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Description
Chymotrypsin Pharmacodynamics
It hydrolyzes proteins and peptones with formation of relatively low molecular weight peptides, cleaves bonds formed by residues of aromatic amino acids (tyrosine, tryptophan, phenylalanine, methionine).
In medical practice, the use of Chymotrypsin is based on the specific feature to break up necrotic tissues and fibrinous formations, to liquefy viscous secretions, exudates and blood clots, and when administered intramuscularly to have an anti-inflammatory effect. The enzyme is inactive against healthy tissues and is safe.
Indications
- Inflammatory diseases of the respiratory system (bronchiectatic disease, pneumonia, pulmonary abscess, atelectasis, exudative pleurisy, pleural empyema, bronchitis).
- Burns, bedsores, purulent wounds.
- Thrombophlebitis, periodontal disease (inflammatory-dystrophic forms).
- In ophthalmology: fresh extensive central retinal vein thrombosis, acute central retinal artery obstruction, vitreous opacity of traumatic and inflammatory origin, cataract extraction.
- In otolaryngology: purulent sinusitis, subacute laryngotracheitis, after tracheostomy to facilitate removal of thick viscous exudate, in acute, subacute, purulent, chronic middle otitis and eustachianitis with viscous exudate.
Contraindications
Hypersensitivity, malignant tumors, pulmonary tuberculosis (open form), II – III degree chronic heart failure, liver dystrophy and cirrhosis, viral hepatitis, pancreatitis, hemorrhagic diathesis, pulmonary emphysema with respiratory insufficiency.
Do not inject into bleeding cavities, apply to ulcerated surfaces of malignant tumors to avoid spread of the malignant process.
With caution:
Empyema of the pleura of tuberculous etiology (resorption of the exudate may in some cases contribute to the development of bronchopleural fistula).
Pregnancy and lactation:
There are no data on the use of the drug in pregnancy and during lactation.
Directions for use and dosages
- For intramuscular injection 5 mg of the drug is dissolved immediately before application in 1-2 ml of 0.9% sodium chloride solution for injection or 0.5-2% procaine solution. The course of treatment is 6-15 injections.
- For respiratory diseases the drug is used intramuscularly in doses of 5-10 mg per day for 10-12 days; combination with Chymotrypsin aerosolized in 5% aqueous solution in an amount of 3-4 ml is possible. The course of treatment may be repeated after 7-10 days.
- In the treatment of burns and bedsores Chymotrypsin in a dose of 20 mg dissolved in 20 ml of 0.25% procaine solution is injected with a thin needle in several injections under the scab. Sterile napkins soaked in a solution of 25-50 mg of Chymotrypsin in 10-50 ml of 0.25 % procaine solution are placed on purulent wound surfaces for 8 hours. For treatment of purulent wounds intramuscular injection of the drug is combined with local treatment of the wound with tampons moistened with 5% aqueous solution of Chymotrypsin.
- In case of thrombophlebitis the drug is administered intramuscularly by 5-10 mg daily for 7-10 days.
- During cataract extraction, Chymotrypsin diluted 1:5000 is injected into the posterior chamber of the eye followed by washing the anterior chamber and the eye with 0.9% sodium chloride solution 4 minutes after the injection.
- In treatment of central retinal vein thrombosis and acute central retinal artery obstruction Chymotrypsin is injected subconjunctivally in 0.2 ml of 5% solution prepared on 1% procaine solution 1-2 times a week.
- When sinusitis the drug is injected into the appropriate cavity in an amount of 5-10 mg in 3-5 ml of 0.9% sodium chloride solution after puncture and irrigation of the cavity.
- In otitis media 0.5-1 ml of 0.1 % Chymotrypsin solution in 0.9 % sodium chloride solution is injected into the ear. During microoperations on the ear to soften fibrinous formations in the middle ear during surgery, 0.1% solution of Chymotrypsin is injected into the cavity. At the same time Chymotrypsin should be administered intramuscularly 2.5-5 mg 1-2 times a day. The drug is diluted in 1-2 ml of 0.25-0.5% procaine solution or 0.9% sodium chloride solution for injection.
