-
Categories
-
Pharmaceutical Intermediates
-
Active Pharmaceutical Ingredients
-
Food Additives
- Industrial Coatings
- Agrochemicals
- Dyes and Pigments
- Surfactant
- Flavors and Fragrances
- Chemical Reagents
- Catalyst and Auxiliary
- Natural Products
- Inorganic Chemistry
-
Organic Chemistry
-
Biochemical Engineering
- Analytical Chemistry
- Cosmetic Ingredient
-
Pharmaceutical Intermediates
Promotion
ECHEMI Mall
Wholesale
Weekly Price
Exhibition
News
-
Trade Service
Only for medical professionals to read for reference.
What are the adverse reactions of cefoperazone and sulbactam? In clinical anti-infective treatment, some moderate to severe infections, we often use antibiotics with enzyme inhibitors, such as piperacillin, tazobactam, amoxicillin, clavulanic acid, and cefoperazone and sulbactam, among which cefoperazone Ketosulbactam does not require skin test because of its high tissue concentration and has always been favored by clinical medical staff.
Although cefoperazone and sulbactam have many advantages, we still have to be wary of its possible adverse reactions during use.
Case Brief introduction of the patient, female, 55 years old.
He was admitted to the hospital due to cough, sputum and fever.
Physical examination: T38.
9°C, P92 beats/min, R 22 beats/min, BP142/83mmHg.
The patient is conscious, has normal development, is malnourished, and is self-conscious.
The superficial lymph nodes are not palpable, the breathing movement is normal, the abdomen is flat, no varicose veins are seen on the abdominal wall, no abdominal lines are seen, the surgical scar is well healed, the abdomen is soft, the abdominal muscles are not tense, the gallbladder is not touched, Murphy's sign is positive, and the rest of the abdomen has no tenderness , Rebound pain.
On auscultation of the lungs, a large number of wet rales and phlegm sounds can be heard in the lungs.
Laboratory examination: blood routine WBC16.
18×109/L, neutrophil percentage 89%; hypersensitivity C-reactive protein 85mg/L; procalcitonin pct1.
12ng/ml.
Pulmonary CT double pneumonia, it is recommended to review after treatment.
Diagnosis after admission: community-acquired pneumonia, the patient had been treated with cefmandol for five days in the clinic outside the hospital before admission, and the effect had not improved significantly.
Therefore, after admission, he was given the enzyme inhibitor cefoperazone and sulbactam for anti-infection.
The long-term doctor in the hospital ordered cefoperazone sodium and sulbactam sodium for injection 3g plus normal saline NS100ml intravenously, once every 8 hours.
Mucosultan injection was 30 mg bid, and 2 ml of budesonide nebulized liquid + 2 ml bid of terbutaline nebulized liquid was given by the temporary doctor to inhale.
On the third day of admission: the patient still has low fever, cough and sputum are alleviated, lung auscultation is better than before, recheck blood routine WBC14.
28×109/L, neutrophil percentage 84%; high sensitivity C-reactive protein 48mg/L; pct0.
85ng/ml.
There were no abnormalities in the blood coagulation function, liver and kidney function.
On the seventh day of admission: the patient’s body temperature was normal, cough and sputum were significantly improved, lung auscultation with a small amount of moist rales and a small number of phlegm sounds, re-examination of coagulation function: prothrombin time 60.
26s↑, partially activated thrombin time 49.
57s↑, consider Cefoperazone and sulbactam caused abnormal blood coagulation function.
The patient had no obvious skin ecchymosis, petechiae, subcutaneous hematoma, bleeding gums, and nose bleeding.
Based on medical history and laboratory examination, cefoperazone sodium and sulbactam sodium were discontinued.
Due to severe coagulation disorders, the patient was indicated for fresh frozen plasma infusion.
On the same day, 200ml of fresh frozen plasma was infused and 10mg of vitamin K was given intramuscularly.
Eighth day: check prothrombin time 16.
45s↑, partially activated thrombin time 36.
92s↑, again infusion of fresh frozen plasma 200ml, vitamin K 10mg intramuscular injection on the ninth day, recheck prothrombin time 10.
8s on the tenth day ↑, the time of partially activated thrombin is 27s↑, and the coagulation function basically returns to normal.
On the 13th day, recheck the recovery of coagulation function.
Which drug causes coagulation dysfunction? After the patient was admitted to the hospital, drugs were given: cefoperazone and sulbactam, ambroxol, budesonide and terbutaline.
The patient was in good health and had no blood coagulation problems after admission.
The blood coagulation function was abnormal after admission.
