Acute respiratory syndrome-2 (SARS-CoV-2): A solution of hydrogen peroxide and sodium bicarbonate as an expectorant for recanalization of the respiratory tract and blood oxygenation in respiratory obstruction (review)

Physical-chemical repurposing of drugs. History of its formation in Russia

It is reported that the traditional scheme of finding and developing a new drug and conducting the whole complex of preclinical studies requires several thousand chemical compounds, hundreds of millions of US dollars and more than 12 years of work. It is shown that physicochemical pharmacology was born in Russia at the end of the 20th century, which in our days has been transformed into physicochemical repurposing of known medicines. The first successfully repurposed known drug was a solution of 4% potassium chloride, which had previously traditionally belonged to the group of macro- and microelements, used by intravenous injections to regulate acid-base balance and rhythmic activity of the heart. In 1983, it was stated that this medicinal solution, when heated to 3942C and applied topically by irrigation of the bleeding surface, could be classified as a vasoconstrictor and hemostatic drug. Hyperthermia was used as a physico-chemical reprofiling factor, which, according to the Arrhenius law, accelerated and intensified, on the one hand, the spastic action of K+ cations on the gaping blood vessels (formation of hyperkalium contracture in the smooth muscles of the vascular wall) and, on the other hand, the blood clotting process in the wound. In subsequent years, the promise of physicochemical repurposing of known drugs was shown on the example of water, hydrogen peroxide, sodium chloride and sodium bicarbonate by purposefully changing their temperature, acid, osmotic activity, as well as the amount and quality of gas content (passing). A chronology of the physicochemical repurposing of known drug solutions and tablets is described and the essence of such new groups of drugs as bleachers of bruises and pyolytics is given. It is shown that both groups of drugs were discovered in Russia and are intended for local use to bleach bruises (blood stains) and dissolve thick mucus, sputum, pus, blood clots, meconium and other dense biological tissues containing the enzyme catalase. It is pointed out that the advantage and at the same time the limitation of the known drugs repurposed according to this scheme is their local application, since their new pharmacological activity is caused mainly by the physical and chemical principle of action, which is manifested by local interaction with the selected area of the patients organism.

Alkaline hydrogen peroxide solutions: expectorant, pyolytic, mucolytic, haemolytic, oxygen-releasing, and decolorizing effects

The local action of hydrogen peroxide solutions on such dense biological masses, such as pus, mucus, sputum, and blood clots, is influenced not only by the concentration of the hydrogen peroxide but also by the alkalinity of the solution and the temperature of the interaction medium. Increasing the solutions temperature from 24C26C to 45C55C and its alkalinity from pH 7.0 to 8.48.5 enhances the pyolytic, mucolytic, hemolytic, bleaching, and oxygen-releasing activity of hydrogen peroxide solutions. Simple heating achieves the desired level of hyperthermia, while the addition of sodium bicarbonate provides the indicated alkalinity. Hyperthermia, according to the laws of physics, reduces the viscosity of biological masses, increasing their fluidity, permeability to the antiseptic solution, miscibility, and solubility in it. Furthermore, hyperthermia accelerates the rate of chemical, physicochemical, and biochemical processes, according to the Arrhenius law. The elevated temperature of interacting media speeds up the alkaline saponification process of proteins and protein-lipid complexes, which constitute the colloidal basis of biological masses. Additionally, hyperthermia intensifies the enzymatic decomposition of hydrogen peroxide into water and oxygen gas, facilitated by the enzyme catalase present in most biological masses. The released molecular oxygen generates gas bubbles that mimic cold boiling, leading to the explosion of biological masses, transforming them into a fluffy white foam. Oxygen in an alkaline environment oxidizes biological pigments, including hemoglobin and its metabolites of different colors, resulting in their discoloration.