The same active ingredients may be used in the formulation of antiseptics, disinfectants and sanitizers. However antiseptics are formulated to minimise tissue irritation and damage. Sanitizers generally contain essential oils such as pine oil to give them a pleasant or "clean" odour.
Phenol (carbolic acid) and its derivatives were the first antiseptics and disinfectants used in medicine. The phenolic compoundsare referred to as coal tar derivatives and are still commonly used in veterinary medicine.
The oral LD50 of phenol alone is approximately 0.5 g/kg except for the cat which is more sensitive.
Some of the more common coal tar (Phenolic) products used in veterinary medicine
| Phenolic | Trade Name | Use |
|---|---|---|
| Hexachlorophene | Septisol (pHisohex) | Surgical hand scrub |
| O Phenylphenol | Intracal | Disinfectant |
| Lysol | ||
| Dowicide A | ||
| O Benzyl p chlorophenol | Intracal | |
| Cresol | Cresylicacid | Disinfectant |
| Tricresol | ||
| Resorcinol | Resorcin | Antiseptic and disinfectant |
Phenol is very corrosive and produces a penetrating lesion. It is rapidly absorbed through the skin and from the gastrointestinal tract. There are marked species differences in the biotransformation of the phenolics. Cats, certain reptiles and birds appear most susceptible. The phenolics are hepato, nephro, and neurotoxic. The primary target organ varies from product to product. The phenols are generally very caustic to oral and ocular membranes and produce visible erosions. Hence the clinical signs recorded following accidental ingestion include, salivation, vomiting, apprehension, ataxia, severe respiratory depression with the formation of methaemoglobinaemia. Seizures, coma and death are more common in the cat.
Clinical signs of hepatic and renal damage will be present usually 12 to 24 hours after exposure.
A history of exposure, clinical signs, lesions are suggestive of phenol poisoning. An aromatic lamp oil odour may be observed. A rapid presumptive test to confirm the diagnosis is done with 10 ml of urine mixed with 1 ml of 20% ferric chloride. A purple color indicates the presence of phenol. Alternatively serum, urine or kidney may be tested for phenols by some laboratories.
Intoxication with phenolics presents a clinical emergency. Gastric lavage with olive or mineral oil is considered the treatment of choice. Avoid induced vomition in case of oesophageal injury. Methylene blue (8.0 mg/kg by slow infusion) or acetylcysteine (140 mg/kg loading dose, followed by 70 mg/kg 4 times daily per os (PO) for 3 days) may be used to counter the methaemoglobinaemia. Other treatments are symptomatic, including attention to eye damage.
For dermal exposure use polyethylene glycol or glycerol (glycerine) prior to washing. If neither is available use a mild liquid dishwashing detergent (not for automatic dishwashers) and plenty of water. Avoid oily (oil based) skin products initially as these may enhance the absorption of phenol. A 0.5% sodium bicarbonate soaked dressing is recommended after washing has removed all traces of phenol.
Isopropanol (isopropylalcohol) is an aliphatic alcohol widely used as a rubifacient, an antiseptic, a disinfectant, in the formulation of skin lotions, hair tonics and after shave lotions, as a cleaning solvent and as a solvent in window cleaners and in sanitizers. It is sometimes used to sterilise surgical instruments and suture materials. Intoxication is not common but has been reported. The usually disinfectant is 70% isopropanol, but sometimes mixtures with ethanol are used.
Isoropanol is readily absorbed from the gastrointestinal tract, by inhalation and, to a lesser extent, by skin. It produces irritation of the gut, it decreases response to stimuli and induces hypotension. It has a characteristic smell which may be noticed in the blood stained vomit following its accidental ingestion. Gastritis rapidly develops in a toxicosis followed by central nervous system depression leading to coma with marked respiratory depression.
Isopropanol is metabolised to acetone, which can cause ketosis.
Pine oil (alpha terpineol, aromatic pine oil) is used as a sanitizer and disinfectant. Pine oil has a low solubility and solvents such as isopropanol are often added. Small animals have frequently been poisoned by this material.
