Recently, Ms. Ni suffered from a cold, coughing, coughing and bleeding, and went to the hospital to open antibiotics. Half an hour after taking the medicine home, Ms. Ni began to have an adverse reaction, her body itching, redness, rash, redness and swelling of the head such as "pig head", accompanied by nausea and difficulty breathing. Later, I went to the doctor and diagnosed the adverse drug reaction and stopped the drug immediately.
"It is a three-point drug, and the adverse reactions of drugs can not be completely avoided." Li Guofeng, chief pharmacist of the Pharmacy Department of Nanfang Medical University, said in an interview that the incidence of adverse drug reactions in clinical practice is increasing. The number of cases reported by adverse reactions has increased year by year. Southern Hospital reported more than 200 cases of adverse drug reactions in 2010, the most common of which is the adverse reactions of antibiotics.
Li Guofeng believes that the existence of doctors' rushing time, lack of medical treatment, and random use of drugs by patients can be associated with a high rate of adverse drug reactions. However, even if the doctor is reasonable and standardizes the medication, the adverse reaction rate after the patient takes the medicine still exists. Therefore, the patient must read the instructions in detail before taking the medicine to master certain pharmacological knowledge.
Medical Guidance/Li Guofeng, Chief Pharmacist, Department of Pharmacy, Southern Hospital of Southern Medical University â— In recent years, the number of adverse drug reactions reported by Guangdong Province has been increasing, and the most common adverse reactions are antibiotics. â— The most common cause of drug defects is skin and accessory damage. It is characterized by rash, itching, redness and swelling; followed by systemic damage, which is characterized by chills and fever. â— Experts believe that doctors' treatment time is rushed, medicine is driven by interest, and patients are free to buy medicines for troubles. Adverse reaction rate
The case has eaten a cold head such as a "pig head"
Ms. Ni couldn’t think of it. A cold medicine might cause shock to be fatal. Recently, she has a cold and cough, bloodshot in the sputum, and rushed to see a doctor. The doctor prescribed antibiotics such as levofloxacin, citrate, and enteric soft capsules. In the evening, after Ms. Ni took the medicine for half an hour, the palm of her hand suddenly began to itch. Then, the arms, legs and even the whole body became red, and a piece of rash appeared on the skin quickly, and itching was difficult. At the same time, a burst of nausea came and it was extremely uncomfortable. Ms. Ni looked in the mirror and saw her face red and swollen like a "pig head". She could not recognize herself.
"Is it a drug reaction?" Ms. Ni has never had a history of drug allergy. She turned out the drug manual, only to find that the adverse reactions of 桉 蒎 蒎 蒎 溶 软 soft capsules have rash, facial edema, difficulty breathing, and levofloxacin adverse reactions have rash itching, nausea and vomiting. The incidence of adverse reactions is between 0.1% and 5%.
After Ms. Ni lay down for a few hours, the symptoms of nausea eased. The next morning, the rash gradually faded and the face was still swollen. Ms. Ni went to see a doctor again. The doctor diagnosed the adverse drug reaction. Ms. Ni immediately stopped the drug and re-opened anti-allergic drugs, cefaclor capsules and theophylline sustained-release tablets.
With the "previous car", Ms. Ni carefully read the instructions before taking the drug and found that the use of cefaclor capsules also had a urticaria-like rash and other adverse allergic reactions, accounting for about 1.5% of the patients. The incidence of gastrointestinal syndrome such as nausea, vomiting, and diarrhea accounts for 2.5%, and pseudomembranous colitis syndrome may occur during or after antibiotic treatment. Certain cephalosporins can cause epilepsy. The adverse reaction of theophylline sustained-release tablets is that at the beginning of treatment, nausea and vomiting are more common in the early stage. When the theophylline in the serum exceeds 40ug/ml, dehydration, convulsions, severe respiratory or cardiac arrest can occur.
Drugs have adverse reactions, how can we ensure safety when using drugs? Ms. Ni is very confused.
Adverse drug reactions to the phenomenon of "killer" adverse reaction most antibiotic drugs <br> <br> security issues in recent years more and more attention. In 2010, the State Food and Drug Administration's first annual report, in 2009, China received a total of 638,996 reports of adverse drug reactions, of which the most adverse drugs were anti-infective drugs, followed by cardiovascular system drugs.
