Jiang Wei
The country and localities continue to optimize epidemic prevention and control measures, and the public has further increased their attention to personal health and protection. The recent "drug stocking list" and "drug order" circulated on the Internet have triggered a wave of family preparations.
As the saying goes, being prepared, having enough medicine boxes at home has given many people the confidence and peace of mind to overcome the new crown, but it should also be reminded that: currently, the vast majority of infected people do not need to be hospitalized or even need to be hospitalized if they are infected with the new crown virus Omicron strain. If you take medicine and take medicine indiscriminately, you will be poisoned and even cause irreversible organ damage. You must be vigilant without being hospitalized.
Taking a variety of cold medicines at the same time, the girl has acute liver damage
Recently, we encountered such a case: A Mei, a 14-year-old girl, took 7 kinds of cold medicine in the first 2 days of her cold.
I thought that taking multiple medicines together would make her recover faster, but Ah Mei's cold symptoms not only did not get relieved, but she developed more severe symptoms such as vomiting and abdominal pain.
Accompanied by her family, Ah Mei was sent to the local hospital for emergency treatment, and was diagnosed with acute liver injury by the doctor.
Clinically, the phenomenon of acute liver and kidney injury caused by self-administration of drugs frequently occurs, mainly manifested as increased levels of transaminases and/or alkaline phosphatase, creatinine, etc. in varying degrees, and severe fever, anorexia, nausea, and vomiting and abdominal discomfort.
I would like to remind everyone: the more medication you take, the better the curative effect is not necessarily. You can’t mix different types of medicines by yourself, and don’t blindly follow the advice on taking medicine on the Internet.
Here are a few of the more concentrated medication misunderstandings explained in detail.
Is it better to take a variety of cold medicines together?
Caution: Do not overdose on yourself
If you suddenly catch a cold, most people will choose to buy over-the-counter medicines first, and do not take the medicines under the guidance of a doctor or pharmacist.
However, many cold medicines on the market today, especially compound preparations, Chinese patent medicines, antipyretics and painkillers contain acetaminophen, and you must read the instructions carefully before taking them.
If you take two cold medicines at the same time, or take antipyretics and painkillers at the same time, it will cause excessive intake of acetaminophen, which will lead to acute liver damage, and severe liver failure or even death.
Common cold medicines containing acetaminophen: paracetamol pseudomamefen tablets, phenmamemin tablets, phenmamemin suspension, etc.
When taking cold medicine, remember that there is no so-called "1+1>2" effect, but there is a "1+1>2" drug risk.
Can different types of drugs be mixed together?
Vigilance: Do not take medicine casually, let alone mix it at will
We have always advocated that medicine should not be taken casually. There is no such thing as "taking some medicine to prevent diseases". If you have symptoms, take the medicine according to the symptoms.
When taking medicine, you can't "mix it up" at will.
It should be noted that these drug combinations cannot have.
[Cannot be taken at the same time: Huoxiang Zhengqi Water, Cephalosporin]
Huoxiang Zhengqi Water and Cephalosporin cannot be taken at the same time.
Since Huoxiangzhengqi water contains alcohol, it will be digested in the body to produce ethanol, and cephalosporins will inhibit the metabolism of ethanol in the body, resulting in the accumulation of ethanol, which can induce acute liver damage, apnea and even death in severe cases.
[Cannot be taken at the same time: probiotics, antibiotics]
Probiotics and antibiotics may not be effective if eaten incorrectly.
Probiotics are what we commonly call beneficial intestinal bacteria, while antibiotics are mostly antibacterial drugs whose main function is to kill bacteria.
If probiotics are taken together with antibiotics, while antibiotics kill harmful bacteria, they will also kill probiotics, then the probiotics will be eaten for nothing.
Therefore, in principle, it is recommended that antibiotics and probiotics be taken at least two hours apart.
However, there are exceptions for individual probiotics, such as antibiotic-associated diarrhea. Doctors will recommend Saccharomyces boulardii, which belongs to fungi and can be taken together with antibiotics.
Of course, acute diarrhea is not necessarily completely bacterial infection, especially for children, especially in autumn and winter, we must be vigilant against norovirus infection.
