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LO11 PC2 ANTI-INFECTIVE AGENTS

Terminology
Anti-infective aka antimicrobial — General term referring to drugs active against
pathogens
Antibiotic aka antibacterial — active against bacteria
Chemoprophylaxis — prophylactic use of a medication
Pathogenicity — ability of an organism to cause disease in a human
Virulence — severity of disease that an organism is able to cause; a highly virulent
pathogens causes disease when present in very small numbers
Acquired Resistance — when a microbe is no longer affected by an anti-infective
Nephrotoxicity — adverse effect on the kidneys
Hepatotoxicity — an adverse effect on the liver
Ototoxicity — an adverse effect on hearing
Superinfection — condition caused when a microorganism grows rapidly as a result
of having less competition in its environment
Common Human Pathogens
o Viruses
o Gram (+) organisms: enterococci,
streptococci and staphylococci
o Gram (-) organisms: E.coli, Bacteroides, Klebsiella, Proteus, Pseudomonas
o Opportunistic
o Community-acquired vs. nosocomial
Common Bacterial Pathogens
o Staphylococci—Common in wounds , URI’s and pneumonia (MRSA—resistant
strain)
o Streptococci—Common infection in URI’s, ear infections & pneumonia
o Enterococci—Common infection in UTI’s & wounds (VRE—resistant strain)
o Escherichia coli—UTI’s; GI infection most commonly related to contaminated
ground beef
o Klebsiella—Causes respiratory tract infections, UTI’s, bloodstream, burn
wound infections
o Pneumococci—Most common cause of pneumonia in children; otitis media
o Proteus—Cause UTI’s and wound infections
o Pseudomonas—Cause respiratory tract infections, UTI’s, wound & burn wound
infections (high resistance to many antibiotics)
Definitions and Standards for Removing Microorganisms (Block and Beale,
11th edition)
Antisepsis Application of an agent to living tissue for the purpose of
presenting infection.
Decontamination Destruction or marked reduction in the number of
activities of microorganisms.
Disinfection Chemical or physical treatment that destroys most
vegetative microbes or viruses, but nut spores, in or on
inanimate
surfaces.
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and usually including viruses with an acceptably low probability of survival. Most demonstrate broad-spectrum antimicrobial activity.nih. Chemical agents present are alcohols. Extensively used in hospitals and other health care settings for a variety of topical and hard-surface applications. Sterilants. phenols. o the amount and nature of organic material present. o the pH.nlm. o the mixture of the population of microorganisms present. o the microbial load. o the time and temperature of exposure. iodine.Sanitization Reduction of microbial load on an level considered acceptable for public health purposes. inanimate surface to a Sterilization A process intended to kill or remove all types of microorganisms. http://www. antiseptics and disinfectants are evaluated by: o intrinsic resistance of the microbe.ncbi. o the hydration and binding of the agent to the surface. Antiseptics and Disinfectants Sterilants.gov/pmc/articles/PMC88911/ Page . and chlorine. Pasteurization A process that kills non-sporulating microorganisms by hot water or steam at 65-100 degrees Centigrade. o the concentration and stability of the disinfectant or sterilant. including spores.

oral rinses and preoperative total body washes. Bacteriocidal or bacteriostatic. iodine compounds. o routine disinfection of the oral cavity as part of a program of oral hygiene.hand scrubs or face washes. o Iodine compounds – like tincture of iodine and povidone iodine have the broadest spectrum compared to all topical anti-infectives. hexachlorophine. chlorhexidine. o For skin cleaning . mercury compounds. Uses: o cleansing of skin and wound surfaces after injury. spores. o Chlorhexidine . alcohol and hydrogen peroxide. o disinfection of inanimate objects. viruses. and yeasts. with action against bacteria.Antiseptics Diverse class of compounds Applied to skin surfaces or mucous membranes for anti-infective effects. o preparation of skin surfaces prior to injections or surgical procedures. o Benzalkonium chloride and hexachlorophine . Page . protozoa. including instruments and furniture surfaces.benzalkonium chloride. fungi.

