Pharmacology and toxicology
The oral absorption of lincomycin is poor, and the blood concentration reaches the peak at 0.5 hour after intramuscular injection, and intravenous administration is faster. Clindamycin was absorbed 90% orally and reached the peak in blood at 65438 0 ~ 2 hours, 2.5 hours after intramuscular injection and 30 minutes after intravenous drip. Drugs can be distributed to various tissues, especially bone tissues. It is mainly metabolized in the liver and excreted through bile and feces. Oral administration of these drugs is prone to gastrointestinal irritation, and long-term use can cause acute pseudomembranous enteritis and liver injury, and some patients may have allergic reactions.
Diagnostic points
1. medical history has a history of using such drugs.
2. The main side effects of clinical manifestations are gastrointestinal irritation, such as nausea, vomiting, anorexia and diarrhea. Long-term use can cause symptoms similar to acute pseudomembranous enteritis, such as intractable diarrhea, high fever, purulent bloody stool and so on. Occasionally rash, stomatitis, eosinophilia, liver function damage, proteinuria, hematuria and so on. A rare and serious reaction is a large dose of rapid intravenous drip or push injection, which can cause fainting, blood pressure drop, ECG changes, and even respiratory and heartbeat stops.
Emergency treatment and prevention
(1) Patients with acute pseudomembranous enteritis were given vancomycin 0.5g orally, four times a day. Or metronidazole 0.2g orally, 4 times a day.
(2) In case of syncope or blood pressure drop, the drug should be stopped immediately, that is, adrenocortical hormone, m-hydroxylamine, dopamine and other vasoactive drugs should be given to maintain blood pressure. Artificial respiration, cardiac compression and resuscitation drugs should be performed when the heartbeat and breathing stop (see relevant chapters).
(3) symptomatic treatment.
(4) To prevent severe hepatic and renal insufficiency, pregnant women and newborns should use it with caution.