Ethacridine

Usage

• Ethacridine is an antiseptic and disinfectant primarily used for the topical treatment of minor wounds and skin infections. It has also been used in some regions for second-trimester abortions via extra-amniotic administration, though this usage has largely been replaced by safer and more effective methods.
• Pharmacological classification: Antiseptic, disinfectant, abortifacient (historical).
• Mechanism of action: Ethacridine inhibits bacterial growth by interfering with DNA replication and other cellular processes in susceptible microorganisms, primarily gram-positive bacteria.

Alternate Names

• Acrinol
• Rivanol

How It Works

• Pharmacodynamics: Ethacridine exerts a bactericidal effect primarily on gram-positive bacteria. It inhibits bacterial DNA replication and other cellular processes.
• Pharmacokinetics: Topical application limits systemic absorption. When administered extra-amniotically, absorption is slow. Specific details on metabolism and elimination pathways are limited.

Dosage

Standard Dosage

Adults:

• Topical: Apply a 0.1% solution or cream to the affected area as needed.

Children:

• Topical use in children should be under the guidance of a healthcare professional.

Special Cases:

• Elderly Patients: No specific dosage adjustments are typically required for topical use.
• Patients with Renal Impairment: No specific dosage adjustments are required for topical use due to limited systemic absorption.
• Patients with Hepatic Dysfunction: No specific dosage adjustments are required for topical use.
• Patients with Comorbid Conditions: No specific adjustments are generally needed for topical use.

Clinical Use Cases

The following dosages are based on historical usage and are not generally recommended in current practice. Safer and more effective alternatives are typically preferred.

• Intubation: Not applicable for current standard practice.
• Surgical Procedures: Not applicable for current standard practice.
• Mechanical Ventilation: Not applicable for current standard practice.
• Intensive Care Unit (ICU) Use: Not applicable for current standard practice.
• Emergency Situations: Not applicable for current standard practice.

Dosage Adjustments

• Dosage adjustments are generally not needed for topical use. For historical extra-amniotic use in abortion, the dose was sometimes based on gestational age. This practice is not currently recommended.

Side Effects

Common Side Effects

• Local skin irritation (burning, itching, redness).

Rare but Serious Side Effects

• Allergic reactions (rash, hives, itching, swelling).

Long-Term Effects

• Prolonged topical use may delay wound healing.

Adverse Drug Reactions (ADR)

• Severe allergic reactions (anaphylaxis).

Contraindications

• Hypersensitivity to ethacridine.

Drug Interactions

• Incompatible with chlorine-containing solutions, chlorides, iodides, phenol, iodine preparations, and alkaline drugs. Concomitant use with other topical agents should be avoided.

Pregnancy and Breastfeeding

• Pregnancy: Ethacridine has historically been used for second-trimester abortions. However, this practice is largely obsolete due to safer and more effective methods being available. Topical use during pregnancy should be limited and only under the guidance of a doctor.
• Breastfeeding: Limited information is available about excretion in breast milk. Topical use during breastfeeding should be done with caution and under the guidance of a doctor.

Drug Profile Summary

• Mechanism of Action: Inhibits bacterial DNA replication and cellular processes.
• Side Effects: Local skin irritation, allergic reactions.
• Contraindications: Hypersensitivity.
• Drug Interactions: Incompatible with various solutions and medications.
• Pregnancy & Breastfeeding: Limited safety information, topical use with caution. Consult with a healthcare professional.
• Dosage: Topical: Apply 0.1% solution/cream to the affected area.
• Monitoring Parameters: Monitor for local skin reactions and signs of infection.

Popular Combinations

• Combinations are generally not recommended.

Precautions

• General Precautions: Avoid contact with eyes. Discontinue use if irritation or allergic reaction occurs.
• Specific Populations: Use cautiously during pregnancy and breastfeeding. Consult with a healthcare professional.
• Lifestyle Considerations: None specifically identified.

FAQs (Frequently Asked Questions)

Q1: What is the recommended dosage for topical ethacridine?

A: Apply a 0.1% solution or cream to the affected skin area as needed.

Q2: What are the common side effects of topical ethacridine?

A: Common side effects include local skin irritation, such as burning, itching, and redness.

Q3: Is ethacridine safe to use during pregnancy?

A: Topical ethacridine should be used with caution during pregnancy and only under the guidance of a doctor. Historical usage as an abortifacient is no longer recommended due to safer alternatives.

Q4: Can ethacridine be used during breastfeeding?

A: Limited information is available. Consult with a healthcare professional before using ethacridine during breastfeeding. Topical use during breastfeeding should be done with caution and under the guidance of a doctor.

Q5: What are the contraindications for using ethacridine?

A: The primary contraindication is known hypersensitivity to ethacridine.

Q6: How does ethacridine work against bacteria?

A: Ethacridine primarily targets gram-positive bacteria by inhibiting DNA replication and other essential cellular processes, leading to bacterial death.

Q7: Are there any drug interactions I should be aware of with ethacridine?

A: Ethacridine is incompatible with several solutions and medications, including chlorine-containing solutions, chlorides, iodides, phenol, iodine preparations, and alkaline drugs.

Q8: What should I do if I experience side effects from ethacridine?

A: Discontinue use and consult with a healthcare professional.

Q9: Can ethacridine be used for deep wounds?

A: Ethacridine is primarily indicated for superficial, minor wounds and skin infections. Deep wounds may require different treatment approaches. Consult with a healthcare professional.

Q10: Is ethacridine effective against all types of bacteria?

A: Ethacridine is primarily effective against gram-positive bacteria. It is not effective against gram-negative bacteria such as Pseudomonas aeruginosa.