It is used as a skin disinfectant and rubefacient.thefreedictionary. Potency increases but water solubility decreases with chain length until amyl alcohol (6 carbons) is reached.merckmanuals. which may be useful for wound cleansing through removal of tissue debris. Isopropanol is slightly more potent than ethanol due to its greater depression of surface tension. Do not destroy bacterial spores.com/vet/pharmacology/antiseptics_and_disinfectants/alco hols.html Alcohol is metabolized in the human body by a series of oxidations. Thimerosal (Mersol) is a mercurcontains Hg and has activity against bacteria and yeasts. Specially denatured alcohol is ethanol treated with one or more substances so that its use may be permitted for a specialized purpose. and fluidextracts. http://www. Alcohol is used in the practice of pharmacy for the preparation of spirits. 70% Ethyl alcohol (ethanol) and 50% isopropyl alcohol (isopropanol) are the most widely used. http://www. USP or absolute ethanol contains not less than 99% w/w of C2H5OH.com/Antiseptics Alcohols and related compounds 1° aliphatic alcohols are germicidal. tinctures. o Chlorhexidine should not be instilled into the ear. o Iodine compounds should be used sparingly during pregnancy and lactation due to risk of infant absorption of iodine with alterations in thyroid function. as an antiseptic. o Systemic toxicity from ingestion of iodine or mercury compounds. benzalkonium and hexachlorophine. preservative. with isopropanol as its principal ingredient. eg. http://medical-dictionary. o Skin dryness and irritation for products containing alcohol. Tinctures are hydroalcoholic mixtures. prepared commercially by azeotropic distillation of an ethanol:benzene Page . For preparation of tincture of iodine.merckmanuals. or ointment. The primary medicinal use of alcohol is external. o Interactions o Antiseptics should not be used together with any other topical cream.com/vet/pharmacology/antiseptics_and_disinfectants/alco hols. Prolonged use may result in mercury toxicity. Precautions: o Hypersensitivity reactions for chlorhexidine.o o Hydrogen peroxide acts through the liberation of oxygen gas. Denatured alcohol is ethanol that has been rendered unfit for use in intoxicating beverages by the addition of other substances. solution. Dehydrated Ethanol.html Alcohol is produced by fermentation from grain and carbohydrates or by sulfuric acid—catalyzed hydration of ethylene. Completely denatured alcohol contains added wood alcohol (methanol) and benzene and is unsuitable for internal or external use. or solvent. “Rubbing alcohol” is a mixture of alcohols. mild counter-irritant. Spirits are preparations containing ethanol as the sole solvent.

glutaraldehyde and buffer. Iso-PrOH is prepared commercially by the sulfuric acid—catalyzed hydration of propylene. Carboxide is a commercial sterilant containing 10% EO and 90% carbon dioxide. EO effectively destroys all forms of microorganisms at ambient temperatures. Isopropyl Alcohol. Azeotropic iso-PrOH USP. USP . The alcohol is rapidly bactericidal from 50 to 95%. Thus. Glutaraldehyde Disinfectant Solution. The activated solution contains 2% glutaraldehyde buffered at pH 7. mixed together immediately before use. The explosion hazard is eliminated when the gas is mixed with sufficient concentrations of carbon dioxide. a 5-carbon dialdehyde) is used as a solution for sterilization of equipment and instruments that cannot be autoclaved.5 to 8. Side effects . Aldehydes Formaldehyde Solution. Commercial glutaraldehyde is stabilized in alkaline solution. Exposure to skin and mucous membranes should be avoided. Glutaldehyde (Cidex. hydroxyl. should be stored in tightly closed. The mechanism of the germicidal action of EO probably involves the alkylation of functional groups in nucleic acids and proteins by nucleophilic opening of the oxide ring. MOA: direct nonspecific alkylalion of nucleophilic functional group (amino. with ingestion. light-resistant containers. Formalin readily undergoes oxidation and polymerization. USP or Isopropanol (2-propanol) is considered a substitute for ethanol in most cases but must not be ingested. Iso-PrOH is used primarily as a disinfectant for the skin and for surgical instruments. leading to formic acid and paraformaldehyde. has been used to sterilize temperature-sensitive medical equipment and certain pharmaceuticals that cannot be heat sterilized in an autoclave. The preparation has two components. with efficient removal of water. Ethylene oxide (EO). pure form – carcinogen. is used on gauze pads for sterilization of the skin prior to hypodermic injections and in pharmaceuticals and toiletries as a solvent and preservative. which develops at lower temperatures. and sulfhydryl) in proteins and acids to form carbinol derivatives. HCHO must be stored at temperatures above 15°C to prevent cloudiness. GI distress. EO is a nonselective alkylating agent and as such is extremely toxic and potentially carcinogenic.6. Action not confined to microorganisms. contact dermatitis. causes hardening of the skin. and inhalation of the gas should he prevented by use of an appropriate respiratory mask during handling and sterilizalion procedures. This is used primarily as a chemical reagent or solvent but has been injected for the local relief of pain in carcinomas and neuralgias.mixture. EO forms explosive mixtures in air at concentrations ranging from 3 to 80% by volume. Activity: germicidal action is slow but powerful. USP.irritating to the mucous membranes.colorless aqueous solution containing not <37% w/v of HCHO with MeOH added to retard polymerization. Stabilized glutaraldehyde solutions retain over 80% of the original activity 30 days after Page .

