Sodium bicarbonate, also called baking soda, is often used in this kind of drugs. It is a white and salty tablet, which bubbles when it meets acidic substances and produces carbon dioxide gas. After oral administration, it can quickly neutralize excessive gastric acid in the stomach, but the effect lasts for a short time. Take 0.5- 1.0g orally, three times a day, and the effect is better before meals. It should be noted that sodium bicarbonate will produce a large amount of carbon dioxide gas when neutralizing gastric acid, which will increase the pressure in the stomach. Patients with severe gastric ulcer may cause gastric perforation, so patients with gastric ulcer should use it with caution. Moreover, taking it in large quantities for a long time, alkalized blood may cause alkalemia, which should also be paid attention to.
Category II: Non-absorbable antacids include metoclopramide (compound aluminum hydroxide tablets) and aluminum hydroxide gel.
These drugs contain hard-to-absorb cations, which can only neutralize the stomach after oral administration and cannot be absorbed by the gastrointestinal tract. It has the functions of neutralizing gastric acid, protecting ulcer surface and stopping bleeding locally, with weak, slow and lasting effect. At present, tablets are rarely used, and aluminum hydroxide gel is mostly used. Every time 10- 15 ml, 3-4 times a day, before meals and before going to bed 1 hour. Because it can cause constipation, patients with long-term constipation should use it with caution. In addition, a very small amount of drugs can be converted into aluminum chloride in the stomach, absorbed and excreted from urine. Patients with renal insufficiency can increase the concentration of aluminum ions in blood after taking it, which may cause dementia, so they should be cautious when using it.
Antipyretic and analgesic drug-aspirin
Synthetic Antimicrobial Agents-Sulfonamides
Antibiotic-penicillin
The role of penicillin: it can prevent the growth of various bacteria and treat various inflammations.
Type: f, g, x, k, v.
Among them, penicillin G (common name: penicillin) is the most commonly used.
Note: Skin allergy test must be carried out before use.
1. Selection of drugs
(1) The right medicine is the first principle. If the cause is unknown, you must seek medical attention in time.
Blind medication. Drugs should not be taken indiscriminately. It is necessary to keep in mind the truth that "taking medicine when you are sick is harmful and useless".
② Pay attention to drug quality. Keywords pills are discolored, deliquescent and spotted, pills are moth-eaten and moldy, syrup,
Plaster mildew, fermentation, liquid medicine turbidity precipitation and other deterioration phenomena, do not choose.
2. Usage and dosage of drugs
① Is the oral medicine taken before meals, after meals or before going to bed?
Taking medicine before meals, after meals or before going to bed depends on the purpose of taking medicine, the time of absorption and excretion of medicine and the stimulation of medicine to gastrointestinal tract.
② Usage and dosage of drugs
Strictly control the dosage, which is a three-point poison.
Generally, warm water is used to take medicine, and it is generally not appropriate to drink tea during taking medicine, because the ingredients in tea and the ingredients of medicine will react chemically.
Drugs that can only be bought with a doctor's prescription.
The so-called prescription drugs mean that they can only be obtained from pharmacies or pharmacies after being prescribed by doctors, and they must be monitored or referred by doctors.
Drugs used under the guidance. Prescription drugs, or R (doctor's prescription), are usually used internationally.
R) It is common in the upper left corner.
Prescription drugs generally include: new drugs just listed: their activities and side effects need further observation; can
Some drugs that produce dependence: such as morphine analgesics and some hypnotics; The toxicity of the drug itself
Larger: such as anticancer drugs; Some diseases must be diagnosed by doctors and laboratories, and doctors need drugs.
Prescription and use under the guidance of a doctor, such as cardiovascular drugs.
Over-the-counter drugs/medicines
Contrary to prescription drugs, over-the-counter drugs refer to consumers who can buy drugs directly from pharmacies without a doctor's prescription.
Or drugs bought at a pharmacy. The commonly used term in the world is: over-the-counter drugs.
OTC drugs, referred to as OTC drugs, have now become an international idiom for OTC drugs.
Most of these drugs belong to the following situations: cold, fever, cough; Diseases of digestive system; Headache;
Joint diseases; Allergies such as rhinitis; Nutritional supplements such as vitamins and some traditional Chinese medicine supplements.