[Cannot be taken at the same time: expectorants, cough medicine]
Take expectorants and cough suppressants at the same time, be careful not to block the airway.
The role of expectorants is not to make the sputum disappear out of thin air, but to make the sputum thinner and easier to be discharged.
The volume of diluted sputum will increase. If it is not discharged in time, it will easily block the respiratory tract. Therefore, we should use coughing to expel the sputum.
If you take cough medicine at the same time, which prevents expectoration, it may cause shortness of breath.
The younger the child, the higher the risk of airway blockage and the poorer the expectoration ability, the more vigilant they should be.
Therefore, it is not recommended to take both at the same time, nor is it recommended to take them at intervals.
[Cannot be taken at the same time: painkillers, anticoagulants]
Anticoagulants prevent the synthesis of clotting factors and are often used to prevent thrombosis; painkillers have antiplatelet effects.
The effects of the two are similar, the former is to prevent blood coagulation, the latter is to prolong the time of blood coagulation, taking it at the same time will increase the chance of bleeding and easily cause internal bleeding in patients, such as: skin congestion, ecchymosis, gastrointestinal bleeding, etc.; if accidentally injured, it is easy to cause Difficulty stopping bleeding.
Common anticoagulants: warfarin, rivaroxaban tablets, edoxaban, etc.;
Common painkillers: ibuprofen, diclofenac sodium, etc.
[Cannot be taken at the same time: nasal congestion relief medicine, blood pressure medicine]
The combination of nasal congestion relief drugs and blood pressure lowering drugs will affect the blood pressure lowering effect.
Nasal congestion relief drugs usually contain decongestant ingredients (mainly ephedrine-containing drugs), which can relieve nasal congestion by constricting blood vessels, but this may cause blood pressure to rise and affect the efficacy of blood pressure-lowering drugs.
Hypertensive patients, especially those who regularly take blood pressure-lowering drugs, should cautiously use nasal congestion-relieving drugs under the guidance of a specialist doctor or pharmacist when they experience nasal congestion, such as ephedrine nasal drops, paracetamol and pseudoephedrine capsules, and paracetamol pseudoephedrine capsules. Ananamin tablets, compound bellflower ephedrine syrup, etc.
These common medicines must be remembered not to be used in combination, as the interaction may endanger human health.
Can special populations take their own medicines as needed?
Vigilance: Be careful when taking these drugs in special populations
【Medicine for the Elderly】
The metabolism of the elderly slows down, the functions of various organs weaken, drug sensitivity increases, and adverse drug reactions are more likely to occur.
Because compound cold medicines (such as Tylenol, Xincontek, Baijiahei, etc.) contain pseudoephedrine, it is easy to cause adverse reactions such as increased blood pressure and rapid heartbeat; elderly people with enlarged prostates should use cold medicines containing pseudoephedrine with caution. Afterwards, it may aggravate the condition, such as inability to urinate, bladder swelling, etc.
【Medicine for pregnant women】
It is not that pregnant women cannot take medicine, but they must take medicine when they should take medicine, and they should take medicine under the guidance of a doctor or pharmacist.
The first trimester (5-14 weeks) is a critical period for the development of the fetal brain, nerves, and organs. Both the cold virus itself and anti-cold medicines have a great impact on the fetus. It is recommended to avoid medication in the first trimester, but colds and fevers occur during pregnancy Symptoms should seek medical attention in time.
【Pediatric medicine】
Because infants and young children are immature in liver and kidney development, the clearance and excretion of drugs are slow, and adverse reactions are prone to occur when using drugs.
Both the World Health Organization (WHO) and China's fever guidelines recommend that children with fever can choose acetaminophen or ibuprofen to reduce fever, but it is not recommended to use the two in combination or alternately.
In addition, pay attention: Do not take two or more cold medicines at the same time, so as to avoid overdose due to the same ingredients; use medicines in children’s dosage forms or medicines with recommended doses for children; At 38°C, it is suitable for use with antipyretics.
(The author is the director of the Department of Internal Medicine and the executive director of the Department of Gastroenterology, Xiamen Hospital, Zhongshan Hospital Affiliated to Fudan University)