapeutic and prophylactic purposes. Also indicated for reflux esophagitis, enteritis and colitis. During therapy with glucocorticosteroids, Almagel is often prescribed.
Bismuth preparations include De-Nol, Vikair, Bismofalk in this group. Bismuth forms a chelate bond with protein molecules, thereby providing mucosal protection. They also have antimicrobial activity against Helicobacter pylory. All bismuth-based medications are taken in a course for 1-2 months, before eating. Used for stomach and duodenal ulcers, duodenitis and gastritis.
Aluminum hydroxide is produced in the form of a powder compound and is prescribed in the form of a suspension 5-6 times a day for duodenal ulcers, poisoning and gastritis.
Sucralfate is an antacid with an enveloping effect, inhibits the production of the gastric enzyme, which is produced under the influence of hydrochloric acid, pepsin, and also “binds” hydrochloric acid itself. Used for ulcers and gastritis, 3 times a day, 1-2 tablets, you should drink the drug generously and do not chew it.
Phosphalugel is produced in the form of a white gel, has a neutralizing effect on hydrochloric acid, enveloping and adsorbing effects. Well used for food poisoning and toxic infections. Recommended for use for stomach ulcers, gastritis, alcohol intoxication, and dyspeptic syndrome. Side effects include flatulence and constipation.
Conclusion
Thus, enveloping drugs are very widely used today and are a first aid remedy for epigastric pain, heartburn, attacks of nausea and food poisoning.
Enveloping drugs are high-molecular compounds that form colloidal solutions in water. By covering the surface of the skin and mucous membranes with a thin layer, such drugs protect nerve endings from irritating substances. Most enveloping drugs have adsorbing properties, as a result of which they prevent contact of a harmful agent with nerve endings.
In case of inflammatory processes of the digestive canal, enveloping drugs, by eliminating irritations of the mucous membrane, help relieve pain, reflex dysphagia, nausea, vomiting, heartburn, and diarrhea. By slowing down the absorption (absorption) of toxic substances, these medications exhibit a detoxification effect. Starch mucus, which is prepared from various raw materials (corn grains, wheat, rice, potato tubers), is used as an enveloping medicine. Flax seeds are used in the form of mucilage. Starch and white clay are also used to make pastes. Enveloping substances are found in many medicinal plants: marshmallow, river grass, various types of orchis, common oats, cinquefoil erecta, licorice and the like.
Emollients
Emollient drugs include lipids, which cover the surface of the skin or mucous membrane with a thin layer and protect receptors from irritation. At the same time, they give elasticity to the fabrics. These medicines, which include petroleum jelly, lanolin, lard, flaxseed and olive oils, etc., are also used as a basis for the manufacture of ointments, pastes, and liniments. Some emollient drugs (pork fat, lanolin) easily penetrate into the deep layers of the skin and are used to facilitate the resorptive effect of drugs; Vaseline does not penetrate into the deep layers of the skin, therefore it has a local effect.
Astringent drugs
The group of astringents includes substances that react with tissue proteins (exudates of cell membranes, mucus) and, forming albuminates, cause the transformation of sol into gel and partial coagulation of the protein. Albuminates, which in the form of a film cover the surface of the skin or mucous membrane, protect nerve endings from irritation, reducing pathological impulses, including painful (nociceptive) ones. In addition, the elastic film mechanically compresses the vessels, as a result of which the permeability of their walls decreases and the exudation process slows down. Anti-inflammatory, deodorizing, minor analgesic and hemostatic effects are realized. When the drug is taken orally, it has an antidiarrheal and, in some cases, a detoxifying effect. At the same time, the activity of enzymes and the formation of inflammatory mediators is suppressed. Thus, the local action of astringents is aimed at reducing the inflammatory process.
Astringent drugs are divided into two groups: inorganic and organic origin. Astringent drugs of inorganic origin include salts of some metals (basic bismuth nitrate, lead acetate, copper sulfate, zinc sulfate, silver nitrate, etc. in small concentrations).
Bismuth nitrate basic prescribed in ointments, pastes, liniments, due to its antimicrobial and anti-inflammatory effects. The drug is part of complex antacid drugs (Vicalin, Vikair), which are prescribed for peptic ulcers.
For inflammatory diseases of the skin and mucous membranes (dermatitis, ulcers, eczema), dermatol (bismuth subgalate), xeroform (basic bismuth tribromophenolate), which have an astringent and antiseptic effect, are also used in the form of powders and ointments.
Pharmacology of other inorganic astringents (see. Antiseptics and disinfectants ).
The effect of inorganic astringents is short-lived.
Side effects (nausea, vomiting, dyspepsia) can be observed with long-term use of drugs containing metals, or with individual intolerance.
Astringents of organic origin are obtained from medicinal plant materials. They are contained in extracts from the bark of common oak, roots of angelica officinalis, common knotweed herb, thistle, St. John's wort, flowers of immortelle sandy, herbs and roots of celandine, leaves of mackerel, lingonberry, chamomile inflorescences, leaves and unripe fruits of walnuts, fruits of common juniper, blueberries, leaves and fruits of chestnut, rhizomes of cinquefoil erecta, serpentine, etc. Although the chemical composition of medicinal plants is different, most of them contain tannins that have astringent properties. Medicinal plants are especially widely used in folk medicine, however, some drugs (oak bark, sage leaves, chamomile inflorescences, etc.) are included in the arsenal of drugs of official medicine.
Oak bark used as a decoction for rinsing for inflammatory processes in the throat and oral cavity and internally for colitis and diarrhea. An infusion of sage leaves and a preparation of salvia, as well as a tincture of St. John's wort herb, are prescribed for gums and gargling and mouthwash for gingivitis and stomatitis, decubital ulcers of the oral mucosa. Chamomile flowers are prescribed for rinsing in the form of an infusion or decoction, and well-known preparations from this plant - Romazulan, Rotokan - for inflammatory processes in the oral cavity. Rotokan, Romazulan, and azupol treat inflammatory diseases of the mucous membrane of the throat and oral cavity. For gastritis, enteritis, infusions and decoctions of plants (St. John's wort, sage leaves, chamomile flowers, serpentine rhizomes, cinquefoil, etc.) are used orally for colitis in the form of enemas.
Salvia sage preparation is prescribed for gargling and mouthwash. As an astringent in a decoction for gargling the throat and mouth, you can prepare decoctions from the rhizome of cinquefoil and meadowsweet flowers.
Tannin- tannic acid from ink nuts (growths on oak and other plants). In solutions, depending on the concentration, the drug is prescribed for rinsing the mouth during inflammatory processes of the throat with a 1-2% solution; for burns and ulcers, it is treated with a 3-10% solution. The stomach is washed with a 0.5% tannin solution in cases of poisoning with salts of alkaloids and heavy metals (with these substances, tannin forms insoluble compounds that are almost not absorbed).
With some alkaloids (morphine, cocaine, atropine, nicotine), tannin also forms unstable compounds, which requires their rapid removal.
Astringent drugs are used topically for inflammatory processes of various localizations (stomatitis, gingivitis, rhinitis, conjunctivitis, cystitis, vaginitis, dermatitis, enteritis), prescribed to patients with gastric ulcers (bismuth subcitrate in the preparations de-nol and gastro-norm, bismuth nitrate main - in vikalin and vikair).
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