Antihypertensive drugs play a hypotensive role mainly by affecting the sympathetic nervous system, renin-angiotensin-aldosterone system and endothelin system, which play an important role in the physiological regulation of blood pressure. Commonly used antihypertensive drugs are: sympathetic nerve inhibitors such as clonidine, guanidine, prazosin, propranolol and so on. Antihypertensive drugs that mainly affect blood volume, such as hydrochlorothiazide; Angiotensin I invertase inhibitors, such as captopril; Calcium antagonists such as nifedipine and drugs that directly relax vascular smooth muscle such as hydralazine.
1. Why do you want to take medicine for hypertension?
Generally speaking, hypertension is a chronic disease. Most patients need long-term drug treatment to effectively control their blood pressure to the target level (generally speaking, the blood pressure is required to be lower than 140/90mmHg), which can not only reduce cardiovascular and cerebrovascular events, such as preventing the occurrence and progress of stroke, coronary heart disease, heart failure and kidney disease, but also effectively reduce the risk of death.
2. What are the common antihypertensive drugs? Principles of drug selection in different situations
In recent 40 years, with the progress of medical science and technology, new antihypertensive drugs have been published continuously, and all of them have been scientifically evaluated by large-scale clinical trials. At present, the first-line antihypertensive drugs commonly used in China mainly include diuretics (such as hydrochlorothiazide and furosemide), beta blockers (such as betaloc), angiotensin converting enzyme inhibitors (ACEI) (such as captopril), angiotensin II receptor blockers (ARB) (such as Dai Wen) and calcium antagonists (CCB, such as betaloc).
As the name implies, antihypertensive drugs have the same function of lowering blood pressure, but different types of antihypertensive drugs have different emphasis due to different antihypertensive mechanisms, which is the basis for doctors to choose different antihypertensive drugs for patients with different conditions.
1) Thiazine diuretics (such as hydrochlorothiazide) are more effective in reducing systolic blood pressure than diastolic blood pressure, and are more suitable for elderly patients with isolated systolic hypertension or heart failure. Attention should be paid to avoid hypokalemia in application. If there is hyperuricemia or gout, please be sure to inform your doctor to avoid using such drugs.
2) Beta blockers are suitable for hypertensive patients with angina pectoris, myocardial infarction, heart failure, tachyarrhythmia, glaucoma and pregnancy, but if they have asthma or peripheral vascular diseases, they should not be used. At the same time, these drugs will also affect the metabolism of sugar and lipid, thus increasing the risk of diabetes.
3) ACEI drugs are more suitable for patients with insulin resistance, diabetes, left ventricular dysfunction, heart failure and myocardial infarction. At the same time, ACEI and ARB are beneficial to prevent the progression of kidney disease, but they should not be used in pregnant women.
4) Long-acting CCB (such as "Baixintong") has a good effect on preventing stroke, vascular dementia and anti-atherosclerosis, but has no effect on sugar, lipid and electrolyte metabolism.
5) Alpha blockers (not mentioned above, but also commonly used) are suitable for elderly patients with prostatic hyperplasia or lipid metabolism disorder.
3. On the principle of single drug and small dose
When hypertension is not serious, we can start treatment with a small dose of drugs, so that we can not only understand the patient's response to the efficacy and tolerance of a drug, but also minimize the adverse reactions. If the curative effect of small dose is not good, you can increase the dose or change the medicine (especially for elderly patients). If blood pressure is still out of control, we should consider a combination of drugs.
4. Why should several antihypertensive drugs be used in combination?
For most hypertensive patients, if the above-mentioned single drug therapy still can't control their blood pressure, and the increase of drug dosage is often accompanied by the aggravation of adverse reactions (such as cough caused by ACEI), patients are often unbearable. At this time, according to the synergistic effect of different types of antihypertensive drugs, the antihypertensive effect can be increased without increasing or slightly increasing adverse reactions. We usually choose two or more low-dose antihypertensive drugs to combine drugs to make blood pressure reach the standard. At present, combined medication has become the mainstream concept and method to control blood pressure, so there is no need to worry too much about whether multiple drugs will produce more adverse reactions. However, it should be remembered that combined medication is not the repeated use of the same antihypertensive drug, because the curative effect is not good and the risk of adverse reactions increases.
