On November 13, the 2023 “National Safe Medication Month” event was launched in Beijing. It is reported that the “National Safe Medication Month” activity is an important science popularization brand activity in the field of drug safety. With the theme of “Safe Medication and Health for the People”, this year’s Safety Month continues to popularize drug safety knowledge through drug safety online knowledge competitions, drug safety interactive experience activities, drug inspection public open day activities, and “Looking for the Most Beautiful Pharmacist Around You” activities. , promote social co-governance.
At the launching ceremony, Wang Aiguo, Vice Chairman and Secretary-General of the Chinese Pharmaceutical Association, released the top ten medication tips for 2023, calling on everyone to pay attention to safe medication use, learn medication knowledge, and promote national health.
1. “Cough” should not be dealt with slowly and skillfully. Choose the correct expectorant.
Cough is one of the most common symptoms of the respiratory system. It is a defensive reflex action caused by irritation of the respiratory mucosa. Coughing can clear respiratory secretions and airway foreign bodies. In pathological conditions such as respiratory inflammation, the increase in respiratory secretions can aggravate coughing, and large amounts of sputum can also block the respiratory tract and cause breathing difficulties, allowing pathogens to breed and easily cause infection. When coughing fails to expel phlegm smoothly, expectorants can be considered for symptomatic treatment.
Common expectorants include:
Nausea irritating expectorant. Representative drugs: ammonium chloride, guaiacol glyceryl ether, often used in compound preparations with other antitussive and expectorant drugs, such as compound licorice oral solution, brown ammonium mixture, etc. After taking it, it stimulates the gastric mucosa and causes mild nausea. It reflexively causes the secretion of tracheal and bronchial glands to increase, making sputum thinner and easier to cough up. Excessive doses of these drugs can cause many adverse reactions, such as vomiting, abdominal distension, heart palpitations, etc., and should be used with caution especially in patients with liver and kidney dysfunction.
Stimulant expectorant. Representative drugs: eucalyptus oil, guaiacol, benzoin tincture, turpentine, etc. These drugs are mainly volatile substances that have a mild stimulating effect on the respiratory mucosa. They can cause mild congestion of the mucous membrane, accelerate local blood circulation, and at the same time moisten the respiratory tract. Through the above effects, the viscosity of sputum is reduced, making it easier to cough up. . At the same time, this type of drug also has a certain disinfection and antiseptic effect and can inhibit the growth of respiratory bacteria.
Mucolytic drugs. Representative drugs: bromhexine, acetylcysteine, ambroxol, standard myrtle oil, carbocysteine, etc. This type of drug can decompose mucopolysaccharide fibers in sticky sputum, or inhibit the synthesis of acidic glycoproteins, while decomposing mucin, thereby reducing the viscosity of sputum and making it easier to cough up. Strongly acidic drugs can significantly reduce the effect of acetylcysteine and should be avoided in combination.
Patients should seek medical treatment promptly to identify the causes of increased sputum, and choose appropriate treatment options under the guidance of doctors and pharmacists. It should be noted that expectorants are only one aspect of the treatment of respiratory diseases such as pneumonia and bronchitis. In many cases, they need to be combined with a variety of other drugs for comprehensive treatment. Therefore, when using expectorants, attention should be paid to the issue of combined medications. When using expectorants, care should be taken to avoid using strong antitussives at the same time, because expectorants dissolve and dilute sticky phlegm and enhance ciliary movement to promote sputum discharge. At this time, combined use of strong antitussives will make it impossible to cough up sputum. The purpose of eliminating phlegm cannot be achieved, and only those with severe coughs need antitussives for control.
2. What to do about diarrhea in autumn, timely intervention to protect your health
Autumn diarrhea occurs most frequently from October to December. It is generally an acute intestinal infectious disease caused by rotavirus infection. The main transmission route is fecal-oral transmission. The main symptoms are vomiting and increased frequency of stools, which are egg drop soup-like or watery, and may be accompanied by fever, nausea and abdominal pain. If effective intervention and treatment are not carried out in time, it may cause dehydration and electrolyte imbalance, leading to death and other serious consequences.
It is most important to prevent and reduce the occurrence of intestinal infectious diseases, develop good personal hygiene habits, and prevent “diseases from entering through the mouth”. If diarrhea symptoms occur, treatment drugs should be selected based on your own situation.