Considering the cause of cefoperazone and sulbactam, the blood coagulation function returned to normal after the symptomatic treatment was discontinued.
The other three drugs continued to be used.
The patient had no blood coagulation function.
Obviously worsened, it was confirmed that cefoperazone and sulbactam caused coagulation dysfunction. Cefoperazone and Sulbactam cause 4 major reasons for coagulation dysfunction 1.
The structure of cefoperazone contains the side chain of N-methyl tetrazolium sulfide.
This side chain structure is similar to glutamic acid, and it will interact with vitamin K in the liver.
Competitive binding of γ-glutamate hydroxypeptidase leads to vitamin K synthesis obstacles, which in turn affects the reduction in the synthesis of vitamin K-dependent prothrombin and coagulation factors II, VII, IX, and X.
Moreover, the N-methyl sulfide tetrazolium group will also consume vitamin K in the process of metabolism in the body.
2.
Intestinal bacilli are extremely sensitive to cefoperazone sodium and sulbactam sodium.
When cefoperazone sodium and sulbactam sodium are excreted through the intestine, the intestinal flora is inhibited, which directly leads to a reduction in the production of vitamin K.
In addition, enterobacteria can also interact with vitamin K in the body to increase its consumption and jointly cause vitamin K deficiency.
3.
When cefoperazone binds to platelet membrane receptors, it will compete with adenosine diphosphate, thereby weakening the aggregation effect of adenosine diphosphate to activate platelets.
Cefoperazone sodium and sulbactam sodium can also act as an immune mediator or hapten in the body, destroying platelets, causing a decrease in the number of platelets and a decline in function, thereby affecting the blood coagulation mechanism.
4.
According to literature reports, the high-risk factors for the coagulation function of patients using cefoperazone sodium and sulbactam sodium may include: excessive drug dose (>9g/day), longer course of treatment (>5 days), advanced age (>60 years old), body Weakness, malnutrition, severe disease, liver and kidney dysfunction, etc.
What other antibacterial drugs can cause blood coagulation? In addition to cefoperazone sodium and sulbactam sodium, clinically commonly used antibiotics can cause coagulation dysfunction: cefradine, cefotiam, ceftazidime, ceftriaxone, cefuroxime, laoxycephalosporin and other cephalosporins; amoxicillin sodium and sulbac Penicillins such as tan sodium, amoxicillin, clavulanate potassium, piperacillin, quinolones such as levofloxacin, pefloxacin, enoxacin, etc.
; macrolides such as azithromycin, midenomycin, and erythromycin, Antifungal drugs such as fluconazole and voriconazole; drugs such as rifampicin, rifapentin, clindamycin, metronidazole, trimethoprim and gentamicin have also been reported to cause coagulopathy and bleeding.
Once we need to use these antibacterial drugs, we should pay attention to monitoring the coagulation function before and after the drug, and monitor the coagulation function before and after the drug.
How to deal with drug-induced coagulation dysfunction? Once the coagulation dysfunction is discovered during the medication process, the relevant suspicious drugs should be stopped first, and the patient's clinical symptoms such as skin ecchymosis, petechiae, subcutaneous hematoma, gum bleeding, nose bleeding, and even hematuria, melena, etc.
should be observed.
Secondly, after stopping the drug, corresponding symptomatic treatment is given.
Generally, fresh plasma is infused, and 10mg of vitamin K injection is given intramuscularly.
The coagulation function is rechecked the next day.
If the patient has severe coagulation abnormality, vitamin K The injection can be made twice a week.
In the course of medication, in addition to paying attention to the patient’s coagulation function, we also need to monitor the patient’s blood routine, liver and kidney function, etc.
, because cefoperazone and sulbactam can also cause other adverse reactions.
Once the patient has related symptoms, or blood If the routine and coagulation function are abnormal, the drug must be stopped immediately and corresponding symptomatic treatment should be given.
References: [1] Wu Bin, Dai Xiaoqin, etc.
The effect and treatment of cefoperazone sodium and sulbactam sodium on coagulation function.
Clinical rational drug use, 2013, 3:228-230.
[2] Jiang Hong, Chen Jingxia.
Effect of cefoperazone sodium and sulbactam sodium The effect and treatment of coagulation function[J].
Pharmaceutical Care and Research, 2016,300-302.
.
[3].
The effect of cefoperazone sodium and sulbactam sodium on coagulation function[J].
Frontier of Medicine,2017,7( 21): 190-191.
[4] Li Yanyan, Shi Lei, etc.
Analysis of factors causing abnormal coagulation function caused by cefoperazone and sulbactam.