5. Is the fixed compound preparation also a combination drug? What are the common compound antihypertensive drugs? At present, there is also a very common form of combined medication, which is fixed compound antihypertensive drugs. Although we can't adjust the dosage of different components, it is convenient for patients to use. At present, the common compound antihypertensive preparations are: 1) haijieya: each tablet contains losartan 50mg or 10mg/ hydrochlorothiazide 12.5mg or 25mg, which complement each other. The latter can reduce blood potassium and increase uric acid level, while the former can prevent blood potassium loss, reduce uric acid level and play a role in preventing metabolic abnormalities; 2) Ambono: each tablet contains irbesartan 150mg/ hydrochlorothiazide12.5mg; ; 3) compound captopril tablets: each tablet contains captopril 10mg/ hydrochlorothiazide 6 mg; 4) Propranolol: each tablet contains perindopril 2mg/ indapamide 0.625mg；; 5) No release: each tablet contains bisoprolol 2.5mg/ hydrochlorothiazide 6.25mg；; ; 6) Reprint: each tablet contains valsartan 80 mg/ hydrochlorothiazide12.5mg; 7) Beijing Jiangya No.0: each tablet contains hydrochlorothiazide 12.5mg, triamcinolone acetonide 12.5mg, dihydralazine sulfate 12.5mg and reserpine 0.1mg; ; 8) Compound antihypertensive tablets: each tablet contains reserpine 0.032mg, hydrochlorothiazide 3.lmg, vitamin B6l.0mg, calcium pantothenate/kloc-0.0mg, magnesium trisilicate 30mg, potassium chloride 30mg, vitamin B6 1.0mg, hydralazine 4.2mg and promethazine 2.lmg；; 9) Compound amiloride hydrochloride tablets: each tablet contains amiloride hydrochloride 2.5mg/ hydrochlorothiazide 25mg；; 10) Zhenju jiangya tablets: each tablet contains clonidine 0.03mg, hydrochlorothiazide 5mg and rutin 20mg.
6. What is a long-acting antihypertensive drug? Why use long-acting antihypertensive drugs? Generally speaking, antihypertensive drugs marked with "sustained release" or "controlled release" on prescriptions or medicine boxes are long-acting preparations, such as our common Paixintong (nifedipine controlled release tablets), Boydine (felodipine sustained release tablets), Pell (nicardipine hydrochloride sustained release capsules) and so on. Generally speaking, long-acting antihypertensive drugs are more expensive than ordinary preparations. Why use them? Because doctors found in clinical practice that keeping blood pressure within the target range 24 hours a day can effectively prevent sudden death, stroke or heart attack caused by low blood pressure at night and sudden increase of blood pressure in the morning, and can reduce organ damage caused by high blood pressure. At the same time, the frequency of taking medicine once a day can also prevent patients from forgetting to take medicine, so that blood pressure can meet the requirements of effective, stable and long-term control.
7. What are the adverse reactions of antihypertensive drugs and how should they be treated? Adverse reactions are what we generally call "side effects". As the saying goes, "three drugs are toxic." While controlling blood pressure, antihypertensive drugs may also have some adverse effects on our health. For example, the diuretic hydrochlorothiazide will lead to the decrease of blood potassium and the increase of uric acid; ACEI drugs (such as captopril) may cause cough and vascular edema; Calcium antagonists may also cause headache, edema, flushing and so on. So how should patients treat these adverse reactions? First, don't be scared to take medicine by the adverse reactions in the instructions, which will delay your illness. Second, don't ignore the adverse reactions, write down your feelings, notify the doctor when necessary or at the time of follow-up, and ask the doctor to help you adjust the treatment plan from a professional perspective. Generally speaking, our commonly used antihypertensive drugs have been tested by long-term multi-center clinical practice, and their safety is still relatively high.