Not used much as an antiseptic except to cauterize infected areas. in general. but many Gram (-) bacteria are resistant. Cresol. and cold temperatures. but still available by prescription. eg. lipids. stings. death may result. Oral ingestion or extensive application to skin can cause systemic toxicity . Hexachlorophene. 5% solution strongly irritating and corrosive to tissues.5). p-Chloro-m-xylenol (PC-MX: Metasep) is a non-irritating antiseptic agent with broad-spectrum antibacterial and antifungal properties. At higher pH (>8. possibly because of an acidic proton on the hemiacetal form. Hexachlorophene is used in concentrations of 2-3% soaps. 5% solution kills anthrax spores in 48 hr. detergent creams. soaps. Liquefied Phenol. decreased by alkaline medium (through ionization). Banned for OTC antiseptic and cosmetic preparations. Incorporated into cutaneous applications for pruritus. whereas the non-stabilized alkaline solution lose about 44% activity after 15 days. Non-buffered solutions are acidic. USP is phenol containing 10% water. bites. p-Chlorophenol is used in combination with camphor in liquid petrolatum as an external antiseptic and anti-irritant. The acidic solutions are stable but had sporocidal activity. increases its antiseptic potency further. Because of this. bactericidal/fungicidal at 1–2% .CNS and cardiovascular effects. infected food and excreta). burns. etc. USP (pHisoHex) is a biphenol possessing greater potency than a monophenol. Phenol (carbolic acid) bacteriostatic at concentrations of 0. infected umbilicus of neonates. The compound has a phenol coefficient of ~4. effective against Gram (+) bacteria. Phenols and derivatives Phenolic compounds denature proteins and are general protoplasmic poisons. and used topically for the treatment of tinea (ringworm) infections such as athlete's foot (tinea pedis and jock itch (tinea cruris). glutaraldehyde polymerizes. This is a convenient way of adding phenol to a variety of pharmaceutical preparations because of ease of measurement and facility of transferring. Used for disinfection of equipment or organic materials that are to be destroyed (eg. marketed at 2% concentration as a shampoo. topical application elicits a prolonged antiseptic effect.1–1% . NF is actually a mixture of three isomeric methylphenols: Page . and shampoos for a variety of antiseptic uses. It is. Bactericidal action enhanced by EDTA and warm temperatures.preparation.5% exert local anesthetic effect. because of its local anesthetic and antibacterial properties to relieve itching and control infections. even in low concentrations. Hexachlorophene is easily adsorbed onto the skin and enters the sebaceous glands. Increased degree of chlorination. lotions. Concentrations >0.