Clinical Features
Pine oil has a turpentine like odour; it is a complex mixture of terpene alcohols. The lethal oral dose of pine oil for small animals ranges from 1.0 to 2.5 ml/kg bodyweight and a substantially lower dose can result in severe intoxication. It is readily absorbed from the gastrointestinal tract and rapidly distributed to fat. Pine oil is irritating to eyes and skin.
Affected animals usually have a turpentine like odour on the breath and there is marked irritation of the mouth and pharynx. Vomiting and retching are common signs. Progressive signs of central nervous system intoxication develop with hyperaesthesia, ataxia, muscular weakness and coma. Tachycardia, toxic nephritis and elevated body temperature are usually seen. If the eye is affected the signs are usually very severe. Severe acid base imbalances develop and renal damage becomes severe.
Treatment is again along conservative lines. Care must be taken not to cause an aspiration pneumonia when vomiting is induced.
Boric acid and sodium borate (borax), although only weakly bacteriostatic, are used as antiseptics and disinfectants and are the ingredients of a large number of consumer products. They are used as food preservatives, in laundry materials and wood preservatives for interior use (H1). Much of NZ is deficient in boron, so it is often included in herbicides and fertilizers, particularly for use around citrus and pine trees. They are generally of low toxicity; the oral LD50 in rats is 2.7 - 5g/kg.
Poisoning has been reported in cats and dogs. They are nephrotoxic and produce central nervous system damage. The main clinical signs of acute poisoning include vomiting, salivation, diarrhoea, abdominal pain, ataxia, hyperaesthesia, general muscle weakness, convulsions and death.
Treatment involves the early induction of vomiting and gastric lavage followed by activated charcoal. Fluid balance should be maintained and respiratory depression treated with intermittent positive pressure ventilation. Seizures should be treated.
Formaldehyde and glutaraldehyde have been used as disinfectants, and glutaraldehyde 2% aqueous solution has been used for sterilising surgical instruments. They are irritant, and the fumes may cause irritation to the respiratory system. OSH requirements for handling mean that these are unlikely to be used much. Treatment is as for other irritants.
Treatment involves the early induction of vomiting and gastric lavage. The airway must be secured as the onset of CNS depression can be rapid. Fluid balance should be maintained and respiratory depression treated with intermittent positive pressure ventilation.
A commonly used antiseptic, surgical scrub and disinfectant. It has a low oral toxicity, but because of its low solubility, many formulations contain anionic and cationic detergents to increase its solubilization. If absorbed it can cause haemolysis. It will cause irritation and fibrosis of mucous membranes. It should be kept away from eyes, and not used for cleaning ears unless the ear drum is intact.
Same as cationic detergents.
Iodine, as povidone iodine, is a commonly used antiseptic, surgical scrub and disinfectant. Povidone iodine is generally safe as it is not absorbed to any great extent from the gut or the skin. However, significant absorption can occur after flushing of wounds or serosal surfaces. Signs of mild toxicity usually relate to the CNS and include depression and possibly seizures.
Treatment is symptomatic, although osmotic diuresis may hasten excretion of iodine. Symptomatic treatment may include fluid therapy (phenols are excreted in the urine) and for oral exposure, demulcents such as milk and egg.
Bath, M.L. (1978). Hexachlorophene Toxicity in dogs. J. Small. Anim. Pract. 19: 241 244.
Beasley, V. (1997) Phenolics and Coal Tar. A Systems Affected Approach to Veterinary Toxicology. Publisher Illinois Press, USA.553 555.
Clarke, M.L., Harvey, D.G. and Humphreys, D.J. (1981). Veterinary Toxicology: 2nd ed. Bailliere Tindall, London.
Coppock, R.W., Mostrom, M.S. and Lillie, L.E. (1988). The Toxicology of Detergents, Bleaches, Antiseptics and Disinfectants in Small Animals. Vet. Hum. Toxicol. 30: 463 473.
Temple, A.R. and Veltri, J.C. (1979). Outcome of Accidental Ingestion of Soaps, Detergents and Related Household Products. Vet. Hum. Toxicol. 21: 9 11
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