8. When is the best time to take antihypertensive drugs?
Generally speaking, our daily blood pressure level fluctuates regularly: there are two peak times of blood pressure in 24 hours, namely 6- 10 in the morning and 4-8 in the afternoon (the so-called "spoon curve"). Then taking medicine half an hour before these two peaks will have a better antihypertensive effect. However, there are some special cases, such as some patients with high blood pressure in the early morning and need to take medicine before going to bed. But then again, when most people go to sleep at night, their blood pressure drops by about 20% compared with that during the day. Therefore, taking antihypertensive drugs before going to bed can easily lead to a sharp drop in blood pressure, leading to insufficient blood supply to organs such as heart, brain and kidney. So whether to take medicine before going to bed, be sure to consult your doctor on the basis of blood pressure monitoring.
9. Do antihypertensive drugs need to be given or changed?
Our blood pressure will be influenced by many factors, such as diet, working environment, interpersonal communication and so on. Such as busy work, emotional excitement, cold climate, and sometimes even eating more animal fat will raise blood pressure. Since blood pressure changes, drugs naturally need to be adjusted, but this does not mean that they should be adjusted at any time. General "old patients" have worked out a set of adjustment strategies suitable for them in the long-term medication process. At the same time, under the guidance of doctors, for "new patients" or in the case of great changes in their condition, they still need to see a doctor in time. Please ask your doctor to make a new plan for you. But remember not to stop taking drugs at will, especially after some patients have achieved good antihypertensive effect, they begin to be careless, don't monitor their blood pressure often, and often miss taking antihypertensive drugs; What's more, if you find that your blood pressure is still normal for a few days after you stop taking drugs regularly, you will subjectively think that you are "cured". In fact, this is just a "follow-up effect" caused by the fact that antihypertensive drugs are not metabolized in the body. Once the antihypertensive effect disappears, your blood pressure will soar again, so you must not stop taking the medicine at will.
The problem of dressing change of antihypertensive drugs is also the focus of discussion. Generally speaking, although there are many kinds of antihypertensive drugs, your doctor will generally choose the best individual treatment plan for you according to the characteristics of different kinds of antihypertensive drugs and his own clinical experience. However, some patients worry that long-term use of antihypertensive drugs will produce "drug resistance" like antibiotics. After a long time, they will start to worry. Actually, there is no need to think so. Hypertension itself is a long-term treatment process, as long as it is used under the guidance of a doctor, it is relatively safe. As for whether to replace antihypertensive drugs, it generally depends on several factors, such as the curative effect of drugs, the patient's tolerance to adverse reactions, the change of his condition, and whether he can buy drugs. If these points are all right, you don't have to change the medicine at will.
10. What common drugs can raise blood pressure?
In daily life, we often encounter antihypertensive drugs such as licorice, oral contraceptives, steroid hormones, non-steroidal anti-inflammatory drugs (such as acetaminophen and ibuprofen), cocaine, amphetamine, erythropoietin and cyclosporine. If you are going to take or taking these drugs, be sure to tell your doctor so that he can adjust your antihypertensive plan.
1 1. What antihypertensive drugs should pregnant expectant mothers use? ACEI and ARB antihypertensive drugs (such as captopril and valsartan) are not suitable for pregnant women because they may cause fetal growth retardation, oligohydramnios, neonatal renal failure and fetal malformation. The second is diuretic, because it can further reduce blood volume and aggravate fetal hypoxia.
Principles of use of antihypertensive drugs ◇ You should not rush to achieve success when taking antihypertensive drugs, and your blood pressure should not rise too fast, but should be gradually and steadily reduced. The choice of drugs should vary from person to person and suit the remedy to the case. ◇ The first treatment should start with a single drug and gradually add drugs. Severe hypertension is an exception. ◇ Combination medication is superior to high-dose single medication. ◇ Mastering and using several drugs skillfully, new drugs, expensive drugs and imported drugs are not necessarily the best. You can't suddenly stop taking drugs or a drug. ◇ Dose should be sufficient according to the regulations. ◇ Choose drugs that don't affect mood and thoughts. ◇ Unless it is necessary to change the treatment plan, the drug treatment of most patients must continue.
Antibiotics are a kind of secondary metabolites produced by microorganisms (including bacteria, fungi and actinomycetes) or higher animals and plants in the course of life, which have anti-pathogen or other activities and can interfere with the development function of other living cells.