1. Oral rehydration salts: Severe diarrhea often leads to a large loss of water and electrolytes, causing dehydration. The first principle of diarrhea treatment is to prevent and treat dehydration. Oral rehydration salts are an economical, simple and effective treatment method. For children with diarrhea, oral rehydration salt III can be chosen.
When using rehydration salt III, dissolve a complete bag of rehydration salt in 250 ml of warm water. The amount of water must be accurate, otherwise the solution will be too thin or too concentrated, affecting the osmotic pressure and thus the efficacy of the medicine. Do not dissolve a bag into several times, as it cannot be divided accurately and will affect the osmotic pressure and electrolyte concentration. After it cools down, you can heat it over water. Do not add hot water directly to it. Do not add sugar, milk, juice, etc. to avoid affecting the effect. When feeding oral rehydration salt III to a child, follow the principle of small amounts and often times. If the child vomits, stop feeding for 10 minutes before feeding slowly.
2. Microecological preparations (live bacterial preparations): Virus invasion will cause an imbalance in the intestinal flora. Appropriate supplementation of probiotics will help maintain normal intestinal peristalsis, promote intestinal function to restore normal ecological environment and physiological functions, and relieve diarrhea symptoms. Probiotics should be taken after meals, and live bacteria preparations can be taken with warm water, but the temperature should not be higher than 40°C. Most probiotics have temperature requirements for storage, and must be stored according to instructions.
3. Antidiarrheal agents: Commonly used are montmorillonite powder, which has strong fixation and adsorption effects and has the ability to protect the mucous membrane of the digestive tract. This type of drug itself is not absorbed and can absorb toxins and be excreted from the body after taking them. You should avoid eating and drinking within 2 hours after taking the medicine to prevent the montmorillonite powder from adsorbing and adhering to food and affecting the coverage of the medicine at the diseased site. It is recommended that the interval be more than 2 hours when combined with general drugs. When using antibacterial drugs or microbial preparations in combination, it is recommended to take the antibacterial drugs first, then use montmorillonite powder, and the microbial preparations should be placed last, and the three should be separated by 1-2 hours. .
3. When a tragedy of myocardial infarction occurs, scientific prevention is the key
Cardiovascular disease has always been the number one killer of national health, and the mortality rate of acute myocardial infarction ranks first among cardiovascular and cerebrovascular diseases. Once a myocardial infarction occurs, it enters the “countdown mode”, and the treatment of myocardial infarction is a “race against time.”
There are many factors that affect cardiovascular health, and a lot of them are related to lifestyle. Therefore, if you want to stay away from cardiovascular diseases, you should pay attention to the following in your life:
1. Develop a healthy lifestyle: don’t smoke, increase physical exercise appropriately, improve sleep, eat properly, maintain a healthy weight, and keep your mood relaxed. It is crucial to prevent myocardial infarction and recover after myocardial infarction. These cannot be replaced by any medicine or treatment.
2. Regular physical examination: It is extremely important to participate in a physical examination once a year to understand your physical condition, especially for middle-aged and elderly people. In addition, in addition to routine examinations, a carotid artery ultrasound examination can be added to determine the progress of atherosclerosis through non-invasive ultrasound. If carotid artery plaque is found and there are multiple risk factors (such as smoking, high blood pressure, high blood lipids and high blood sugar, etc.), statin therapy can be carried out under the guidance of a doctor.
3. Drug prevention: For high-risk groups, especially those who have had myocardial infarction, secondary prevention should be actively carried out. It is necessary to choose to take drugs to prevent myocardial infarction and improve the prognosis under the guidance of doctors and pharmacists. Such as anti-platelet drugs, lipid-lowering drugs, beta-blockers, angiotensin-converting enzyme inhibitors (ACEI)/angiotensin II receptor blockers (ARB), etc. Do not stop medication at will.
4. High blood pressure should not be ignored, and medication should be used rationally and not indiscriminately.
Hypertension is a relatively high-incidence and common disease. Treatment of hypertension should follow the treatment plan of a cardiovascular physician. Targeted treatment can get twice the result with half the effort.
There are five main categories of antihypertensive drugs used clinically:
Calcium channel blockers are widely used, including nifedipine, felodipine, and amlodipine besylate. These drugs are more suitable for patients with hypertension and arteriosclerosis. This type of medicine lowers blood pressure safely and long-lastingly, but may cause problems such as facial flushing and ankle edema.
