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Potassium permanganate (medical use)

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Potassium permanganate
Clinical data
Trade namesPermitabs,[1] others
Routes of
administration
Topical
ATC code
Identifiers
  • Potassium manganate(VII)
CAS Number
PubChem CID
ChemSpider
UNII
KEGG
Chemical and physical data
FormulaKMnO4
Molar mass158.032
3D model (JSmol)
  • [O-][Mn](=O)(=O)=O.[K+]
  • InChI=1S/K.Mn.4O/q+1;;;;;-1
  • Key:VZJVWSHVAAUDKD-UHFFFAOYSA-N

Potassium permanganate is used as a medication for a number of skin conditions.[2] This includes fungal infections of the foot, impetigo, pemphigus, superficial wounds, dermatitis, and tropical ulcers.[3][2] For tropical ulcers it is used together with procaine benzylpenicillin.[2] Typically it is used in skin conditions that produce a lot of liquid.[3] It can be applied as a soaked dressing or a bath.[2]

Side effects may include irritation of the skin and discoloration of clothing.[2] If it is taken by mouth, toxicity and death may occur.[4] Potassium permanganate is an oxidizing agent.[5] The British National Formulary recommends that each 100 mg be dissolved in a liter of water before use.[3]

Potassium permanganate was first made in the 1600s and came into common medical use at least as early as the 1800s.[6] It is on the World Health Organization's List of Essential Medicines, the most effective and safe medicines needed in a health system.[7] The wholesale cost in the developing world is about 0.01 USD per g.[8] In the United Kingdom this amount costs the NHS about £1.33.[3]

Medical uses

Uses include for fungal infections of the foot, impetigo, pemphigus, superficial wounds, dermatitis (eczema), and tropical ulcers.[3][2] Typically it is used in skin conditions that produce a lot of liquid.[3] For tropical ulcers it is used together with procaine benzylpenicillin for two to four weeks.[2][9]

It can be used in children and adults.[9] It can be applied as a soaked dressing or a bath.[2] Petroleum jelly may be used on the nails before soaking to prevent their discoloration.[1] The U.S. Food and Drug Administration does not recommend its use in either the crystal or tablet form.[10]

Side effects

Topical

Side effects may include irritation of the skin and discoloration of clothing.[2] A harsh burn on a child from an undissolved tablet has been reported.[11] For treating eczema, it is recommended using for a few days at a time due to the possibility of it irritating the skin.[11] Higher concentration solutions can result in chemical burns.[12] Therefore, the British National Formulary recommends 100 mg be dissolved in a liter of water before use to for a 1:10,000 (0.01%) solution.[3][11] Wrapping the dressings soaked with potassium permanganate is not recommended.[9]

By mouth

If taken by mouth it is deemed to be very toxic.[13] Side effects may include nausea, vomiting, and shortness of breath may occur.[14] If a sufficiently large amount (about 10 grams) is eaten death may occur.[4][14]

Concentrated solutions when drunk have resulted in adult respiratory distress syndrome or swelling of the airway.[15] Recommended measures for those who have ingested potassium permanganate include gastroscopy.[15] Activated charcoal or medications to cause vomiting are not recommended.[15] While medications like ranitidine and N-acetylcysteine may be used in toxicity, evidence for this use is poor.[15]

Mechanism of action

Potassium permanganate functions as an oxidising agent.[16] Through this mechanism it results in disinfection, astringent effects, and decreased smell.[16]

History

Potassium permanganate was first made in the 1600s and came into common medical use at least as early as the 1800s.[6] During World War I Canadian soldiers were given potassium permanganate in an effort to prevent sexually transmitted infections.[17] Some have attempted to bring about an abortion by putting it in the vagina, though this is not effective.[18][19][20] Other historical uses have included as an effort to wash out the stomach in those with strychnine or picrotoxin poisoning.[21]

Society and culture

In the United States the FDA requires tablets of the medication to be sold by prescription.[10] Potassium permanganate, however, does not have FDA approved uses and therefore non medical grade potassium permanganate is sometimes used for medical use.[citation needed]

It is available under a number of brand names including Permasol, Koi Med Tricho-Ex, and Kalii permanganas RFF.[22] It is occasionally called "Condy's crystals".[16]

Other animals

Potassium permanganate may be used to prevent the spread of glanders among horses.[23]

