It has been shown that some drugs considered to be of good quality today can cause an iatrogenic disease known as Nicolau syndrome. Nicolau syndrome is a rare cutaneous drug reaction occurring after injection many drugs. This disease has been found to be caused by the very strong local irritant activity of drug solutions. It turned out that the standard for assessing the quality of drug solutions does not include assessment of their osmotic activity and the strength of their local irritating effect on various tissues during injection. At the same time, drug solutions produced by different pharmaceutical companies may contain, in addition to the main ingredients, other ingredients (hydrochloric acid, sodium hydroxide, propylene glycol, etc.). Very often the additional ingredients increase the osmotic activity of the drug solution, which is not controlled today, so it remains unknown.  This is why drug solutions produced by some pharmaceutical companies can have hypertonic activity, which can sometimes by ignorance reach values that are incompatible with the vital activity of human body tissue cells. Therefore, injections of such drug solutions can have a very strong dehydrating effect on the tissue cells at the injection sites, have a local irritating and cauterizing effect. It has been shown that even steroid solutions in some manufacturers may have excessive hypertonic and acidic activity, which gives them a local irritating effect. This is why in some cases the injection of a steroid solution does not eliminate, but rather increases local inflammation and causes necrosis. Therefore, to exclude postinjection necroses and abscesses, it is proposed to include an assessment of the osmotic activity and local irritant effect of drug solutions in the drug quality control standard and to prohibit the injection of drug solutions with excessive hypertonic activity.

Pyolytics are drugs that dissolve thick pus when applied topically. This group of drugs was discovered in early 21st century in Russia as a result of successful repurposing of antiseptics hydrogen peroxide, sodium bicarbonate and sodium chloride from antiseptics to pyolytics. Prior to this watershed event in pharmacy, the problem of effective treatment of purulent diseases had not been solved. The fact is that before that in the treatment of various purulent diseases mainly antiseptics and disinfectants solutions were used, of which hypertonic sodium chloride solution and 3 - 6% hydrogen peroxide solutions took the leading role as "antipurulent" drugs. However, the use of the known antiseptics and disinfectants solutions provided disinfection of the treated surface, but not dissolution of thick pus masses, as the solutions had no effective pyolytic action. Pyolytic activity, i.e. activity of dissolution of thick pus masses, was fantastically increased in hydrogen peroxide solutions only after the possibility of transformation of "old" drugs into "new" drugs by means of artificial changes in physical and chemical properties of their dosage forms was discovered. The greatest (explosive) effect was achieved by developing warm alkaline hydrogen peroxide solutions enriched with oxygen gas under increased pressure. In chronological order, an overview is given of Russian inventions, which formed the basis for the physicochemical repurposing of hydrogen peroxide solutions into pyolytics as well as the basis of temperature and physicochemical pharmacology and pharmaceutics.

It has been established that warm alkaline solutions of hydrogen peroxide with local interaction with thick pus, mucus, sputum and blood have local pyolytic, mucolytic and hemolytic effects. It was found that the dissolving effect is associated with the alkaline properties of the drug, which are provided by sodium bicarbonate. Sodium bicarbonate provides the process of alkaline saponification of proteins and protein-lipid complexes. It is shown that hydrogen peroxide intensively decomposes into water and oxygen gas under the action of the catalase enzyme. In turn, catalase is always present in blood, mucus, sputum, pus, fibrous and serous fluid. At the same time, the released oxygen forms gas bubbles that literally tear apart biological masses during cold boiling and turn them into fluffy white foam. At the same time, the appearance of oxygen in an alkaline environment ensures the process of discoloration of biological pigments, such as hemoglobin and its color metabolites. The indicated pharmacological effect of a warm alkaline solution of hydrogen peroxide at local interaction is proposed to be used for the treatment of purulent diseases, thrombosis, bruising and hematomas. The technologies of using the drug for urgent restoration of breathing in obstructive purulent bronchitis, for urgent discoloration of the skin and nail plate with bruising and hematoma, as well as for urgent and safe peeling of a bloody bandage from a wound are listed.

Historically, the bulk of known drugs was created for resorptive action. Therefore, the mechanism of action of drugs was attributed to the specific action of the main ingredients once they were absorbed into the bloodstream. In recent years, it has been found that the mechanism of local action of drugs is determined not only by the specific activity of their main ingredients but also by the nonspecific activity of the excipients and formulation ingredients included in the ready-to-use drug: tablet, injectable solution, aerosol, etc. In this regard, there is an opportunity to repurpose drugs by purposefully changing their quality by changing the physical, chemical, and physical-chemical properties of the finished products. As an example, two new groups of drugs intended for local application to dissolve dense pus and discolor blood stains, namely, piolytics and drugs that bleach bruises, have been created. It is shown that the advantage and at the same time the limitation of the upgraded preparations is their local application, as their peculiarity is the realization of the physical-chemical principle of the drug action in local interaction with the selected part of the patient’s organism.

: A review of the literature shows that bruises impair the aesthetic appearance of the skin. At the same time, official medicine has no cure for urgent skin discoloration in the area of bruises. Attention is drawn to the fact that alkaline hydrogen peroxide solutions effectively decolorize blemishes and the traces of blood by local interaction under in vitro and in vivo conditions. It has been shown that the main ingredients of these solutions are water, hydrogen peroxide, and sodium hydrogen carbonate. Some products have been developed for bleaching blood stains and marks on textiles, bandages, skin, nails, and inside the skin in the area of bruises. Here, the leading medical technologies for whitening cosmetic products are reviewed.