Angiotensin-converting enzyme inhibitors (ACEI), representative drugs include captopril, enalapril, benazepril, etc., are more suitable for patients with hypertension, proteinuria, diabetes, and changes in cardiac morphology. They have obvious antihypertensive effects and help improve heart function, but some patients will have adverse reactions such as dry cough after taking them.
Angiotensin II receptor blockers (ARB), representative drugs include losartan, valsartan, irbesartan, telmisartan, etc. These drugs are suitable for patients with high blood pressure and diabetes, or high blood pressure and People with proteinuria.
Beta-blockers, representative drugs include propranolol, metoprolol, atenolol, etc., are mainly targeted at high blood pressure, mainly high diastolic blood pressure, and are better for anxiety disorders and high blood pressure dominated by mental factors. The effect is suitable for patients with high blood pressure accompanied by tachycardia, or with angina pectoris and myocardial ischemia.
Diuretics mainly achieve the purpose of lowering blood pressure by reducing blood volume. Representative drugs include hydrochlorothiazide, indapamide, etc., and are suitable for combined use with other types of antihypertensive drugs.
The use of antihypertensive drugs should also follow the following principles: follow the doctor’s advice, start with a small dose, and give priority to long-acting preparations, which can maintain long-term and stable blood pressure; use in combination, a combination of low-dose multiple drugs is better than a large-dose single drug; individualized medication, Consider both patient tolerance and drug effectiveness.
5. Commonly used statins for lowering lipids. Four major points to note.
Statins, as the most classic and effective lipid-lowering drugs, have been widely used in people with hyperlipidemia. In daily life, you should pay attention to a light diet, mainly a low-fat, low-salt balanced diet, pay attention to reducing cholesterol intake, ensure adequate sleep, and moderate exercise. In addition, when using statins, you should pay attention to:
1. Pay attention to the medication time. Cholesterol synthesis has a circadian rhythm and is most synthesized at night, so most statins are recommended to be taken before going to bed. However, atorvastatin and rosuvastatin have longer-lasting effects and can be taken at a fixed time every day. Take the dose in accordance with the doctor’s instructions. If you miss a dose, take it as soon as you remember. Some may need to take twice the amount of medicine before the next dose.
2. Adhere to taking medicine for a long time. Lipid lowering is a long-term process. For most patients, even if blood lipids have returned to normal, they still need to continue taking statins. However, blood lipids, transaminases, creatine kinase, etc. need to be regularly monitored and the drug treatment plan adjusted.
3. Beware of adverse reactions. Statins are well tolerated by most patients, and side effects are usually mild and short-lived, and discontinuation of medication is generally not required. However, once adverse reactions such as muscle soreness or weakness, muscle spasm, or darkening of urine are found, the drug must be stopped immediately and seek medical treatment in time. Carry out relevant examinations under the advice of your doctor and take appropriate adjustment measures according to the situation.
4. Pay attention to interactions. There are interactions between statins and many drugs, which can lead to a reduction in therapeutic effect or an increase in adverse reactions. When using other drugs in combination, be sure to consult a doctor or pharmacist. In addition, do not consume grapefruit or grapefruit juice while taking the medicine, as it will increase damage to the liver and muscles.
6. Commonly used oral medicines for children, you need to know the different usages
There are certain differences between medication for children and medication for adults, and children’s characteristics are usually taken into consideration in terms of dosage form. Currently, commonly used oral dosage forms for children include dry suspensions, granules, oral liquid preparations, tablets and capsules. The oral liquid preparations include solutions, syrups, suspensions, etc., and the tablets include chewable tablets, sustained-release tablets, effervescent tablets, dispersible tablets, etc.
When choosing medications, attention should be paid to selecting medications that are suitable for children, taking into account both drug effects and children’s acceptance. Generally speaking, children under 3 years old have poor swallowing ability and should not directly swallow solid drugs such as tablets and capsules. They can choose drugs in granular or liquid dosage forms. For older children, you can choose tablets or chewable tablets, which are more convenient. Different oral drug dosage forms have different usages.
Granules and dry suspensions: stir and dissolve with appropriate amount of warm water before taking.
Oral liquid preparations: Use a measuring cup or pour accurately according to the scale on the bottle. Do not touch the bottle directly with your mouth for oral administration.
Suspensions, syrups and other liquid preparations: The liquid must be accurately measured and shaken thoroughly before taking the medicine.
