Submitted To

Dr. Rukhsana
Submitted By
Hafiza Sidra Yaseen
Subject
Metabolic Disorders
Department
Pharmacy
Introduction

Oxidizing Agents

An oxidizing agent/oxidizer or oxidant is a substance that oxidizes other substances by gaining

or accepting electrons.

Examples of common oxidizing agents include:

o Oxygen (O2)
o Ozone (O3)

o Hydrogen peroxide (H2O2) and other inorganic peroxides

o Fluorine (F2), chlorine (Cl2), and other halogens

o Nitrate compounds such as potassium nitrate (KNO3) and Nitric acid (HNO3)
o Potassium chlorate (KClO3)
o Peroxydisulfuric acid (H2S2O8) and Peroxymonosulfuric acid (H2SO5) (Finnegan et al., 2010)

Oxidizing Agents As Local Anti-Infective Agents

1. Hydrogen Peroxide As Local Anti-infective Agent
Hydrogen peroxide solution (3%) reacts with the catalase present on wound surfaces and
mucous membranes to release oxygen. The effervescent action mechanically helps remove pus
and cellular debris from wounds and is useful to clean and deodorize infected tissue. The
antimicrobial action is of short duration and is limited to the superficial layer of the applied
surface because hydrogen peroxide does not penetrate the tissue (Finnegan et al., 2010;
Hallmon & Rees, 2003).

 Detrimental Effects

Hydrogen peroxide can also exert a direct cytotoxic effect via lipid peroxidation. Ingestion of
hydrogen peroxide may cause irritation of the gastrointestinal tract with nausea, vomiting,
hematemesis and foaming at the mouth; the foam may obstruct the respiratory tract or result in
pulmonary aspiration (Travagli, Zanardi, & Bocci, 2009).

 Physiological Uses

 Wound Cleaning: Hydrogen peroxide is commonly used to clean and disinfect wounds.
 When applied to a wound, it releases oxygen, which helps to kill bacteria and remove
debris from the wound site, promoting healing.

 Mouthwash: Hydrogen peroxide is used in some mouthwashes and oral rinses to help kill
bacteria and reduce plaque buildup. It can also be used as a gargle to help relieve minor
throat irritation.

 Whitening Teeth: Some toothpaste and teeth-whitening products contain hydrogen

peroxide as an active ingredient. It helps to bleach the teeth by breaking down stains and
discoloration.

 Ear Cleaning: Hydrogen peroxide can be used to soften and remove earwax buildup in
the ear canal. It bubbles when it encounters earwax, helping to dislodge it from the ear
canal.

 Acne Treatment: Hydrogen peroxide can be used topically to treat acne. It has
antibacterial properties that can help to kill the bacteria responsible for acne breakouts.

 Sinus Rinse: In some cases, hydrogen peroxide is used as a nasal rinse to help clear nasal
passages and sinuses. It can help to break down mucus and reduce inflammation.

 Foot Soak: Hydrogen peroxide can be used as a foot soak to help treat fungal infections
such as athlete's foot. It can help to kill the fungus and prevent further infection.

 Disinfectant: Hydrogen peroxide can be used as a household disinfectant to clean

surfaces and kill bacteria, viruses, and other pathogens (Hanes & Purvis, 2003).

2. Ozone As Local Anti-Infective Agent

 Mode of Action

 Disruption of Cell Membranes

Ozone can penetrate the cell membranes of microorganisms, including bacteria and viruses.
Once inside the cell, ozone reacts with various cellular components, such as lipids and proteins,
leading to damage to the cell membrane. This disruption can cause leakage of cellular contents
and ultimately cell death.

 Inactivation of Enzymes
Ozone can oxidize and inactivate key enzymes necessary for the metabolic processes of
microorganisms. By disrupting enzymatic activity, ozone can impair the ability of
microorganisms to carry out essential functions, leading to their inactivation (Travagli et al.,
2009).

 Oxidative Stress: Ozone exposure can induce oxidative stress in microorganisms by

generating reactive oxygen species (ROS) such as singlet oxygen and hydroxyl
radicals. These ROS can damage DNA, proteins, and lipids within the
microorganism, leading to cell death.

