Papers Category:Medicine Papers
- Pharmacy Papers
Post Time:2013-1-28 8:19:00
Abstract: Integrative development and how combined with Western medicine in order to enhance the efficacy and avoid adverse reactions, the purpose of rational drug use, has been plagued clinicians, clinical pharmacist research paper will not appropriate drugs occurred in Western medicine combined with the change of the physical and chemical properties, pharmacological change, resulting in the reduction of drug treatment, increased toxicity summing up the discussion.
Keywords: adverse drug reactions reasonable compatibility of drug safety
Chinese and Western medicine compatibility has become a means of today's clinical, in western medicine compatibility, this can improve the efficacy, reduced toxicity, but some reduce the efficacy or produce toxic side effects, the application and development of Chinese medicine has a long history, after a long practice a certain understanding, total compatibility ban of Chinese and Western medicine in clinical paid insufficient attention to, and often there is the phenomenon of irrational use of drugs. now discuss the incompatibility of Chinese and Western medicine from pharmacological chemistry and pharmacology.
First, the physical and chemical properties change leading to reduced efficacy or increased toxicity 1, the formation of the precipitate contains tannin Burnet, pomegranate rind, gall, rhubarb and other traditional Chinese medicine as well as Maren, choleretic piece proprietary Chinese medicine with western medicine preparations associated with change: its physical and chemical properties such as tetracycline, erythromycin and other glycosides, alkaloids ephedrine, atropine, etc., and ferrous salt formulations, sodium bicarbonate formulations associated with precipitation affect absorption.
2 to form complexes contain quercetin Bupleurum, mulberry leaves, Huaijiao,, and preparations containing these herbs with western medicine containing various metal ions form complexes affect absorption.
3, pH combined alkaline western medicine and five ignorant child, Ligustrum lucidum acidic Chinese medicine and oxygen alumina, aminophylline, calcined keel, calcined oyster, borax, alkaline Chinese medicine with pepsin mixture, acetyl salicylic acid and other acidic western medicine will play in reaction to reduced efficacy or even lose their efficacy.
Second, pharmacological changes leading to reduced efficacy or increased toxicity
Pharmacokinetic change (1 borax, cuttlebone, corrugated sub, saponins and other alkaline Chinese medicine and its preparation with propranolol, chlorpromazine, ferrous sulfate associated with its absorption decreased with quinine, chloroquine, doxycycline, neostigmine combination will make it from the urine, prompting lower plasma concentration, and the quinidine associated with the discharge to reduce, increase in the blood concentration of lead poisoning.
(2 alkaline traditional Chinese medicine, such as borax, calcined oyster, so urine acidification drugs dissociation increased, excretion rate, the duration of action and lower intensity.
(The 3 Western medicine compatibility, different drug plasma protein binding rate, so that the plasma concentration of the drug varies, thus affecting its tissue binding., Such as traditional Chinese medicine containing tannin compounds in combination with sulfa drugs, leading to blood and the increase in the concentration of sulfa drugs in the liver, severe toxic hepatitis occurs. (4 urine pH affect drug reabsorption, acidified or alkalized fluids, thus affecting excretion of the drug.
Shuanghuanglian combination with ampicillin Shuanghuanglian competitive inhibition of ampicillin from the tubular secretion, thereby increasing the blood concentration of the ampicillin and Experimental determination of the blood concentration is higher than a single use.
Pharmacodynamic changes (1 ephedra and ephedrine-containing Chinese medicine preparations myocardial B receptor can be excited and strengthening myocardial contractility of digitalis, digoxin and other cardiac drugs increased role of increased toxicity, causing arrhythmia , heart failure and other adverse reactions.
(2 ethanol can increase the activity of the hepatic drug metabolizing enzyme, it is served with wine rhubarb wine angelica and tincture ethanol preparations containing ethanol, above western medicine will enhance the in vivo metabolism, half-life shortened: reduced efficacy, increased toxicity. Such Chinese medicine would be inappropriate for the same service with chloral hydrate, ethanol and chloral hydrate can generate toxic alcohol chloral toxicity exacerbate severe cases can cause death.
(3 glycosides Chinese medicine, such as ginseng, Sophora, rhubarb and a the Apocynum piece, JiuXinWan deer antler preparations with codeine, morphine, pethidine associated with heavier anesthesia, suppression of breathing, cardiac glycosides associated with pharmacodynamic accumulate, increasing toxicity. traditional Chinese medicine preparation Zushima containing daphnetin associated with vitamin K antagonism will produce. (4 bezoar bezoar preparations with the hydrated chloral, urethane, morphine, phenobarbital combination be central inhibition.
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Third, the incompatibility of Chinese and Western medicine injections, along with traditional Chinese medicine injections are more widely used in clinical, Chinese and Western medicine injections mixed application compatibility gradually increased, due to TCM injections ingredient complex, with the other medicine-induced pH changes, a change in solvents active ingredients or impurities precipitate compatibility of concentration and compatibility conditions of impact are likely produce insoluble particles. these particles are deposited in the capillaries can cause local circulation disorder, caused by blockage of blood vessels, resulting in phlebitis, granulomatous reaction and can lead to allergies and hot as it. stability of Chinese and Western medicine injections associated with intravenous infusion should give rise to clinical attention. Shuanghuanglian injection with oxidation loose, norfloxacin. Ciprofloxacin, ofloxacin, vitamin C, sulfuric acid kanamycin compatibility: with vitamin C, the hydrogenation of cortisone compatibility of UV absorption significantly reduce the chemical reaction may occur with norfloxacin ring ciprofloxacin, ofloxacin, kanamycin sulfate compatibility ring precipitate formation, it is not appropriate to the compatibility of Danshen injection and ciprofloxacin, ofloxacin compatibility: compatibility produce a large number of black-brown flocculent precipitate shall intravenous infusion. wear Hu Ning injection with gentamicin, amikacin, ciprofloxacin, ofloxacin compatibility: produce precipitation, not compatibility. 2, affecting the efficacy of Qing Kai Ling injection of penicillin, lincomycin hydrochloride, vitamin C, vitamin B.
, sulfuric acid kanamycin compatibility: kanamycin sulfate, vitamin B6 compatibility precipitate may mycophenolate, and penicillin hydrochloric Lin , vitamin C compatibility 8h pH downward trend, compatibility 2h when UV absorbance at 276nm at different degrees of decline, it is not appropriate to compatibility.
Conclusion reasonable in western medicine associated with can improve efficacy, reduce side effects and unreasonable compatibility will affect the efficacy of the drug, Enhanced known or new adverse clinical combined with Western medicine, especially considering the compatibility avoid using unknown incompatibility, and the strengthening of clinical observation and monitoring in order to achieve the purpose of the rational use of drugs.
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