In Guangdong's 2009 adverse drug reaction monitoring report, the total number of adverse drug reaction cases reported in the province reached 42,425, and the number of deaths was 43. The reporter was informed that since 2006, the number of adverse drug reactions reported by the province has been increasing: 20,100 cases in 2006, 27,366 cases in 2007, and 400,64 cases in 2008. The number of reported cases in 2009 was more than twice that of 2006.
"I think that the number of adverse drug reactions will only be reported less than over-reported, and the phenomenon of underreporting still exists." Li Guofeng introduced that in 2010, Nanfang Hospital reported more than 200 cases of adverse drug reactions in the province, but according to medication The amount of adverse reactions of the drug and the drug, the actual adverse reaction situation is far more than this number. Most of the cases reported were mainly mild, and severe cases were often not reported.
According to the person in charge, the most common non-Chinese patent medicines that cause adverse reactions are antibiotics, non-antibiotics, and water/electrolyte/acid-base balance and nutraceuticals.
Among them, the adverse reactions caused by antibiotics are the first to bear the brunt, and the top ten drugs that cause non-Chinese patents to cause adverse reactions are all antibiotics for injection.
From the performance of patients with adverse drug reactions, skin and its attachment damage is the most common, mainly rash, itching, redness and swelling; followed by systemic damage, mainly characterized by chills and fever. The more serious reactions are arrhythmia, blood pressure, red throat, liver and kidney dysfunction, myelosuppression and deafness.
Analyze why the rate of adverse reactions has increased?
One reason: Doctors rush to see a doctor indiscriminate drug <br> <br> inappropriate medication will push the high rate of adverse reactions of drugs. Li Guofeng believes that for doctors, the patient's medication history and drug allergy history should be known in detail before prescribing, and appropriate examinations should be done when needed. However, nowadays the big hospital is overcrowded, and the doctor's treatment time is very hasty, sometimes a patient is seen in just a few minutes. On the other hand, there are also a small number of doctors who are subject to the trend of interest, giving patients more drugs and drugs. For example, the original Chinese medicine is relatively safe and effective, but doctors may open more expensive, more effective, but more serious side effects of imported drugs, "drugs." In addition, drug abuse will undoubtedly increase adverse drug reactions, and the abuse of antibiotics in China is a testimony.
Two reasons: the patient just eat their own medicines <br> <br> patient in this regard, they know very little pharmacological, often casually own medication is unclear. The most common is to encounter a cold, headache, cough and other minor illnesses, go to the pharmacies on the street to buy medicine. Li Guofeng emphasized that at present, the supervision of drug use in China is not standardized enough, and it is easier to buy prescription drugs in small pharmacies. Many salesmen in pharmacies do not have the qualifications of professional pharmacists. The drugs they recommend to patients are not necessarily safe. They have a small cold to go to the pharmacy to buy a lot of medicines, which makes the repeated use of drugs very common.
In addition, Li Guofeng reminded that many patients do not tell the doctor what medicine they have eaten when they see a doctor. They deliberately conceal the situation of taking medicine and taking medicine before. This is also likely to lead to excessive dosage and increase the risk of adverse drug reactions.
Proposed to encounter adverse reactions, panic
Li Guofeng said that it is impossible to completely avoid adverse drug reactions. What patients should do is:
First of all, if you are sick, try to go to a regular hospital for treatment. Do not buy medicine yourself. When you see a doctor, try to explain your illness and medication history as clearly and systematically as possible. Don't hide it. If you have already bought a medicine before you see a doctor, you must tell the doctor the name of the medicine and avoid repeating the medicine.
Secondly, after the doctor has opened the medicine, the patient should ask in detail how to use the medicine. Read the instructions carefully before taking the medicine to understand the possible adverse reactions. In addition, patients should also be aware that excessive doses, excessive drug use, excessive drug concentrations, and improper use of drugs may increase adverse reactions and should be avoided.
If the adverse drug reaction occurs under the premise of rational drug use, the patient does not have to be too alarmed. Read the drug instructions first, check whether your adverse reactions are common adverse reactions of the drug, and if so, stop the drug immediately, find a specialist for prescribing yourself, and treat the symptoms to eliminate the consequences of adverse reactions. In most cases, adverse reactions will be alleviated after discontinuation.
However, there are also a few cases where the patient has serious adverse reactions after taking the medicine, leading to irreversible failure of organ function, or an irreversible allergic reaction. Where should the patient "speak"? In this case, Li Guofeng said that if the quality of the drug itself is up to standard, the doctor's medication is also in line with the guidelines and the norms are reasonable. The serious adverse reactions of the patients are only cases with very small chances, so it is difficult to recover the responsibility. In response to this very few "unlucky", the medical profession has explored the feasibility of implementing "drug adverse reaction insurance". It is understood that Shanghai is planning to implement this insurance.