When applied to the tongue it produces a sensation of numbness. with a thyme-like odor. although alcohols and other organic solvents will solubilize it. acidification.4. Obtained from coal tar or petroleum by alkaline extraction into aqueous medium. and fractional distillation. Page . possessing both hactericidal and fungicidal properties. It is formulated into throat lozenges because of its mild anesthetic and antiseptic properties. Phenol coefficient is 14. Possesses surfactant properties and local anesthetic activity. Resorcinol is only a weak antiseptic (phenol coefficient 0. but the local anesthetic property can anesthetize the larynx. USP 4-Hexylresorcinol. Eugenol. NF occurs as colorless crystals. Slightly soluble in water and is useful only as a preservative. Thymol. Cresol is sparingly soluble in water. much less stable in solution. Resorcinol. opening the barriers to penetration for antifungal agents. USP obtained from clove oil. USP.5. Slightly soluble in water but is miscible with alcohol and other organic solvents. The phenol coefficient against S. This property causes the stratum corneum of the skin to slough. but it is used in 1 to 3% solutions and in ointments and pastes in concentrations of 10 to 20% for the treatment of skin conditions such as ringworm. Hexylresorcinol. The mixture is an inexpensive antiseptic and disinfectant possessing a phenol coefficient of 2. Possesses both local anesthetic and antiseptic activity and can used to relieve toothaches. It is only slightly soluble in water. Psoriasis and seborrheic dermatitis. or hexylresorcinol is a white crystalline substance with a faint phenolic. but extremely soluble in alcohols and other organic solvents. eczema.4). The compound (in the concentration present in lozenges) is probably not antiseptic. especially at alkaline pH. Hexylresorcinol is an effective antiseptic. m-Dihydroxybenzene (resorcin) is prepared synthetically. It crystallizes as white needles or as an amorphous powder that is soluble in water and alcohol. It has mild fungicidal properties and is used in alcohol solutions and in dusting powders for the treatment of tinea (ringworm) infections. Drawback to its use as an antiseptic is its unpleasant odor. Also used in mouthwashes because of its antiseptic property and pleasant taste. Chlorocresol. Resorcinol is light sensitive and oxidizes readily. NF or isopropyl m-cresol is extracted from oil of Thymus vulgaris or thyme by partitioning into alkaline aqueous medium followed by acidification. It is also a keratolytic agent.The mixture occurs as a yellow to brownish-yellow liquid that has a characteristic odor of creosote. aureus is 98. The crystals obtained from the mother liquor are large and colorless.

Hydrogen peroxide is finding increased application as a disinfectant in water treatment and food processing facilities and for sterilization of dental and surgical instruments.10. The compound is formulated with 30% water for safe handling. Chloroxylenols are broad-spectrum bactericides with more activity against gram(+) than gram (-) bacteria. contact with organic matter diminishes their activity. http://www. The effervescent action mechanically helps remove pus and cellular debris from wounds and is valuable for cleaning and deodorizing infected tissue but of short duration and is limited to the superficial layer of the applied surface. Page . In its pure powder form it is explosive.html Oxidizing agents (OA) Value as germicidal agents depend on their ability to liberate oxygen in the tissues. and water) is diluted with water (1:4) for skin sterilization and (1:25 to 1:50) for wound cleansing and irrigation of the uterus and vagina. including H2O2. Compounded at 5 and 10% concentrations. They are active in alkaline pH. Pine tar has antimicrobial properties. Vanoxide) is a white granular powder. denature proteins in microorganisms through a direct oxidation reaction. benzoyl peroxide is both keratolytic and keratogenic. The bubbles that form during the liberation of oxygen help to dislodge debris. Oxy. Additionally. the action of the oxidizers is typically transient. Benzoyl peroxide induces proliferation of epithelial cells. alcohol.com/vet/pharmacology/antiseptics_and_disinfectants/phe nols_and_related_compounds. however. Many are inorganic cornpounds. Hydrogen peroxide solution (3%) liberates oxygen when in contact with catalase present on wound surfaces and mucous membranes. Effectiveness of OA is limited by their generally poor penetrability into infected tissues and organic matter. USP. used primarily for antiseptic bandaging of wounds of the hoof and horn. DCMX > active than PCMX. a number of metal peroxides and sodium perborate. leading to sloughing and repair. Streptococci are more susceptible than staphylococci. soap. Parachloro-metaxylenol (PCMX) and dichlorometaxylenol (DCMX) are most commonly used members of this group. PEROXIDES Hydrous Benzoyl Peroxide.merckmanuals. PCMX is also combined with hexachlorophene to enhance its antibacterial spectrum and to prevent contamination by gram-negative organisms. A 5% chloroxylenol solution (in α-terpineol. OA are effective against anaerobic bacteria and can be used in cleansing contaminated wounds. All react in the tissues to generate oxygen and oxygen radicals. Hydrous benzoyl peroxide (Oxy-5. It is used in the treatment of acne.Pine tar is a viscid blackish brown liquid. such as KMnO4. Other OA.