 Induction of Apoptosis: In some cases, ozone exposure can trigger apoptosis

(programmed cell death) in microorganisms. This process may involve the activation
of specific signaling pathways within the microbial cell, ultimately leading to its
demise.
 Enhanced Immune Response: Ozone therapy has been shown to stimulate the
immune system, leading to increased production of immune cells and enhanced
immune function. This can help the body in combating infections by bolstering its
natural defense mechanisms (Travagli, Zanardi, Valacchi, & Bocci, 2010).

 Detrimental Effects

 Respiratory Irritation: Ozone inhalation can cause coughing, throat irritation, and
 exacerbate conditions like asthma.

 Lung Damage: Prolonged exposure to ozone can harm lung cells, leading to
inflammation and impaired lung function.

 Eye and Skin Irritation: Ozone exposure can irritate the eyes and skin, causing
redness and itching.

 Oxidative Stress: Excessive ozone exposure can lead to oxidative stress, damaging
DNA, proteins, and lipids, potentially contributing to various health issues.

 Increased Air Pollution: Ozone is a component of smog and ground- level ozone
contributes to poor air quality, posing health risks.

 Potential for Toxic Byproducts: Ozone can react with other compounds to form
toxic byproducts, further worsening air quality and health risks (Travagli et al., 2009).
  Physiological Uses

o It is used as a germicide, disinfectant, and water sterilizer.

o It is also used to bleach oils, ivory, flour, starch, and other materials.
o In the production of potassium permanganate, it acts as an oxidizing agent.
o Ozone is used in water treatment plants that do not have filtration systems.
o Commonly used equipment, such as photocopiers, laser printers, and other electrical
devices, can also produce ozone.
o By minimizing the impacts of bacteria, viruses, fungi, yeast, and protozoa, ozone
treatment is used in medicine to disinfect and treat disorders.
o Several ozone-depleting compounds have refrigerant properties, which means they
can efficiently transfer heat from one location to another (Travagli et al., 2010).

3. Oxygen As Local Anti-Infective Agent

 Mode of Action
Oxygen can serve as a local anti-infective agent, particularly in wound healing contexts.
Hyperbaric oxygen therapy (HBOT) increases oxygen levels in the bloodstream, combating
bacteria and promoting tissue repair. Topical oxygen therapy delivers oxygen directly to infected
wounds, inhibiting bacterial growth and aiding healing. Oxygen releasing compounds and
photodynamic therapy (PDT) are also used to kill bacteria and treat infections. Combining oxygen
therapy with antibiotics enhances antibiotic efficacy, potentially reducing antibiotic resistance.
Overall, oxygen-based therapies offer promising approaches for local infection treatment, though
further research is needed for optimization and clinical use (A Babizhayev, I Deyev, & E
Yegorov, 2014).

 Detrimental Effects

 Oxygen Toxicity: Prolonged exposure to high oxygen levels can lead to oxidative stress
and tissue damage.

 Delayed Wound Healing: Excessive oxygen can impede wound healing by reducing
blood flow to the wound site.

 Risk of Fire: Oxygen-rich environments pose a fire hazard, particularly in hyperbaric

 chambers.

 Infection Risk: Improperly cleaned equipment used in oxygen therapy can introduce
infection.

 Cost and Accessibility: Some oxygen therapies are expensive and may not be readily
available to all patients.

 Potential Side Effects of PDT: Photodynamic therapy can cause skin sensitivity and
other side effects (Çimşit, Uzun, & Yıldız, 2009).

 Physiological Uses
 Cellular Respiration: Oxygen is crucial for ATP production during cellular
respiration.

 Energy Production: It is needed for generating energy required for muscle

contraction, nerve transmission, and protein synthesis.

 Metabolism: Oxygen aids in the breakdown of nutrients and elimination of metabolic

waste products.

 Immune Function: It supports immune cell activities and tissue repair processes.

 Brain and Heart Function: Oxygen is vital for maintaining cognitive function and
proper cardiac function.
  pH Balance: Oxygen helps regulate the acid-base balance in bodily fluids (A
Babizhayev et al., 2014).

4. Fluorine, Chlorine (Halogens) As Local Anti-Infective Agents

 Mode of Action

 Disruption of Cell Structures: They damage microbial cell membranes and proteins,
leading to cell death.

 Oxidative Damage: They generate reactive oxygen species, causing cellular damage
and impairing microbial function.

