Rare adverse reactions of 1 cimetidine
Heart damage 1. 1 Huang Zijie reported that intravenous cimetidine 0.8g, 1 time /d, 1 case had heart block after 3 days, 2 cases had heart block after 5 days, and 1 case had heart block after 7 days. Age 54 ~ 73 years old; 3 male 1 female; Geng Liping reported that/A male patient aged Kloc-0/34 took cimetidine 0.4g orally, three times a day, and atrioventricular block appeared two days later. This shows that both oral and intravenous administration may cause arrhythmia in the case of routine usage and dosage. Zhou Ying also reported two cases of arrhythmia caused by oral cimetidine. Zong Liyan and others reported 2 cases of cardiac block caused by cimetidine. Zhao Rike and others reported 2 cases of arrhythmia caused by gastric and duodenal ulcer treated with cimetidine. Li Songyang and others reported hypotensive myocardial damage caused by intravenous infusion of cimetidine 1 case, all of which were cured.
1.2 Yao Yingying Report of Pancreatitis 1 Male patient, 5 1 year, taking cimetidine 0.4g orally, 1 time/d; After taking it for 3 ~ 5 hours every day, I feel tired, sleepy and painful in limbs and joints. On the third day, abdominal pain was unbearable and radiated to both sides of the waist in a bundle, and the pain was aggravated when lying flat. The hemogram showed: wbc 12.7× 10 9 /l, n93%, l6%, and the blood amylase 328ub showed pancreatitis. Intramuscular injection of atropine 0.3mg, intravenous infusion of penicillin 8 million U, ampicillin 4g, relieved after 5 hours and cured after 3 days.
1.3 Gao Qun et al. reported 1 female patient, 58 years old, who was given 0.4g of cimetidine intravenously and diluted with 20ml of 5% glucose injection twice a day. After 16 days, pancytopenia occurred, and the WBC was 2.0× 109/L, N 0. Considering that it was caused by cimetidine. Another 1 male patient, 26 years old, vomited 200ml of coffee-like stomach contents, added 0.4g of cimetidine, diluted with 20ml of 5% glucose injection and injected intravenously twice a day. 10 days later, vomiting stopped. After 7 days, the patient's whole blood cells decreased, and after 1 1 day, the whole blood cells further decreased, WBC. N0.385, rbc2.97× 10 12 /l, hgb86g/l, plt40× 109 /l, reticulocyte 0.002; Continuous reexamination showed a low level, which was thought to be caused by cimetidine. After stopping the drug 1 month, the hemogram returned to normal.
1.4 Li Xiuqing Report of Bladder Irritation Syndrome 1 A 70-year-old female patient was given cimetidine 0.2g each time, three times a day, plus 0.4g before going to bed and taking bismuth pectin 0. 1g each time, three times a day, with frequent micturition, urgency and dysuria aggravated for five days. After two months of treatment with antibiotics and Chinese herbal medicine, the symptoms did not improve, but after four days of stopping cimetidine, the symptoms of bladder irritation reappeared and disappeared automatically after stopping cimetidine.
1.5 Weekly Report on Anaphylactic Shock 1 A 36-year-old female patient developed symptoms of anaphylactic shock such as pallor, sweating and blood pressure drop after taking 0.58g of cimetidine orally, which was improved after being rescued. Wang Chunsheng once reported 1 female patient, aged 57, who developed sweating, flushing, dry mouth and blood pressure drop of 40/20mmhg after intravenous infusion of 0.4g cimetidine and 5ml 5% glucose injection. He was diagnosed as anaphylactic shock and recovered after rescue. It was later reported that 1 male patient, 20 years old, had similar symptoms after infusion of the above fluids and recovered after rescue. Dong et al reported anaphylactic shock 1 case caused by intravenous infusion of cimetidine.
1.6 acute renal failure Wang Shunying et al. reported 1 male patient, who was given 0.8g of cimetidine intravenously, 1 time /d, and when 200ml was infused, the patient developed symptoms of anuria and edema of both lower limbs, which was considered as acute renal failure and gradually recovered after stopping taking the drug.
1.7 Report by Yu Bingxin et al. 1 A 20-year-old female patient took cimetidine 0.4g three times a day. Five days later, purpura appeared in many parts of both legs. Laboratory test: pc20× 109 /l, diagnosed as thrombocytopenic purpura, changed to omeprazole plus prednisone, vitamin C tablet 0. 1g, three times a day, 1 week later, purpura disappeared.
1.8 mental disorder Shi aiyun and others reported 3 female patients, aged 66-96 years; Two patients were given cimetidine 200mg twice a day. 1 Patients were given cimetidine 200mg three times a day. The patient developed symptoms such as mental excitement, gibberish and disorientation on the second to third day, and all the symptoms disappeared after stopping the drug. Huang Zhixin reports mental disorder caused by cimetidine 1 case; Ying Zhao and others reported 1 case of mental symptoms caused by cimetidine; Yang reported neuropsychiatric disorder caused by intravenous infusion of cimetidine 1 case. Lin Song and others also reported 1 case of mental symptoms, and Yu Guiping and others reported 1 case of mental disorder.
1.9 muscle pain Xia Bin et al. reported 1 a male patient, aged 32, who was given intravenous drip of hormone due to weakness of both lower limbs. To prevent gastrointestinal bleeding, cimetidine was given 0.6g/d intravenous drip. After 3 days, there was severe pain in both lower limbs, obvious tenderness in buttocks and bilateral thigh muscles, and sweating aggravated the pain. Check creatine kinase 2436u/l, and then stop using cimetidine for 4 days.