it is more potent but also more irritating than tincture of iodine. Page . They are effective against bacteria. 0. has broad antimicrobial spectrum and lack of harmful decomposition products of hydrogen peroxide with greater lipid solubility and freedom from inactivation by tissue catalase and peroxidase. and carbon-tipped instruments.5–2% hydrogen peroxide with anionic and non-ionic surfactants and stabilizers that possess broad-spectrum antimicrobial activity. and viruses at conc. where they are believed to oxidize proteins and interfere with vital metabolic reactions. Benzoyl peroxide slowly releases oxygen to act as an antiseptic. it can cause skin irritation. which then gradually liberates oxygen. Strong iodine tincture contains 7% iodine and 5% potassium iodide (KI) dissolved in 95% ethanol. but staining property is a disadvantage. However. It is effective against bacteria. Sodium perborate. Strong iodine solution (Lugol's solution) contains 5% iodine and 10% KI in aqueous solution. acts by decomposing into sodium metaborate and hydrogen peroxide. Peracetic acid has been recognized only recently as a useful sterilant and antiseptic.Recently developed accelerated hydrogen peroxide (AHP) formulations are synergistic blends of 0. and fungi. decomposing to water and oxygen with no active chemical residues. and used as a skin disinfectant. including meat and poultry processing plants and dairies. and aluminum.4% sodium iodide (NaI) dissolved in 50% ethanol. Potassium permanganate has broad antimicrobial properties.5%. spores. Elemental iodine is a potent germicide with a wide spectrum of activity and low toxicity to tissues. but concentrations >1:10. They owe their activity to high affinity for protoplasm.003% and is sporicidal at 0. viruses. Iodine solution contains 2% iodine and 2. It is an effective algicide (0.000 tend to irritate tissues. Halogen-containing compounds Iodine and chlorine are used as topical antimicrobial agents. which enhances its antibacterial activity.01%) and virucide (1%) for disinfection. They have become leading disinfectants in human hospitals and dental clinics in recent years. which makes it useful in treating pyoderma in dogs. A disadvantage is the potential to damage soft metals. copper. Easily degraded.001–0. mycobacteria. of 0. It is poorly soluble in water but readily dissolves in ethanol. 50 ppm I2 solution kills bacteria in 1 min and spores in 15 min. It has been accepted worldwide in the food industry.2% solutions applied to compresses are effective at reducing microbial populations in severely contaminated wounds. fungi. AHP formulations are non-irritating to eyes and skin and are biodegradable. Iodine tincture contains 2% iodine and 2. with short contact times. it is used as a nonirritant antiseptic on wounds and abrasions. such as brass. used in antiseptic solutions and in mouthwashes.4% NaI dissolved in aqueous solution. yeasts.25–0. It also has keratolytic and antiseborrheic activity.

The antiseptic action of chloroazodin is long lasting because of its extremely slow reaction with water. Chloroazidin. and keratolytic actions of an anionic detergent. It combines the germicidal properties of HOCI with the emulsifying. viruses. They slowly release iodine as an antimicrobial agent and are widely used as skin disinfectants. in dairies. Iodophor solutions retain good antibacterial activity at pH <4. USP. and milk houses. Calcium hypochlorite is used as a disinfectant. as packing for dental caries.html Chlorine-containing compounds Halazone. viruses. and for lavage and irrigation. Povidone-iodine) are water-soluble combinations of iodine with detergents. and a more diluted form (0. 5% NaOCl decomposes.com/vet/pharmacology/antiseptics_and_disinfectants/oxid izing_agents. Alkaline pH ionizes chlorine and decreases its activity by reducing its penetrability.merckmanuals. Organic chlorides contain chlorine weakly bonded to nitrogen. and spores.5%) can be used for irrigating suppurating wounds. Oxychlorosene (Clorpactin) is a complex of the sodium salt of dodecylbeozenesulfonic acid and hypochiorous acid. more stable. and other carriers. but it dissolves blood clots and delays clotting. They have been used in teat dips to control mastitis. wetting agents that are solubilizers. a 2–5% NaOCl can be used as a disinfectant. The agent has a marked and rapid -cidal action against most microorganisms. N. molds. Used to disinfect water supplies and inanimate objects (eg. which is slowly released for germicidal activity. They are generally less irritant. A glyceryltriacetate solution is used as a wound dressing. The complex slowly releases hypochlorous acid in solution. Inorganic chlorides like NaOCl solutions (bleach). particularly before surgery. Iodophores are nontoxic to tissues but may be corrosive to metals. and as a general antiseptic or disinfectant for various dermal and mucosal infections. creameries. They are effective against bacteria. Oxychiorosene Sodium. and fungi but less so against spores. viruses.N-Dichlorodicarbonamidine (Azochloramid) is used in very dilute solution to disinfect wounds. They do not sting or stain. and fungi by forming undissociated hypochlorous acid (HOCl) in water at acid to neutral pH. Chlorine Potent germicidal effect against most bacteria. protozoa. It is effective against most organisms at a concentration of 0. yeasts. Phosphoric acid is often mixed with iodophores to maintain an acidic medium. and more convenient to use than hypochlorite solutions. p-Dichlorosulfamoylbenzoic acid sodium salt is used to disinfect drinking water. bottles). Page .1 ppm. http://www. even in the presence of organic matter. higher concentrations are required in the presence of organic matter.Iodophores (eg. wetting. including both Gram-positive and Gram-negative bacteria. and often change color when the activity is lost. as dairy sanitizers.

