Monograph: |
Glutaraldehyde.
Adverse Effects
As for Formaldehyde Solution.
Effects on the gastrointestinal tract.
Insufficient rinsing of a glutaral 2% solution from flexible endoscopes after disinfection appears to be responsible for outbreaks of glutaral-induced colitis in patients undergoing colonoscopy and sigmoidoscopy. Symptoms may occur within minutes or up to 48 hours after endoscopy and are usually abdominal pain, mucous diarrhoea, and rectal bleeding. Fever, nausea, vomiting and leucocytosis have also been reported. A case of glutaral-induced colitis has also been attributed to inadequate flushing and drying of the endoscope channels.
Occupational exposure.
Reviews, of the occupational hazards of glutaral have noted that several studies showed adverse effects, including nausea, headache, airway obstruction, asthma, rhinitis, eye irritation, and dermatitis, occurring among medical personnel exposed to glutaral, generally at concentrations below the recommended limits. Skin reactions were due to hypersensitivity or a direct irritant effect. It was concluded that, when using glutaral, workers should take suitable precautions to protect the skin and eyes and should avoid inhaling the vapour. Appropriate procedures should also be followed for disposal and clean-up of spills.
The risk of occupational exposure to glutaral vapour may be higher in warm climates.
There has also been a report of accidental ocular contact with glutaral due to leakage of glutaral solution retained in an anaesthesia mask; moderate chemical conjunctivitis ensued.
Uses and Administration
Glutaral is a bactericidal disinfectant that is rapidly effective against Gram-positive and Gram-negative bacteria. It is also effective against Mycobacterium tuberculosis, some fungi, and viruses, including hepatitis B virus and HIV, and is slowly effective against bacterial spores. Aqueous solutions show optimum activity between pH 7.5 and 8.5; such solutions are chemically stable for about 14 days. Solutions at lower pH values are more stable.
A 2% aqueous solution buffered to a pH of about 8 (activated glutaral; alkaline glutaral) may be used for the sterilisation of endoscopic and dental instruments, rubber or plastic equipment, and for other equipment which cannot be sterilised by heat. Glutaral is non-corrosive towards most materials. Complete immersion in the solution for 10 to 20 minutes is sufficient for rapid disinfection of thoroughly cleansed instruments but exposure for up to 10 hours may be necessary for sterilisation. For further details, see Disinfection of Endoscopes, and Disinfection in Hepatitis and HIV Infection.
A 10% solution is applied twice daily for the treatment of warts; a 5% solution and a 10% gel have also been used. Glutaral should not be used for facial or anogenital warts. Glutaral has also been used topically for treating hyperhidrosis of the palms and soles, although other agents are generally preferred.
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