Exploration of rational drug use in China, 2017 (3).
Source of this article: Clinical Pharmacy Channel of the medical community : Sunflower Review of this article: Wang Shuping Chief pharmacist Editor in charge: Vanjay Sun Ying Scan the code to download the doctor station App5w+ drugs for free inquiries
What are the adverse reactions of cefoperazone and sulbactam? In clinical anti-infective treatment, some moderate to severe infections, we often use antibiotics with enzyme inhibitors, such as piperacillin, tazobactam, amoxicillin, clavulanic acid, and cefoperazone and sulbactam, among which cefoperazone Ketosulbactam does not require skin test because of its high tissue concentration and has always been favored by clinical medical staff.
Although cefoperazone and sulbactam have many advantages, we still have to be wary of its possible adverse reactions during use.
Case Brief introduction of the patient, female, 55 years old.
He was admitted to the hospital due to cough, sputum and fever.
Physical examination: T38.
9°C, P92 beats/min, R 22 beats/min, BP142/83mmHg.
The patient is conscious, has normal development, is malnourished, and is self-conscious.
The superficial lymph nodes are not palpable, the breathing movement is normal, the abdomen is flat, no varicose veins are seen on the abdominal wall, no abdominal lines are seen, the surgical scar is well healed, the abdomen is soft, the abdominal muscles are not tense, the gallbladder is not touched, Murphy's sign is positive, and the rest of the abdomen has no tenderness , Rebound pain.
On auscultation of the lungs, a large number of wet rales and phlegm sounds can be heard in the lungs.
Laboratory examination: blood routine WBC16.
18×109/L, neutrophil percentage 89%; hypersensitivity C-reactive protein 85mg/L; procalcitonin pct1.
12ng/ml.
Pulmonary CT double pneumonia, it is recommended to review after treatment.
Diagnosis after admission: community-acquired pneumonia, the patient had been treated with cefmandol for five days in the clinic outside the hospital before admission, and the effect had not improved significantly.
Therefore, after admission, he was given the enzyme inhibitor cefoperazone and sulbactam for anti-infection.
The long-term doctor in the hospital ordered cefoperazone sodium and sulbactam sodium for injection 3g plus normal saline NS100ml intravenously, once every 8 hours.
Mucosultan injection was 30 mg bid, and 2 ml of budesonide nebulized liquid + 2 ml bid of terbutaline nebulized liquid was given by the temporary doctor to inhale.
On the third day of admission: the patient still has low fever, cough and sputum are alleviated, lung auscultation is better than before, recheck blood routine WBC14.
28×109/L, neutrophil percentage 84%; high sensitivity C-reactive protein 48mg/L; pct0.
85ng/ml.
There were no abnormalities in the blood coagulation function, liver and kidney function.
On the seventh day of admission: the patient’s body temperature was normal, cough and sputum were significantly improved, lung auscultation with a small amount of moist rales and a small number of phlegm sounds, re-examination of coagulation function: prothrombin time 60.
26s↑, partially activated thrombin time 49.
57s↑, consider Cefoperazone and sulbactam caused abnormal blood coagulation function.
The patient had no obvious skin ecchymosis, petechiae, subcutaneous hematoma, bleeding gums, and nose bleeding.
Based on medical history and laboratory examination, cefoperazone sodium and sulbactam sodium were discontinued.
Due to severe coagulation disorders, the patient was indicated for fresh frozen plasma infusion.
On the same day, 200ml of fresh frozen plasma was infused and 10mg of vitamin K was given intramuscularly.
Eighth day: check prothrombin time 16.
45s↑, partially activated thrombin time 36.
92s↑, again infusion of fresh frozen plasma 200ml, vitamin K 10mg intramuscular injection on the ninth day, recheck prothrombin time 10.
8s on the tenth day ↑, the time of partially activated thrombin is 27s↑, and the coagulation function basically returns to normal.
On the 13th day, recheck the recovery of coagulation function.
Which drug causes coagulation dysfunction? After the patient was admitted to the hospital, drugs were given: cefoperazone and sulbactam, ambroxol, budesonide and terbutaline.
The patient was in good health and had no blood coagulation problems after admission.
The blood coagulation function was abnormal after admission.
Considering the cause of cefoperazone and sulbactam, the blood coagulation function returned to normal after the symptomatic treatment was discontinued.
The other three drugs continued to be used.
The patient had no blood coagulation function.
Obviously worsened, it was confirmed that cefoperazone and sulbactam caused coagulation dysfunction. Cefoperazone and Sulbactam cause 4 major reasons for coagulation dysfunction 1.