Effervescent tablets: Be careful not to swallow them directly, because effervescent tablets contain ingredients that can produce carbon dioxide. Directly orally taken medicines will produce a large amount of carbon dioxide gas when they meet water in the mouth, which may cause the risk of suffocation due to lack of oxygen. Therefore, before taking the medicine, you need to add an appropriate amount of warm water to dissolve the tablets completely, and wait until all bubbles disappear before taking them orally.
Chewable tablets: You do not need to drink water when taking it. Chew or suck it directly in the mouth to dissolve and then swallow.
Dispersible tablets: If the child is too young to swallow tablets, most dispersible tablets can be dissolved in water and then taken. If the drug is insoluble before being taken, it is recommended to change it to a more suitable dosage form.
7. It is not necessary to use too much eye drops, 1-2 drops can achieve the therapeutic amount.
Eye drops are one of the commonly used pharmaceutical dosage forms for eye diseases. Eye drops have a direct and quick therapeutic effect on many eye diseases. Be sure to wash your hands thoroughly before instilling eye drops, and try to avoid direct contact with the eyes with your hands to avoid eye infection. When instilling eye drops, use your index finger to pull down the lower eyelid and separate it from the eyeball, and apply the eye drops into the conjunctival fornix. Just drop one to two drops.
The maximum liquid volume in the conjunctival fornix of normal people is 20-30 microliters, of which the normal tear volume is about 7-10 microliters, and the conjunctival fornix can only hold up to 20 microliters of medicinal solution. Commercially available eye drops have different packaging and opening sizes, resulting in different drop sizes. The average volume of each drop is about 40 microliters, which exceeds the capacity of the conjunctival sac. Therefore, when the eye drops are instilled, about half of the solution will overflow from the conjunctival fornix and flow out of the eye. This is a normal phenomenon.
One drop of eye drops already reaches the therapeutic dose and there is no need to increase the dosage. Taking a few more drops will not result in greater absorption, and in addition to waste may also increase the risk of adverse reactions. For example, if the dosage of certain drugs, such as atropine sulfate eye gel and pilocarpine nitrate eye drops, is increased, they overflow into the eyes and are absorbed through the nasal cavity or mouth, which may cause serious systemic adverse reactions. After instilling eye drops, it is recommended to gently press the nasolacrimal duct in the inner corner of the eye with your fingers for at least 2 minutes to slow down the discharge of the medicine into the nose, thereby increasing the efficacy and reducing adverse reactions.
8. Drug treatment has a course of treatment, and frequent dressing changes interfere with the curative effect.
Many people have high expectations for the therapeutic effect of drugs. They always hope that the symptoms of the disease will be significantly improved after taking the medicine. If the effect does not improve after taking it once or twice, they will think that the medicine does not work and replace it immediately. Another kind of medicine, especially some over-the-counter medicines, such as cold medicines, antipyretics and analgesics, etc. However, frequent dressing changes not only do not bring benefits to the treatment of diseases, but may also bring some negative effects, such as increasing adverse drug reactions and developing bacterial resistance. Therefore, you should have a correct understanding of changing medications.
How well a drug works depends not only on the drug itself, but also on the body’s response to the drug. For example, oral drugs need to be absorbed and distributed before they can reach the corresponding site. Therefore, it takes a certain amount of time for the concentration of the drug in the blood to increase. Even if the effective concentration is reached, the drug needs time to exert its effect. Usually, it cannot be started immediately. effect. Frequent dressing changes may lead to insufficient drug concentration and affect the therapeutic effect. Different drugs have different onset times. For example, some antidepressant drugs even take about 2 weeks to take effect. If you are impatient and change drugs frequently, it will worsen the symptoms of depression. For infectious diseases treated with antibacterial drugs, random and frequent use of antibacterial drugs without indications can easily induce bacterial resistance, making potentially effective antibacterial drugs less effective or even ineffective. Therefore, it is generally necessary to use the drugs for a period of time before conducting clinical trials. Evaluate the effect and replace it when there are indeed indications for replacement.
If the effect of the drug is not obvious when starting treatment with a drug, it is necessary to consider whether the dosage and time of medication are insufficient. The dosage should be adjusted according to the doctor’s advice, and frequent dressing changes should not be used. The decision whether to change should be made based on the progression of the disease and under the guidance of a physician or pharmacist.