A typical application uses a 0. especially at slightly alkaline pH. soaps. hexachlorophene.1 to 0. antiseptics.000 to 1:5. or potassium iodide. Therefore. Gram-negative bacteria are generally resistant. Dyes Organic dyes were used very extensively as anti-infective agents before the discovery of the sulfonamides and the antibiotics. most soap solutions are alkaline (pH 8–10) and may irritate sensitive skin and mucous membranes. where they become adsorbed and cause changes in permeability. Based on the position of the hydrophobic moiety in the molecule.or aryl-substituted quaternary ammonium compounds (eg. benzathonium chloride. Soaps emulsify lipoidal secretions of the skin and remove. eg. to counteract odorous discharges. The antibacterial potency of soaps is often enhanced by inclusion of certain antiseptics. to act as an irritant. they are of limited value in the presence of blood and tissue debris. fatty acids. A few cationic dyes still find limited use as antinfectives. The difference in susceptibility is probably related to the cellular characteristics that underlie the Gram stain. The dyes form colorless leucobase under alkaline conditions. benzalkonium chloride. Oxychlorosene is marketed as a powder for reconstitution into a solution. cetylpyridinium chloride) with an ionizable halogen. NaOH and KOH are strong bases (whereas most fatty acids are weak acids). carbanilides.2% are used in urology and ophthalmology.000 have good antimicrobial activity. Activity is reduced by porous or fibrous materials that adsorb them.1 to 0. and to disinfect cysts and fistulas.Oxychiorosene is used to treat localized infections (especially when resistant organisms are present).5% concentration in water. As antimicrobials. emulsifiers. some fungi (including yeasts). Cationic dyes are active against Gram-positive bacteria and many fungi. Cationic surfactants Surfactants lower the surface tension of an aqueous solution and are used as wetting agents. They are incompatible with cationic surfactants. which are then rinsed away with the lather. and protozoa but not against viruses and spores. They are effective against most bacteria. Cationic detergents are a group of alkyl. surfactants are classified as anionic or cationic. they alter the energy relationship at interfaces. proteins. These include the triphenylmethane dyes gentian violet and basic fuchsin and the thiazinc dye methylene blue. along with most of the accompanying dirt. detergents. Dilutions of 0. and disinfectants. to remove necrotic tissue from massive infections or radiation necrosis. which dissociate in water into hydrophilic K+ or Na+ ions and lipophilic fatty acid ions. Aqueous solutions of 1:1. phosphates). phenols. Page . desquamated epithelium and bacteria. Major site of action: cell membrane. Anionic Surfactants Soaps are dipolar anionic detergents with the general formula RCOONa/K. inactivated by anionic substances (eg.

Uses: o vaginal suppositories for the treatment of yeast infections. It exists as a green crystalline powder with a metallic appearance. It is a component of carbol— fuchsin solution (Castellani's paint). The compound occurs as a dark green crystalline powder with a metallic appearance that is soluble in water (1:25) and alcohol (1:65). Variously known as hexamethyl-p-rosaniline chloride. o 1 to 3% solution for the treatment of ringworm and yeast infections. The action of methylene blue is considered to be bacteriostatic. The compound colors the urine and stool blue green. END OF LECTURE Page .Gentian Violet. It occurs as a green powder or green flakes with a metallic sheen. Basic Fuchsln.7-bis(dimethylamino)-phenazathionium chloride (Urised). USP is a mixture of the chlorides of rosaniline and p-rosaniline. notably ringworm and athlete's foot. Methylene blue has weak antiseptic properties that make it useful for the treatment of cystitis and urethritis. USP. Methylene Blue. and methylrosaniline chloride. USP. o orally as an anthelmintic for strongyloidiasis (threadworm) o oxyuriasis. which is used topically in the treatment of fungal infections. The compound is soluble in water and in alcohol but insoluble in ether. The compound is soluble in water (1:35) and alcohol (1:10) but insoluble in nonpolar organic solvents. methyl violet. crystal violet. 3.