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Attention! Patients who take these drugs cannot drink alcohol
[ China Pharmaceutical Network Health and Wellness ] In the Spring Festival, whether it is family reunion or visiting relatives and friends, it is an indispensable item for Chinese people to make wine talks. Many people choose not to get drunk. But what about the friends who are taking medicine in a small illness? How can I do it? I can’t hurt the fire line for a long time. I haven’t had much time to meet my family and friends for a year. At this moment, I have a cup full of blessings. What can you do with the syrup?
(Attention! Patients who take these drugs can not drink alcohol. Source: Baidu Pictures)
You may experience a fatal "disulfiram-like reaction"! Dizziness, headache, nausea, vomiting, palpitation, and weakness, which are medically known as "disulfiram-like reactions", if critically ill patients If the rescue is not timely, it will endanger life.
Disulfiram is a kind of alcohol-free medicine. Even after drinking a small amount of alcohol after taking this medicine, the body will have serious discomfort and achieve the purpose of abstinence. The mechanism of action of disulfiram is that disulfiram can inhibit the acetaldehyde dehydrogenase in the liver when it is combined with ethanol. After the ethanol is oxidized to acetaldehyde in the body, it can no longer decompose and oxidize, resulting in the accumulation of acetaldehyde in the body. Produce a series of reactions.
Many antibacterial drugs have a similar effect to disulfiram. If you drink alcohol after treatment, facial flushing, conjunctival hyperemia, blurred vision, severe pulsation of head and neck blood vessels or pulsating headache, dizziness, nausea, vomiting, sweating, mouth may occur. Dry, chest pain, myocardial infarction, acute heart failure, dyspnea, acute liver injury, convulsions and death, etc., blood pressure can be reduced, heart rate can be accelerated (up to 120 times / min) and the ECG is normal or partially changed (such as ST -T changes), which is a disulfiram-like reaction. The severity is directly proportional to the amount of medication used and the amount of alcohol consumed. Older people, children, cardiovascular and cerebrovascular diseases, and those who are sensitive to ethanol are more severe. This reaction usually occurs 15-30 minutes after medication and drinking.
Which drugs can cause a disulfiram-like reaction?
1, antibacterial drugs
Cephalosporins such as cefoperazone, deoxycephalosporin, cefmetazole, cefmenoprene, cefmenoxime, cefotiam, and metronidazole, tinidazole, furazolidone, etc. can cause disulfiram-like reactions. Further, toluene butyrate, chlorpropamide or the like can also cause the above reaction.
It is characterized by four limbs weakness, weakness, lethargy, dizziness, hallucinations, headache, nausea, vomiting, chest tightness, whole body flushing, collapse, convulsions, even blood pressure drop, respiratory depression, shock and other reactions after drinking.
Those who are light can relieve themselves, and those who are serious should take necessary measures to treat them in time. Therefore, patients should ban alcohol on the 2nd day before using the above drugs, and avoid drinking alcohol and taking beverages and medicines containing ethanol one week after taking the medicine.
2, antipyretic analgesics
Most cold medicines contain acetaminophen. When drinking excessively, it consumes a lot of glutathione in the body, which causes the metabolites produced by acetaminophen to fail to bind to glutathione, increasing the risk of liver failure.
If you take alcohol, such as aspirin, ibuprofen, diclofenac and other drugs, the gastrointestinal mucosa can be stimulated by drugs and ethanol, and even cause digestive ulcers or bleeding.
3, antihypertensive drugs
If you drink alcohol during the period of taking reserpine, captopril, and nifedipine blood pressure lowering drugs, it may cause vasodilatation, resulting in hypotensive shock, which can be life-threatening in severe cases.
Because alcohol has the effect of dilating blood vessels, inhibiting sympathetic nerves and myocardial contractility, it can enhance the effects of antihypertensive drugs, cause headaches, and even shock. Some antihypertensive drugs such as compound antihypertensive tablets, compound diterpenoids and alcohol may also cause a sharp increase in blood pressure.
4, hypoglycemic drugs
Glucosamine, metformin, insulin and other heavy alcohol consumption during the medication can cause dizziness, palpitation, cold sweat and other hypoglycemia reactions, severe cases can occur hypoglycemia coma.