There are the following categories: (1)β- lactams: Penicillins and cephalosporins contain β -lactam rings in their molecular structures. Great progress has been made in recent years, such as thienomycin, mono-lactam, β -lactamase inhibitor and methoxypenicillin. (2) Aminoglycosides: including streptomycin, gentamicin, kanamycin, tobramycin, amikacin, neomycin, ribomycin, micronomicin, astemycin, etc. (3) Tetracyclines: including tetracycline, oxytetracycline, chlortetracycline and doxycycline. (4) Chloramphenicol: including chloramphenicol, thiamphenicol, etc. Macrocyclic lipids: erythromycin, leucomycin, odorless erythromycin, acetylspiramycin, midecamycin, josamycin and azithromycin are commonly used in clinic. (6) Other antibiotics acting on G+ bacteria, such as lincomycin, clindamycin, vancomycin and bacitracin. (7) Other antibiotics acting on G bacteria, such as polymyxin, fosfomycin, cyclosporine, rifampicin, etc. (8) Antifungal antibiotics: such as griseofulvin. (9) Antitumor antibiotics: such as mitomycin, actinomycin D, bleomycin, adriamycin, etc. (10) cyclosporine and other immunosuppressive antibiotics.
The following basic principles must be considered in the clinical application of antibiotics: (1) Strictly grasp the indications, try not to use them, and besides considering the pertinence of antibacterial effects of antibiotics, we should also grasp the relationship between adverse drug reactions and internal processes and curative effects. (2) People with fever of unknown cause should not use antibiotics, except those who are critically ill and highly suspected of being infected with bacteria. People with fever of unknown cause should not use antibiotics, because the use of antibiotics often makes it difficult to detect pathogenic microorganisms, and makes clinical manifestations atypical, affecting clinical diagnosis and delaying treatment. (3) Viral diseases or diseases estimated to be viral infections have no curative effect on various viral infections without antibiotics, and it is also harmless and useless to treat patients with measles, mumps, colds and influenza with antibiotics. More than 90% of patients with angina pectoris and upper respiratory tract infection are caused by viruses, so antibiotics are generally not used except those who are infected by bacteria. (4) Try to avoid the reaction of skin and mucous membrane. After using antibiotics, allergic reactions and drug-resistant bacteria are easy to occur. Therefore, in addition to the main local antibiotics such as neomycin and bacitracin, the local application of other antibiotics, especially penicillin G, should be avoided. Appropriate time and dosage should be selected when antibiotics are used to treat ocular mucosa and skin burns. (5) Strictly control the scope of preventive antibiotics. Preventive treatment can be taken in the following cases: 1. Patients with rheumatic fever should be given penicillin G regularly to eliminate hemolytic streptococcus in the pharynx and prevent the recurrence of rheumatic fever. 2. Use penicillin G or other suitable antibiotics before and after rheumatic or congenital heart disease surgery to prevent subacute bacterial endocarditis. 3. Appropriate antibiotics should be selected according to the sensitivity of the pathogen when the infected focus is removed. 4. Penicillin G or tetracycline family is used to prevent gas gangrene after war injury or compound trauma. 5. Before colon surgery, the intestine is ready to use kanamycin and neomycin. 6. After severe burns, penicillin G was used to eliminate the infection of hemolytic streptococcus on the wound surface before skin grafting. Or according to the wound bacteria and drug sensitivity results, use appropriate antibiotics to prevent septicemia. 7. Patients with chronic bronchitis and bronchiectasis can be given preventive antibiotics in winter (outpatient only). 8. Antibiotics before brain surgery 1 day can prevent infection. (VI) Emphasize the importance of comprehensive treatment In the process of using antibiotics to treat infectious diseases, we should fully realize the importance of the human defense mechanism, and we should not rely too much on the efficacy of antibiotics and ignore the internal factors of the human body. When the quality and quantity of human immunoglobulin are insufficient, the cellular immune function is low, or the performance and quality of phagocytes are insufficient, antibiotic treatment is difficult to be effective. Therefore, when using antibiotics, we should try our best to improve the general condition of patients; Take various comprehensive measures to improve the body's low resistance, such as reducing the patient's excessive body temperature; Pay attention to diet and rest; Correct the imbalance of water, electrolyte and alkali; Improve microcirculation; Replenish blood volume; And the treatment of local diseases.
Continuous use of antibiotics should not exceed one week.