Clinical common drug adverse reactions
Injection of atropine sulfate injection: dry mouth, less sweat, heart rate acceleration, pupil dilation, irritability, dry skin and fever, difficulty in urination, reduced bowel movements.
Aminophylline injection: When the serum concentration is 15-20μg/ml, it is common to have nausea, vomiting, irritability, insomnia, etc. When the serum concentration exceeds 20μg/ml, tachycardia, arrhythmia, serum tea can occur. If the alkali exceeds 40 μg/ml, symptoms such as fever, water loss, and convulsion may occur.
Diammonium glycyrrhizinate injection: mainly anorexia, nausea, vomiting, abdominal distension, and itching, urticaria, dry mouth and edema, common headache, dizziness, chest tightness, palpitations and blood pressure in the cardiovascular and cerebrovascular system. light.
Sodium phenobarbital injection: often have effects such as drowsiness, dizziness, headache, fatigue, and lack of energy. Occasionally, rash, exfoliative dermatitis, toxic hepatitis, jaundice, etc. Giant erythrocyte anemia can also be seen, joint pain.
Oral metformin hydrochloride tablets: common nausea, vomiting, diarrhea, metallic taste in the mouth. Sometimes there is fatigue, fatigue, dizziness, and rash.
Oryzanol tablets: occasionally stomach discomfort, nausea, vomiting, dry mouth, rash, breast swelling, hair loss and so on.
Cimetidine tablets: diarrhea, dizziness, fatigue, headache and rash; mild anti-androgenic effects, occasionally mental disorders, more common in elderly, young children, seriously ill patients, can recover within 48 hours after stopping the drug.
Amoxicillin capsules: 1. Gastrointestinal reactions such as nausea, vomiting, diarrhea and pseudomembranous colitis. 2. Allergic reactions such as rash, drug fever and asthma. 3. Anemia, thrombocytopenia, eosinophilia, etc. 4. Serum aminotransferase can be slightly increased. 5. Double infection caused by Candida or resistant bacteria. 6. Occasionally, nervous system symptoms such as excitement, anxiety, insomnia, and dizziness.
Inosine tablets: occasionally stomach upset.
"It is a three-point drug, and the adverse reactions of drugs can not be completely avoided." Li Guofeng, chief pharmacist of the Pharmacy Department of Nanfang Medical University, said in an interview that the incidence of adverse drug reactions in clinical practice is increasing. The number of cases reported by adverse reactions has increased year by year. Southern Hospital reported more than 200 cases of adverse drug reactions in 2010, the most common of which is the adverse reactions of antibiotics.
Li Guofeng believes that the existence of doctors' rushing time, lack of medical treatment, and random use of drugs by patients can be associated with a high rate of adverse drug reactions. However, even if the doctor is reasonable and standardizes the medication, the adverse reaction rate after the patient takes the medicine still exists. Therefore, the patient must read the instructions in detail before taking the medicine to master certain pharmacological knowledge.
Medical Guidance/Li Guofeng, Chief Pharmacist, Department of Pharmacy, Southern Hospital of Southern Medical University â— In recent years, the number of adverse drug reactions reported by Guangdong Province has been increasing, and the most common adverse reactions are antibiotics. â— The most common cause of drug defects is skin and accessory damage. It is characterized by rash, itching, redness and swelling; followed by systemic damage, which is characterized by chills and fever. â— Experts believe that doctors' treatment time is rushed, medicine is driven by interest, and patients are free to buy medicines for troubles. Adverse reaction rate
The case has eaten a cold head such as a "pig head"
Ms. Ni couldn’t think of it. A cold medicine might cause shock to be fatal. Recently, she has a cold and cough, bloodshot in the sputum, and rushed to see a doctor. The doctor prescribed antibiotics such as levofloxacin, citrate, and enteric soft capsules. In the evening, after Ms. Ni took the medicine for half an hour, the palm of her hand suddenly began to itch. Then, the arms, legs and even the whole body became red, and a piece of rash appeared on the skin quickly, and itching was difficult. At the same time, a burst of nausea came and it was extremely uncomfortable. Ms. Ni looked in the mirror and saw her face red and swollen like a "pig head". She could not recognize herself.