1. 10 bronchial asthma yu zhang et al. reported 1 A 75-year-old male patient developed dry cough, sweating, dyspnea and cyanosis after intravenous infusion of 1.0g cimetidine 5% glucose injection to 26ml. Physical examination: r30 times/minute, wheezing in both lungs. Considering that it was caused by cimetidine, stop the fluid immediately, take oxygen, give aminophylline 0. 125g intravenous drip, hydrocortisone 0. 1g intravenous drip, and then relieve.
1.1/Severe jaundice reported in Yang Xuejin1A 50-year-old male patient was given 5% glucose injection cimetidine 0.6g 1 time /d, and symptoms such as itchy skin, yellow eyes and yellow urine appeared the next day. After physical examination and liver function examination, consider pressing "icteric hepatitis". After that, it was treated with "bile stasis of drug-induced liver disease" and prednisone 25mg was given three times a day. After 7 days, symptoms were relieved and liver function was restored.
1. 12 headache, increased heart rhythm, rapid breathing, Leng Lingjuan, etc. 1 case of upper gastrointestinal bleeding, given cimetidine 800mg intravenous drip, 30 ~ 40 drops/min, about 1 hour later, headache, dizziness and discomfort in the heartache area occurred; After 3 hours, p 124 times/min, r27 times/min; Electrocardiogram showed sinus heart rate, and heart rate and breathing gradually became normal after stopping taking medicine. The second day, the same adverse reactions occurred when taking cimetidine, and the same symptoms occurred when taking 0.4g of cimetidine orally, but no such adverse reactions were found after taking ranitidine orally.
2 Causes of adverse reactions
2. 1 pharmaceutical factors the chemical structure of cimetidine is directly related to its pharmacological activity, and its structure will also produce corresponding adverse reactions; In addition, the impurities in cimetidine raw materials are also related to its adverse reactions, so the impurity limit control in quality standards is a necessary condition to ensure drug safety.
2.2 Factors of patients Individual differences of patients are the factors leading to adverse reactions, and patients' age, gender, pathology and physiological conditions will all affect the adverse reactions of drugs.
Among the above adverse reactions, myocardial damage accounted for 12 cases, mental abnormality accounted for 8 cases, and anaphylactic shock accounted for 4 cases. It is suggested that skin test should be done before using cimetidine, and intravenous injection should be avoided as far as possible to avoid allergic reaction.
Reyanling capsule has never been used, so it is impossible to determine its composition. It is estimated that it is a medicine for dispelling fire and dispersing stagnation, and the side effects should not be great. If it is too much, it is estimated that it will have some influence on the liver.
Metronidazole is a broad-spectrum antibacterial antibiotic, which is used to treat anaerobic infection. There are the following toxic and side effects, but metronidazole tablets, as improved tablets of metronidazole, have little toxic and side effects, so they are widely used.
1 is mild, with nausea, vomiting, loss of appetite, abdominal pain, diarrhea, occasional urticaria, itching, numbness of limbs and abnormal sensation.
If you find symptoms of central nervous system poisoning such as headache, neurasthenia and dyskinesia, you should stop taking the medicine immediately.
All mental patients, pregnant women and lactating women are prohibited.
4 people with liver dysfunction should not use it.
Azithromycin is generally safe. Its side effects occasionally appear after some people take it, mainly gastrointestinal symptoms, such as nausea, stomach upset, loose stool in infants, and others have rashes, but these are rare. However, it should be noted that it is forbidden for people who are allergic to macrolides or other macrolides. Use with caution in patients with severe liver and renal insufficiency. Pregnant women and lactating women should weigh the advantages and disadvantages before deciding whether to use them. Not suitable for use with antacids and ergot derivatives. Please read the instructions carefully before use.
If you take Dexamethasone Acetate Tablets (Flumethasone) at a regular therapeutic dose, it will not affect your health.
However, high dose of this product is easy to cause diabetes, digestive tract ulcer and Cushing-like syndrome, and has a strong inhibitory effect on hypothalamus-pituitary-adrenal axis. Concurrent infection is the main adverse reaction.
Contraindications are prohibited for patients with allergic history of this product and adrenocortical drugs. Patients with hypertension, thrombosis, gastric and duodenal ulcer, psychosis, abnormal electrolyte metabolism, myocardial infarction, visceral surgery, glaucoma, etc. Usually not suitable for use. Under special circumstances, weigh the advantages and disadvantages, but pay attention to the possibility of deterioration.
Tretinoin cream (0.025% divaricate acid) is generally produced by Chongqing Huabang Pharmaceutical Co., Ltd., and the notice is 1. This product can produce adverse reactions such as headache, dizziness (patients under 50 years old are more than the elderly), dry mouth and desquamation. If you control the dosage or take oryzanol, vitamin b 1, b6 and other drugs at the same time, you can alleviate or reduce the headache and other reactions. Now it is made into esters for oral administration to reduce side effects. 2. It can cause liver injury, and should be used with caution for those with poor liver and kidney function. 3. For external use, it should be avoided to be used in the wrinkles with thin skin, and the concentration should not be too high (below 0.3% is appropriate) to avoid local irritation such as erythema, peeling, burning sensation and slight pain. If these reactions are mild, we should insist on continuing treatment. If the reaction is serious, the drug should be stopped immediately. 4. Not suitable for acute dermatitis and eczema. 5. When treating serious skin diseases, it can be combined with corticosteroids, antibiotics and other drugs to increase the curative effect.
So to sum up, read the instructions in detail and contact the attending physician in time. If you encounter special circumstances, especially allergies, you must go to the hospital for treatment. Another point is to avoid spicy food, keep a good mood and take appropriate outdoor activities during taking medicine. Of course, if the outdoor sunshine is strong, you must take an umbrella to prevent ultraviolet rays. I wish you a speedy recovery!