References

  1. ^ a b Burge, Susan; Wallis, Dinny (2011). Oxford Handbook of Medical Dermatology. OUP Oxford. p. 592. ISBN 9780199558322.
  2. ^ a b c d e f g h i WHO Model Formulary 2008 (PDF). World Health Organization. 2009. pp. 295, 300. ISBN 9789241547659. Archived from the original (PDF) on 13 December 2016. Retrieved 8 January 2017. {{cite book}}: Unknown parameter |deadurl= ignored (|url-status= suggested) (help)
  3. ^ a b c d e f g British Medical Association; Royal Pharmaceutical Society (2015). British national formulary (69 ed.). p. 840. ISBN 9780857111562.
  4. ^ a b Shai, Avi; Maibach, Howard I. (2005). Wound Healing and Ulcers of the Skin: Diagnosis and Therapy - The Practical Approach. Springer Science & Business Media. p. 265. ISBN 9783540267614. Archived from the original on 2017-09-18. {{cite book}}: Unknown parameter |deadurl= ignored (|url-status= suggested) (help)
  5. ^ Kasture, A. V.; Wadodkar, S. G.; Gokhale, S. B. (2008). Practical Pharmaceutical Chemistry - I. Nirali Prakashan. ISBN 9788185790442. Archived from the original on 2017-01-16. {{cite book}}: Unknown parameter |deadurl= ignored (|url-status= suggested) (help)
  6. ^ a b Stout, Meg (2013). The Complete Idiot's Guide to Aquaponic Gardening. Penguin. p. Chapter 16. ISBN 9781615643332. Archived from the original on 2017-01-16. {{cite book}}: Unknown parameter |deadurl= ignored (|url-status= suggested) (help)
  7. ^ "WHO Model List of Essential Medicines" (PDF). World Health Organization (19th ed.). April 2015. Archived from the original (PDF) on 13 December 2016. Retrieved 8 December 2016. {{cite web}}: Unknown parameter |deadurl= ignored (|url-status= suggested) (help)
  8. ^ "Potassium Permanganate". International Drug Price Indicator Guide. Retrieved 8 December 2016.
  9. ^ a b c "WHO Model Prescribing Information: Drugs Used in Skin Diseases: Antiseptic agents: Potassium permanganate". apps.who.int. Retrieved 12 October 2017.
  10. ^ a b "CFR - Code of Federal Regulations Title 21". www.accessdata.fda.gov. Retrieved 11 October 2017.
  11. ^ a b c "Should potassium permanganate be used in wound care?". Nursing Times. 5 August 2003. Retrieved 12 October 2017.
  12. ^ Olson, Kent R. (2011). Poisoning and Drug Overdose, Sixth Edition. McGraw Hill Professional. p. 121. ISBN 9780071716765.
  13. ^ Schachner, Lawrence A.; Hansen, Ronald C. (2011). Pediatric Dermatology E-Book. Elsevier Health Sciences. p. 131. ISBN 0723436657.
  14. ^ a b Patnaik, Pradyot (2007). A Comprehensive Guide to the Hazardous Properties of Chemical Substances. John Wiley & Sons. p. 710. ISBN 9780471714583.
  15. ^ a b c d Dart, Richard C. (2004). Medical Toxicology. Lippincott Williams & Wilkins. pp. 904–905. ISBN 9780781728454.
  16. ^ a b c "Potassium permanganate | DermNet New Zealand". www.dermnetnz.org. Retrieved 11 October 2017.
  17. ^ González-Crussi, F. (2008). A Short History of Medicine. Random House Publishing Group. p. 111. ISBN 9781588368218.
  18. ^ Solinger, Rickie (2005). Pregnancy and Power: A Short History of Reproductive Politics in America. NYU Press. p. 120. ISBN 9780814741191.
  19. ^ Code of Federal Regulations: Record 2: 2007-. U.S. General Services Administration, National Archives and Records Service, Office of the Federal Register. 2008. p. 178.
  20. ^ "CFR - Code of Federal Regulations Title 21". www.accessdata.fda.gov. Retrieved 11 October 2017.
  21. ^ "Potassium permanganate definition | Drugs.com". Drugs.com. Retrieved 11 October 2017.
  22. ^ "Potassium Permanganate - Drugs.com". Drugs.com. Retrieved 11 October 2017.
  23. ^ Scott, Danny W.; Miller, William H. (2010). Equine Dermatology - E-Book. Elsevier Health Sciences. p. 168. ISBN 1437709214.