"Is it a drug reaction?" Ms. Ni has never had a history of drug allergy. She turned out the drug manual, only to find that the adverse reactions of 桉 蒎 蒎 蒎 溶 软 soft capsules have rash, facial edema, difficulty breathing, and levofloxacin adverse reactions have rash itching, nausea and vomiting. The incidence of adverse reactions is between 0.1% and 5%.
After Ms. Ni lay down for a few hours, the symptoms of nausea eased. The next morning, the rash gradually faded and the face was still swollen. Ms. Ni went to see a doctor again. The doctor diagnosed the adverse drug reaction. Ms. Ni immediately stopped the drug and re-opened anti-allergic drugs, cefaclor capsules and theophylline sustained-release tablets.
With the "previous car", Ms. Ni carefully read the instructions before taking the drug and found that the use of cefaclor capsules also had a urticaria-like rash and other adverse allergic reactions, accounting for about 1.5% of the patients. The incidence of gastrointestinal syndrome such as nausea, vomiting, and diarrhea accounts for 2.5%, and pseudomembranous colitis syndrome may occur during or after antibiotic treatment. Certain cephalosporins can cause epilepsy. The adverse reaction of theophylline sustained-release tablets is that at the beginning of treatment, nausea and vomiting are more common in the early stage. When the theophylline in the serum exceeds 40ug/ml, dehydration, convulsions, severe respiratory or cardiac arrest can occur.
Drugs have adverse reactions, how can we ensure safety when using drugs? Ms. Ni is very confused.
Adverse drug reactions to the phenomenon of "killer" adverse reaction most antibiotic drugs <br> <br> security issues in recent years more and more attention. In 2010, the State Food and Drug Administration's first annual report, in 2009, China received a total of 638,996 reports of adverse drug reactions, of which the most adverse drugs were anti-infective drugs, followed by cardiovascular system drugs.
In Guangdong's 2009 adverse drug reaction monitoring report, the total number of adverse drug reaction cases reported in the province reached 42,425, and the number of deaths was 43. The reporter was informed that since 2006, the number of adverse drug reactions reported by the province has been increasing: 20,100 cases in 2006, 27,366 cases in 2007, and 400,64 cases in 2008. The number of reported cases in 2009 was more than twice that of 2006.
"I think that the number of adverse drug reactions will only be reported less than over-reported, and the phenomenon of underreporting still exists." Li Guofeng introduced that in 2010, Nanfang Hospital reported more than 200 cases of adverse drug reactions in the province, but according to medication The amount of adverse reactions of the drug and the drug, the actual adverse reaction situation is far more than this number. Most of the cases reported were mainly mild, and severe cases were often not reported.
According to the person in charge, the most common non-Chinese patent medicines that cause adverse reactions are antibiotics, non-antibiotics, and water/electrolyte/acid-base balance and nutraceuticals.
Among them, the adverse reactions caused by antibiotics are the first to bear the brunt, and the top ten drugs that cause non-Chinese patents to cause adverse reactions are all antibiotics for injection.
From the performance of patients with adverse drug reactions, skin and its attachment damage is the most common, mainly rash, itching, redness and swelling; followed by systemic damage, mainly characterized by chills and fever. The more serious reactions are arrhythmia, blood pressure, red throat, liver and kidney dysfunction, myelosuppression and deafness.
Analyze why the rate of adverse reactions has increased?
One reason: Doctors rush to see a doctor indiscriminate drug <br> <br> inappropriate medication will push the high rate of adverse reactions of drugs. Li Guofeng believes that for doctors, the patient's medication history and drug allergy history should be known in detail before prescribing, and appropriate examinations should be done when needed. However, nowadays the big hospital is overcrowded, and the doctor's treatment time is very hasty, sometimes a patient is seen in just a few minutes. On the other hand, there are also a small number of doctors who are subject to the trend of interest, giving patients more drugs and drugs. For example, the original Chinese medicine is relatively safe and effective, but doctors may open more expensive, more effective, but more serious side effects of imported drugs, "drugs." In addition, drug abuse will undoubtedly increase adverse drug reactions, and the abuse of antibiotics in China is a testimony.
