Description of the medicine: Chymopsinum (Chymopsinum)
Chymopsin (or amorphous chymotrypsin) is obtained from the pancreas of slaughter cattle. Contains a mixture of a-chymotrypsin and trypsin.
Shiny flakes or powder of white or white with a faint yellowish tint. Easily soluble in water and isotonic sodium chloride solution; The pH of a 0.2% aqueous solution is 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 during the day at temperatures from + 2 to + 5 ° C.
In terms of biological properties, chymopsin is similar to a -chymotrypsin and trypsin, but less purified and allowed only for topical use (on purulent wound surfaces and for inhalation); parenteral administration of chymopsin is not possible.
In the treatment of purulent wounds and bedsores, 0.025-0.05 g (25-50 mg) of chymopsin is dissolved in 10-50 ml of a 0.25% novocaine solution; 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.
In case of third-degree burns, necrotic tissues that are freely rejected are previously removed, then a thin layer of chymopsin is applied (in the form of powder) and covered with a dressing soaked in isotonic sodium chloride solution or in a 0.25% novocaine solution in borate buffer (pH 8, 6). A waterproof dressing is applied from above. Dressings change in a day. Before each subsequent application, easily separated areas of necrosis are removed. A 0.5-1% chymopsin solution may also be used. For wounds covered with a thick scab, the scab is cut so that the drug penetrates deep into the tissues.
Local use of chymopsin can be combined with the introduction of crystalline chymotrypsin under a scab (0.02 g in 20 ml of a 0.25% novocaine solution).
In the treatment of corneal ulcers and keratitis, baths with 0.2% solution or drops (0.25%) are used 3-4 times a day for 1 to 2 to 3 days.
For inhalations, with inflammatory diseases of the upper respiratory tract and lungs, 25-30 mg of the drug is dissolved in 5 ml of a sterile isotonic solution of sodium chloride or distilled water. The solution can also be administered through a bronchoscope or endotracheal probe. Inhalations are repeated 1 to 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 should be sucked. Antibiotics and bronchodilators can be added to chymopsin solutions.
When using chymopsin, allergic reactions are possible, mainly associated with the absorption of proteolysis products of necrotic tissues. Therefore, before using chymopsin, an antihistamine drug (diphenhydramine or other) should be prescribed to the patient. After inhalation of chymopsin, sometimes hoarseness occurs, disappearing on its own.