Potassium permanganate (medical use)

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]

Potassium permanganate
Clinical data
Trade namesPermitabs,[1] others
Routes of
administration		Topical
ATC code
Identifiers
CAS Number
PubChem CID
ChemSpider
UNII
KEGG
Chemical and physical data
FormulaKMnO4
Molar mass158.032
3D model (JSmol)

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 form 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.

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. Burge, Susan; Wallis, Dinny (2011). Oxford Handbook of Medical Dermatology. OUP Oxford. p. 592. ISBN 9780199558322.
  2. WHO Model Formulary 2008 (PDF). World Health Organization. 2009. pp. 295, 300. ISBN 9789241547659. Archived (PDF) from the original on 13 December 2016. Retrieved 8 January 2017.
  3. British Medical Association; Royal Pharmaceutical Society (2015). British national formulary (69 ed.). p. 840. ISBN 9780857111562.
  4. 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.
  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.
  6. 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.
  7. "WHO Model List of Essential Medicines" (PDF). World Health Organization (19th ed.). April 2015. Archived (PDF) from the original on 13 December 2016. Retrieved 8 December 2016.
  8. "Potassium Permanganate". International Drug Price Indicator Guide. Retrieved 8 December 2016.
  9. "WHO Model Prescribing Information: Drugs Used in Skin Diseases: Antiseptic agents: Potassium permanganate". apps.who.int. Retrieved 12 October 2017.
  10. "CFR - Code of Federal Regulations Title 21". www.accessdata.fda.gov. Retrieved 11 October 2017.
  11. "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. Patnaik, Pradyot (2007). A Comprehensive Guide to the Hazardous Properties of Chemical Substances. John Wiley & Sons. p. 710. ISBN 9780471714583.
  15. Dart, Richard C. (2004). Medical Toxicology. Lippincott Williams & Wilkins. pp. 904–905. ISBN 9780781728454.
  16. "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.
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