5, sedative hypnotics
Some sleeping pills that have a sedative and hypnotic effect have a certain effect of inhibiting breathing and heartbeat, and alcohol has the same effect. Sedative hypnotics such as diazepam, nitrazepam, clonazepam, triazolam, barbiturates, and chloral hydrate can cause drowsiness, mental paralysis, coma, respiratory failure, and even death when combined with ethanol.
6, anti-angina drugs
Nitrate anti-angina drugs (nitroglycerin, isosorbide dinitrate, etc.) improve myocardial blood supply and relieve angina to correct heart failure by dilating coronary arteries and small blood vessels, reducing the load on the heart.
Drinking alcohol during medication can cause significant expansion of small blood vessels, blood pressure, dizziness, weakness, etc. In severe cases, cardiovascular collapse occurs. At this time, myocardial blood supply is further reduced, which is more likely to aggravate angina or induce myocardial infarction.
7, diuretics
Furosemide, hydrochlorothiazide, etc. can lower blood pressure by urinating, and ethanol also has the effect of dilating blood vessels. Drinking diuretic drugs while drinking alcohol may cause symptoms such as dizziness and erectile collapse.
8, anti-allergic drugs
Ethanol can enhance the central inhibition of the first-generation antihistamines (chlorpheniramine, cyprodinil, diphenhydramine, etc.), which can cause drowsiness, mental paralysis, and coma, and should be avoided.
Although the central inhibitory effect of the second-generation antihistamines (cetirizine, loratadine, etc.) is weak at the therapeutic dose, it does not enhance the effect of ethanol, but should also be avoided after drinking.
9, morphine
The combination of ethanol and morphine produces a synergistic effect. May cause poisoning or even death.
10, anti-epileptic drugs
Long-term drinking can reduce the concentration and efficacy of phenytoin, but taking a large amount of alcohol at the same time can increase the blood concentration. Drinking alcohol during sodium valproate can enhance the central inhibition.
11, hemostasis and anticoagulants
Ethanol can inhibit blood clotting factors, counteract the effects of hemostatic drugs, and reduce the effect of hemostatic drugs.
12. Antidepressants/antipsychotics
Drinking alcohol during imipramine and doxe anti-depressant can produce a central calming effect. Phenothiazines such as chlorpromazine and promethazine can delay the catabolism of ethanol, aggravate the symptoms of nausea, vomiting, headache, facial flushing, etc. Drinking alcohol can aggravate adverse reactions such as chlorpromazine and hypotensive reactions, aggravating Central inhibition of cloprofen.
1 cefoperazone in the cephalosporin, cefoperazone sulbactam, ceftriaxone, cefazolin (Pioneer V), cefradine (Pioneer VI) and the like. Among them, the cefoperazone-induced disulfiram-like reaction is the most reported and most sensitive. If a patient eats chocolate, uses musk qi water, or even treats the skin with alcohol alone, a disulfiram-like reaction may occur.
2 Nitrazole drugs such as metronidazole (metidazole), tinidazole, ornidazole, secnidazole.
3 other antibacterial drugs such as furazolidone (vutrin), chloramphenicol, ketoconazole, griseofulvin and the like.
The following nursing measures should be taken for patients with disulfiram-like reactions and anaphylactic shock:
(1) Resting in bed, the shocker takes a "V" position.
(2) Keep the airway open, give oxygen inhalation 4-6L/min, and improve tissue hypoxia.
(3) establish a venous access, according to the doctor's advice to give dexamethasone 5 ~ 10mg into the glucose solution intravenously or static push, rehydration and diuretic, and according to the condition of vasoactive drugs.
(4) symptomatic treatment. Such as nausea, vomiting can give metoclopramide 10mg intramuscular injection; such as lethargy, unconsciousness can give naloxone anti-treatment.
(5) Prepare emergency equipment and medicines at the bedside, such as defibrillators, suction devices, tracheotomy and venous incision bags, respiratory stimulants, diuretics and other rescue drugs.
(6) Closely observe the patient's consciousness, body temperature, pulse, respiration, heart rate, heart rate, blood pressure, urine volume and other clinical changes, and do a good job of nursing records of the condition.
So many drugs that can cause "disulfiram-like reaction"? Can't remember what to do? Collect this article, check the key moments (before drinking), see if the recent oral medication will cause the reaction, and then tell the drinker Friends and family, for health, drink instead! No time to see what to do? Take the easiest way, do not drink medicine, drink alcohol, do not take medicine!