 DNA Damage: Some halogens, like iodine, can interfere with microbial DNA,
inhibiting replication and transcription.
 Disinfection by Chlorination: Chlorine compounds react with water to form
disinfectants that kill microorganisms.

 Fluoride in Dental Health: Fluoride strengthens tooth enamel and inhibits bacterial
growth, reducing the risk of dental decay (Mahapatra, Bharti, & Asati, 2015).

 Detrimental Effects

 Toxicity: Excessive exposure to halogens can cause respiratory, skin, and

gastrointestinal irritation, and even systemic toxicity.

 Skin and Respiratory Irritation: Direct contact or inhalation of halogens can lead to
skin irritation, dermatitis, coughing, and lung inflammation.

 Resistance Development: Prolonged use may lead to microbial resistance, reducing

effectiveness over time.

 Microbial Balance Disruption: Halogen-based disinfectants may disrupt natural

microbial balance, potentially promoting the growth of resistant pathogens (Lesic et
al., 2007).

 Physiological Uses
  Disinfectants: Chlorine and iodine compounds are commonly used as disinfectants to
kill or inhibit the growth of microorganisms on surfaces, in water, and in medical
settings. Chlorine-based compounds like sodium hypochlorite (bleach) are effective
against a broad spectrum of bacteria, viruses, and fungi. Iodine-based disinfectants,
such as povidone-iodine, are used for skin antisepsis and wound treatment.

 Antiseptics: Iodine and chlorine compounds are also used as antiseptics to disinfect
skin and mucous membranes, particularly in surgical and medical procedures. These
antiseptics can prevent infections by reducing the microbial load on the skin and
mucous membranes (Mendling, Weissenbacher, Gerber, Prasauskas, & Grob, 2016).

 Water Purification: Chlorine compounds are widely used to disinfect drinking water
and swimming pools, effectively killing harmful bacteria and pathogens present in
water sources. This helps prevent waterborne diseases and infections.

 Topical Treatments: Iodine-based solutions and creams are used for topical treatment
of wounds, burns, and skin infections. These preparations have broad-spectrum
antimicrobial activity and can prevent or treat bacterial and fungal infections.

 Fluoride for Dental Health: Fluoride is commonly used in dental products such as
toothpaste and mouthwash to prevent dental caries (cavities). Fluoride strengthens
tooth enamel and inhibits the growth of bacteria that cause tooth decay.

 Antiviral Applications: Fluorine compounds have been investigated for their potential
antiviral properties, particularly in the development of pharmaceuticals for treating viral
infections such as influenza and HIV (Lesic et al., 2007).

5. Nitric Acid As Local Anti- Infective Agent

 Mode of Action
  Antimicrobial Activity: It kills or inhibits a broad range of microbes by disrupting
cell membranes and metabolic processes.

 Wound Healing Promotion: Nitric acid stimulates cell growth and angiogenesis,
facilitating tissue repair.

 Anti-inflammatory Effects: It reduces

 inflammation, alleviating pain and swelling associated with infections.

 Synergy with Antibiotics: Nitric acid enhances the effectiveness of antibiotics and
combats microbial resistance.
 Biofilm Disruption: It penetrates and destabilizes microbial biofilms, improving
antimicrobial efficacy (Ghaffari, Miller, McMullin, & Ghahary, 2006).

 Detrimental Effects

 Tissue Irritation: Concentrated nitric acid can cause severe irritation, burning, and
tissue damage upon contact with the skin, mucous membranes, or wounds.

 Safety Risks: Handling and application of nitric acid require strict safety precautions,
including proper ventilation, personal protective equipment (PPE), and adherence to
handling protocols to prevent accidental exposure and injury.

 Systemic Toxicity: Absorption of nitric acid through the skin or mucous membranes
can lead to systemic toxicity, including nausea, vomiting, respiratory distress, and
systemic acidosis.

 Potential Allergic Reactions: Some individuals may develop allergic or

hypersensitivity reactions to nitric acid, leading to skin rashes, respiratory symptoms, or
anaphylaxis.

 Risk of Overuse: Excessive or inappropriate use of nitric acid may disrupt the normal
healing process, delay wound closure, or contribute to the development of microbial
 resistance (M Halpenny & K Mascharak, 2010).