9. There are different types of medicines, and some are more effective when chewed.
When taking oral medications, most of them are swallowed whole and should not be chewed. For example, some drugs are made into sustained-release tablets or controlled-release tablets. The structure of the tablets can ensure that the tablets are decomposed and absorbed in a controlled manner when they reach the gastrointestinal tract. If chewed and taken, slow administration will turn into rapid absorption. Absorbing a large amount of medication in a short period of time will bring more medication risks. There are also some enteric-coated tablets, which are more fully absorbed in the intestinal tract or have a certain irritation to the stomach. If these types of medicines are chewed and eaten, it may affect the absorption efficiency or irritate the gastric mucosa.
However, some medicines are special and need to be chewed before being taken. If swallowed directly, the desired therapeutic effect may not be achieved.
Generally speaking, medicines with the word “chewable tablets” in the name are recommended to be taken after chewing thoroughly. For example, yeast tablets and lactobacillus tablets are not easily dissolved in the digestive tract after being swallowed whole, forming sticky clumps in the stomach, which affects the effect of the drug. Chewing it before taking it will help accelerate the release of the drug, thereby accelerating the dissolution and absorption of the drug in the digestive tract to fully exert the drug effect.
Among digestive system medications, there are mainly some antacids, gastric mucosal protective drugs and digestive aids that need to be chewed and taken. Such as compound aluminum hydroxide, aluminum magnesium carbonate, etc., which are suitable for chewing half an hour before meals. After being chewed, they will disperse into tiny particles, increase the contact range between the drug and the lesion, and cover the mucosa of the digestive tract to form a protective film, thereby reducing the stimulation of gastric wall ulcers by gastric contents and gastric acid, and promoting the ulcer to heal as quickly as possible.
In emergencies, when medication for the cardiovascular system is used, such as when an angina pectoris attack occurs, nitroglycerin can be chewed and taken sublingually to facilitate the dissolution of the drug, accelerate the absorption of the drug, and quickly relieve angina pectoris.
In addition, calcium preparations such as calcium carbonate and calcium gluconate are heavier in texture and disintegrate slowly. Taking them after chewing is not only beneficial to the absorption of calcium ions, but also reduces the burden on the gastrointestinal tract.
When taking medicines, we need to read the drug instructions carefully and take the medicines as directed by the doctor.
10. Be careful when taking medicinal water. Drink more and less.
When we take medicine, most of the time we take it with water. In fact, there are also particularities in how much water we should drink when taking medicine. Each medicine has its own “optimal amount of water to drink.” Only by drinking the right amount can we ensure that the medicine is taken. effect. Medication should be taken under the guidance of a doctor or pharmacist. Be sure to read the drug instructions carefully before taking the medication.
You should drink more water when taking the following medications:
Antibacterial drugs: The metabolites of sulfonamides and quinolone antibacterial drugs such as levofloxacin and moxifloxacin have low solubility in urine and are easy to form crystals in the urinary system, which may cause urinary system stones. Drinking more water can prevent this.
Anti-gout drugs: Because they will promote the excretion of uric acid, you should also drink more water to prevent uric acid from forming crystals in the body and unable to be excreted.
Antipyretic and analgesic drugs: Commonly used antipyretic and analgesic drugs for colds and fevers, such as ibuprofen, etc., will cause people to sweat a lot after taking the drug, which may lead to water and electrolyte imbalance. At this time, replenishing water is very important to help prevent Dehydration.
Bisphosphonate drugs: sodium arenrenate, which is used to treat osteoporosis, has the side effect of irritating the upper gastrointestinal mucosa. It is recommended to take it with a full glass of water.
Some drugs work in a special way, so drink less water when taking them:
Gastric mucosal protective agents: such as sucralfate, aluminum hydroxide, etc., achieve therapeutic effects by forming a protective film on the surface of the gastric mucosa. Drinking a large amount of water will affect the efficacy of the drug. Try not to drink water within 1 hour after taking the drug.
Some antidiarrheal drugs: such as montmorillonite powder, these drugs also have a therapeutic effect by covering the mucous membrane of the digestive tract, and you should also drink less water.
Syrup cough medicines: These medicines work by adhering to the throat, allowing the medicine to fully exert its effectiveness. It is recommended not to drink water within 15 minutes after taking the medicine to avoid flushing out the medicine adhered to the throat.