BENZALKONIUM CHLORIDE

BENZALKONIUM CHLORIDE
(benz-al-koe'nee-um)
Benza, Benzalchlor-50, Germicin, Pharmatex , Sabol, Zephiran
Classifications: topical antibiotic;
Therapeutic: antibiotic

Pregnancy Category: C

Availability

17% concentrate, 1:750 solution, 1:750 tincture/tincture spray

Action

Bactericidal or bacteriostatic action (depending on concentration), probably due to inactivation of bacterial enzyme.

Therapeutic Effect

Effective against bacteria, some fungi (including yeasts) and certain protozoa. Generally not effective against spore-forming organisms.

Uses

Antisepsis of intact skin, mucous membranes, superficial injuries, and infected wounds; also for irrigations of the eye and body cavities and for vaginal douching. A component of several contact lens wetting and cushioning solutions, and a preservative for ophthalmic solutions.

Contraindications

Casts, occlusive dressings, anal or vaginal packs, pregnancy (category C), lactation.

Cautious Use

Irrigation of body cavities.

Route & Dosage

Minor Wounds or Preoperative Disinfection
Adult: Topical 1:750 tincture or spray

Preoperative Disinfection of Denuded Skin and Mucous Membranes
Adult: Topical 1:10,000–1:2000 solution

Wet Dressings
Adult: Topical 1:5000 solution

Urinary Bladder Irrigation
Adult: Topical 1:20,000–1:5000 solution

Urinary Bladder Instillation
Adult: Topical 1:40,000–1:20,000 solution

Irrigation of Deep Infected Wounds
Adult: Topical 1:20,000–1:3000 solution

Vaginal Irrigation
Adult: Topical 1:5000–1:2000 solution

Sterile Storage of Instruments, Thermometers, Ampules
Adult: Topical 1:750 solution

Administration

Topical
  • Use sterile water for injection as diluent for aqueous solutions to be instilled in wounds or body cavities. For other uses, fresh sterile distilled water is used.
  • Do not use tap water (especially hard water) because it may reduce antibacterial potency of benzalkonium chloride.
  • Irrigate eyes immediately and repeatedly with water if medication solution stronger than 1:5000 enters eyes; see a physician promptly.
  • Rinse first with water, then with 70% alcohol, before applying benzalkonium for preoperative skin preparation. Avoid pooling or prolonged contact of solution with skin.
  • Note: Detergent action is antagonized by pus and other organic matter, and by soap substitutes. If these agents have been used, rinse skin thoroughly with water, dry, and then apply benzalkonium.
  • Consult physician about proper dilution of solutions used on denuded skin or inflamed or irritated tissues.
  • Store at room temperature, preferably between 15°–30° C (59°–86° F) in airtight container, protected from light.

Adverse Effects (≥1%)

Body as a Whole: Few or no toxic effects in recommended dilutions. Skin: Erythema, local burning, hypersensitivity reactions.

Pharmacokinetics

Not studied.

Nursing Implications

Assessment & Drug Effects

  • Monitor wounds carefully. Report increasing signs of infection or lack of healing.

Common adverse effects in italic, life-threatening effects underlined; generic names in bold; classifications in SMALL CAPS; Canadian drug name; Prototype drug

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