 Physiological Uses

 Antimicrobial Activity: Nitric acid exhibits broad-spectrum antimicrobial properties,

effectively targeting bacteria, viruses, fungi, and parasites. It can disrupt microbial
cell membranes, interfere with essential enzymes, and inhibit microbial metabolism,
ultimately leading to microbial death.

 Wound Healing Promotion: Nitric acid promotes wound healing by stimulating the
proliferation and migration of skin cells, such as fibroblasts and keratinocytes. It also
enhances angiogenesis, the formation of new blood vessels, and improves tissue
oxygenation, facilitating the repair of damaged tissue (M Halpenny & K Mascharak,
2010).

 Anti-inflammatory Effects: Nitric acid modulates the inflammatory response by

regulating the production of pro- inflammatory cytokines and reducing inflammation
at the wound site. This anti-inflammatory activity helps alleviate pain, swelling, and
tissue damage associated with infections, promoting a conducive environment for
wound healing.

 Synergistic Effects with Antibiotics: Nitric acid may enhance the efficacy of
antibiotics and other antimicrobial agents when used in combination. It can overcome
antibiotic resistance mechanisms in bacteria and potentiate the antimicrobial effects
of conventional treatments.

 Biofilm Disruption: Nitric acid has the ability to disrupt microbial biofilms, which
are complex communities of microorganisms encased in a protective matrix. Biofilms
can contribute to chronic wound infections and are often resistant to conventional
antimicrobial therapies. Nitric acid can penetrate biofilms, destabilize their structure,
and enhance the effectiveness of antimicrobial treatment (Schairer, Chouake,
Nosanchuk, & Friedman, 2012).
6. Potassium chlorate As Local Anti- Infective Agent

 Mode of Action

Potassium chlorate does indeed possess oxidizing properties, which means it can donate oxygen to
other substances. This property has led to various industrial and practical applications, but it also
contributes to its potential use as an anti-infective agent. The oxidizing action of potassium
chlorate can disrupt microbial cell structures and metabolic processes by introducing oxygen,
which can interfere with the functioning of essential cellular components in microorganisms. In
theory, this oxidative stress could lead to the death or inhibition of bacteria, fungi, and other
pathogens. However, while potassium chlorate's oxidizing action may have some antimicrobial
effect, it is not commonly used for this purpose due to safety concerns. Direct application of
potassium chlorate to wounds or infections can cause significant tissue damage and toxicity,
outweighing any potential antimicrobial benefits (Griffith, Udekwu, Gkotzis, Mah, & Alarcon,
2015).

 Detrimental Effects

 Toxicity: Potassium chlorate is toxic and can cause acute poisoning if ingested in
sufficient quantities. Symptoms of potassium chlorate poisoning may include nausea,
vomiting, abdominal pain, diarrhea, dizziness, headache, methemoglobinemia (a
 condition where the blood contains an abnormal amount of methemoglobin, reducing
its oxygen- carrying capacity), and in severe cases, renal failure, cardiovascular
collapse, and death (Turner).

 Irritation and Burns: Direct contact with potassium chlorate can cause irritation and
burns to the skin, eyes, and mucous membranes. This compound is highly corrosive
and can cause chemical burns upon contact.

 Respiratory Effects: Inhaling potassium chlorate dust or fumes can irritate the
respiratory tract and cause coughing, shortness of breath, chest pain, and respiratory
distress. Prolonged exposure to high levels of potassium chlorate dust or fumes can
lead to respiratory irritation, bronchitis, and pulmonary edema (fluid buildup in the
lungs).

 Carcinogenicity: There is limited evidence suggesting that potassium chlorate may

have carcinogenic potential. Long-term exposure to high levels of potassium chlorate
has been associated with an increased risk of cancer, particularly bladder cancer
(Griffith et al., 2015).

 Physiological Uses

Potassium chlorate does not have physiological uses in the human body. In fact, due to its
toxicity, it is not intended for ingestion or any other form of direct exposure to humans.
Potassium chlorate is primarily used in industrial processes, such as in the manufacture of
fireworks, explosives, matches, and disinfectants. It is also used in some laboratory experiments
and processes. However, it is crucial to handle potassium chlorate with care and adhere to safety
protocols due to its potential health hazards (Turner).
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