The structure of cefoperazone contains the side chain of N-methyl tetrazolium sulfide.
This side chain structure is similar to glutamic acid, and it will interact with vitamin K in the liver.
Competitive binding of γ-glutamate hydroxypeptidase leads to vitamin K synthesis obstacles, which in turn affects the reduction in the synthesis of vitamin K-dependent prothrombin and coagulation factors II, VII, IX, and X.
Moreover, the N-methyl sulfide tetrazolium group will also consume vitamin K in the process of metabolism in the body.
2.
Intestinal bacilli are extremely sensitive to cefoperazone sodium and sulbactam sodium.
When cefoperazone sodium and sulbactam sodium are excreted through the intestine, the intestinal flora is inhibited, which directly leads to a reduction in the production of vitamin K.
In addition, enterobacteria can also interact with vitamin K in the body to increase its consumption and jointly cause vitamin K deficiency.
3.
When cefoperazone binds to platelet membrane receptors, it will compete with adenosine diphosphate, thereby weakening the aggregation effect of adenosine diphosphate to activate platelets.
Cefoperazone sodium and sulbactam sodium can also act as an immune mediator or hapten in the body, destroying platelets, causing a decrease in the number of platelets and a decline in function, thereby affecting the blood coagulation mechanism.
4.
According to literature reports, the high-risk factors for the coagulation function of patients using cefoperazone sodium and sulbactam sodium may include: excessive drug dose (>9g/day), longer course of treatment (>5 days), advanced age (>60 years old), body Weakness, malnutrition, severe disease, liver and kidney dysfunction, etc.
What other antibacterial drugs can cause blood coagulation? In addition to cefoperazone sodium and sulbactam sodium, clinically commonly used antibiotics can cause coagulation dysfunction: cefradine, cefotiam, ceftazidime, ceftriaxone, cefuroxime, laoxycephalosporin and other cephalosporins; amoxicillin sodium and sulbac Penicillins such as tan sodium, amoxicillin, clavulanate potassium, piperacillin, quinolones such as levofloxacin, pefloxacin, enoxacin, etc.
; macrolides such as azithromycin, midenomycin, and erythromycin, Antifungal drugs such as fluconazole and voriconazole; drugs such as rifampicin, rifapentin, clindamycin, metronidazole, trimethoprim and gentamicin have also been reported to cause coagulopathy and bleeding.
Once we need to use these antibacterial drugs, we should pay attention to monitoring the coagulation function before and after the drug, and monitor the coagulation function before and after the drug.
How to deal with drug-induced coagulation dysfunction? Once the coagulation dysfunction is discovered during the medication process, the relevant suspicious drugs should be stopped first, and the patient's clinical symptoms such as skin ecchymosis, petechiae, subcutaneous hematoma, gum bleeding, nose bleeding, and even hematuria, melena, etc.
should be observed.
Secondly, after stopping the drug, corresponding symptomatic treatment is given.
Generally, fresh plasma is infused, and 10mg of vitamin K injection is given intramuscularly.
The coagulation function is rechecked the next day.
If the patient has severe coagulation abnormality, vitamin K The injection can be made twice a week.
In the course of medication, in addition to paying attention to the patient’s coagulation function, we also need to monitor the patient’s blood routine, liver and kidney function, etc.
, because cefoperazone and sulbactam can also cause other adverse reactions.
Once the patient has related symptoms, or blood If the routine and coagulation function are abnormal, the drug must be stopped immediately and corresponding symptomatic treatment should be given.
References: [1] Wu Bin, Dai Xiaoqin, etc.
The effect and treatment of cefoperazone sodium and sulbactam sodium on coagulation function.
Clinical rational drug use, 2013, 3:228-230.
[2] Jiang Hong, Chen Jingxia.
Effect of cefoperazone sodium and sulbactam sodium The effect and treatment of coagulation function[J].
Pharmaceutical Care and Research, 2016,300-302.
.
[3].
The effect of cefoperazone sodium and sulbactam sodium on coagulation function[J].
Frontier of Medicine,2017,7( 21): 190-191.
[4] Li Yanyan, Shi Lei, etc.
Analysis of factors causing abnormal coagulation function caused by cefoperazone and sulbactam.
Exploration of rational drug use in China, 2017 (3).
Source of this article: Clinical Pharmacy Channel of the medical community : Sunflower Review of this article: Wang Shuping Chief pharmacist Editor in charge: Vanjay Sun Ying Scan the code to download the doctor station App5w+ drugs for free inquiries
