Temperature, osmotic and acidic activity of infusion solutions as an integral part of their mechanism of action

Abstract

A review of the literature shows that the physical-chemical properties of infusion solutions can be an integral part of the mechanism of their local action on the routes of administration. This new scientific and practical direction in clinical pharmacology was born at the end of the 20th century in Russia. Initially, it was found that isotonic solutions of glucose, mannitol, and sodium chloride with different temperatures have different local effects on the metabolism and viability of isolated biological objects such as mitochondria and blood plasma. At the same time, it was shown that increasing the temperature of solutions from +37 to +45C accelerates the metabolism of these biological objects, increases their reactivity and enhances their response to the action of many drugs-activators of metabolism and function. And vice versa, lowering the temperature of these solutions from +37 to +20C and below (up to 0C) slows down their metabolism, reduces their reactivity, weakens their response to the action of drugs-activators of metabolism and function, and also increases survival in conditions of ischemia and hypoxia. These results allowed us to recommend warm infusion solutions as universal means of activating aerobic metabolism in tissues and the response of tissues to drugs with local physical-chemical action, and cold infusion solutions as universal means of inhibiting aerobic metabolism in tissues and increasing the resistance of tissues to the action of drugs on them. Following this, it was shown that many infusion solutions do not have isoosmotic activity, since the osmotic activity of drugs is not controlled. Therefore, one part of the solutions has hypotonic activity, and the other part has hypertonic activity. Therefore, sometimes the infusion solution can increase the hypoosmotic or hyperosmotic activity of the blood plasma. Then it was shown that the absolute majority of infusion solutions do not have a pH of 7.4. At the same time, very many infusion solutions have acidic activity, so they have an acidifying effect on the blood. The chronology of the development of inventions based on the achievements of the physical-chemical pharmacology of infusion agents is shown.

Osmotic Activity of Drugs is an Important Factor of Their Local Action at the Injection Site: What We Don't Use to Prevent Post-Injection Abscesses

“…It has been established that many drugs in the dosage form "Solution for injection" do not have an isoosmotic activity in the range of 280 -300 mosmol/l of water and with physiological alkaline activity in the range of pH 7.4. Moreover, some of the solutions for injection, which are considered high-quality today, have very much hypotonic or hypertonic and/or hyperacidic activity [2]. In addition, it was shown that an isotonic solution of 0.9% sodium chloride for injection can have different osmotic activity in different series and from different manufacturers [3,4].…”