Two reasons: the patient just eat their own medicines <br> <br> patient in this regard, they know very little pharmacological, often casually own medication is unclear. The most common is to encounter a cold, headache, cough and other minor illnesses, go to the pharmacies on the street to buy medicine. Li Guofeng emphasized that at present, the supervision of drug use in China is not standardized enough, and it is easier to buy prescription drugs in small pharmacies. Many salesmen in pharmacies do not have the qualifications of professional pharmacists. The drugs they recommend to patients are not necessarily safe. They have a small cold to go to the pharmacy to buy a lot of medicines, which makes the repeated use of drugs very common.
In addition, Li Guofeng reminded that many patients do not tell the doctor what medicine they have eaten when they see a doctor. They deliberately conceal the situation of taking medicine and taking medicine before. This is also likely to lead to excessive dosage and increase the risk of adverse drug reactions.
Proposed to encounter adverse reactions, panic
Li Guofeng said that it is impossible to completely avoid adverse drug reactions. What patients should do is:
First of all, if you are sick, try to go to a regular hospital for treatment. Do not buy medicine yourself. When you see a doctor, try to explain your illness and medication history as clearly and systematically as possible. Don't hide it. If you have already bought a medicine before you see a doctor, you must tell the doctor the name of the medicine and avoid repeating the medicine.
Secondly, after the doctor has opened the medicine, the patient should ask in detail how to use the medicine. Read the instructions carefully before taking the medicine to understand the possible adverse reactions. In addition, patients should also be aware that excessive doses, excessive drug use, excessive drug concentrations, and improper use of drugs may increase adverse reactions and should be avoided.
If the adverse drug reaction occurs under the premise of rational drug use, the patient does not have to be too alarmed. Read the drug instructions first, check whether your adverse reactions are common adverse reactions of the drug, and if so, stop the drug immediately, find a specialist for prescribing yourself, and treat the symptoms to eliminate the consequences of adverse reactions. In most cases, adverse reactions will be alleviated after discontinuation.
However, there are also a few cases where the patient has serious adverse reactions after taking the medicine, leading to irreversible failure of organ function, or an irreversible allergic reaction. Where should the patient "speak"? In this case, Li Guofeng said that if the quality of the drug itself is up to standard, the doctor's medication is also in line with the guidelines and the norms are reasonable. The serious adverse reactions of the patients are only cases with very small chances, so it is difficult to recover the responsibility. In response to this very few "unlucky", the medical profession has explored the feasibility of implementing "drug adverse reaction insurance". It is understood that Shanghai is planning to implement this insurance.
Clinical common drug adverse reactions
Injection of atropine sulfate injection: dry mouth, less sweat, heart rate acceleration, pupil dilation, irritability, dry skin and fever, difficulty in urination, reduced bowel movements.
Aminophylline injection: When the serum concentration is 15-20μg/ml, it is common to have nausea, vomiting, irritability, insomnia, etc. When the serum concentration exceeds 20μg/ml, tachycardia, arrhythmia, serum tea can occur. If the alkali exceeds 40 μg/ml, symptoms such as fever, water loss, and convulsion may occur.
Diammonium glycyrrhizinate injection: mainly anorexia, nausea, vomiting, abdominal distension, and itching, urticaria, dry mouth and edema, common headache, dizziness, chest tightness, palpitations and blood pressure in the cardiovascular and cerebrovascular system. light.
Sodium phenobarbital injection: often have effects such as drowsiness, dizziness, headache, fatigue, and lack of energy. Occasionally, rash, exfoliative dermatitis, toxic hepatitis, jaundice, etc. Giant erythrocyte anemia can also be seen, joint pain.
Oral metformin hydrochloride tablets: common nausea, vomiting, diarrhea, metallic taste in the mouth. Sometimes there is fatigue, fatigue, dizziness, and rash.
Oryzanol tablets: occasionally stomach discomfort, nausea, vomiting, dry mouth, rash, breast swelling, hair loss and so on.
Cimetidine tablets: diarrhea, dizziness, fatigue, headache and rash; mild anti-androgenic effects, occasionally mental disorders, more common in elderly, young children, seriously ill patients, can recover within 48 hours after stopping the drug.
Amoxicillin capsules: 1. Gastrointestinal reactions such as nausea, vomiting, diarrhea and pseudomembranous colitis. 2. Allergic reactions such as rash, drug fever and asthma. 3. Anemia, thrombocytopenia, eosinophilia, etc. 4. Serum aminotransferase can be slightly increased. 5. Double infection caused by Candida or resistant bacteria. 6. Occasionally, nervous system symptoms such as excitement, anxiety, insomnia, and dizziness.
Inosine tablets: occasionally stomach upset.
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