Medication Description: Himopsin (Chymopsinum)
Himopsin (or amorphous chymotrypsin) is obtained from the pancreas of slaughter cattle. Contains a mixture of a-chymotrypsin and trypsin.
Brilliant flakes or powder of white or white with a faint yellowish tint of color. Easily soluble in water and isotonic sodium chloride solution; pH of 0.2% aqueous solution 4, 5 - 6, 5. The aqueous solution should be colorless, transparent or with weak opalescence, but not containing sediment. Solutions are unstable, they are rapidly inactivated at high temperatures and can be stored for 24 hours at temperatures from + 2 to + 5 ° C.
According to the biological properties, chemopsin is similar to a -chymotrypsin and trypsin, but is less purified and allowed only for topical use (on purulent wound surfaces and for inhalation); it is impossible to apply himopsin parenterally.
In the treatment of purulent wounds and bedsores, dissolve 0.025-0.05 g (25-50 mg) of himopsin in 10-50 ml of a 0.25% solution of novocaine; the solution is moistened with sterile wipes, which are applied to the wound surface for 8 hours or more (depending on the thickness of the purulent-necrotic layer). At the same time it is advisable to use antibiotics.
For third-degree burns, loosely rejected necrotic tissues are preliminarily removed, then a thin layer of chemopsin (as a powder) is applied and covered with a dressing moistened with isotonic sodium chloride solution or 0.25% novocaine solution in borate buffer (pH 8, 6). Top impose moisture-proof bandage. Bandages change after a day. Before each subsequent application, easily detachable areas of necrosis are removed. A 0.5-1% solution of chemopsin can also be used. For wounds covered with a thick scab, cut the scab so that the drug penetrates deep into the tissue.
Local application of chemopsin can be combined with the introduction of crystalline chymotrypsin (0.02 g in 20 ml of a 0.25% solution of novocaine) under a scab.
In the treatment of corneal ulcers and keratitis, baths with a 0.2% solution or drops (0.25%) are used 3–4 times a day for 1–2–3 days.
For inhalation, with inflammatory diseases of the upper respiratory tract and lungs, dissolve 25 - 30 mg of the drug in 5 ml of sterile isotonic sodium chloride solution or distilled water. The solution can also be administered through a bronchoscope or endotracheal probe. Inhalations repeat 1 - 2 times a day; the duration of treatment depends on the nature and course of the disease. After inhalation, rinse your mouth and rinse your nose. In the next few hours after inhalation, the patient should carefully cough up sputum or it should be sucked away. Antibiotics and bronchodilators can be added to solutions of himopsin.
When using chemopsin, allergic reactions are possible, mainly due to the absorption of necrotic tissue proteolysis products. Therefore, before applying himopsina, an antihistamine preparation (diphenhydramine or others) should be prescribed to the patient. After inhalation of a chemopsin, hoarseness of the voice sometimes disappears on its own.