Use of left oxyfluorasin caution: 6 unreasonable uses to avoid

Guide: Applying decades of drugs, the same can't be ignored with cautionquinolones are concentration-dependent antimicrobialdrugs, clinical indications are very wide, in addition to the respiratory tract, but also can be used to treat the genitourinary tract, skin soft tissue and other types of infectionsBut according to the 56th issue of adverse drug reaction information: a total of 1431 cases of severe adverse reactions/events received from ooxyfluorosin injections were reported6 unreasonable usages ofleft oxygen
1Over-the-top population administration:monitoring database, there are cases of patients under 18 years of age using ooxyfluorosacin injections reportedReminder: The instructions explicitly indicate that patients under 18 years of age are banned, "Guidelines for clinical application of antimicrobial drugs" quinolones antimicrobial precautions notes:under 18 years of age under the age of minor patients to avoid the use of this class of drugs2There are interactions with unreasonable drug use: there are 3 cases reported in themonitoring database for combination with the use of theipha injections, and blood concentration scants are not monitored and dose slowerThere were also reports of cases of mixed intravenous drips with other drugs with other drugsreminder: Left oxyfluorassin injections should not be mixed with other drugs with intravenous drips, or intravenous drips in the same intravenous tubeshould avoid the simultaneous use of theabase, if it is necessary to apply at the same time, should monitor the concentration of the heagenic blood to adjust its dose3 Contratic Drug Use: monitoring database has a case report of the use of oxyoxyfluoroxine injections in patients with allergy to quinolones Reminder: The instructions clearly indicate that allergies to quinolones are prohibited 4 Does not conform to the principle of drug use under special pathological and physiological conditions: case reports of use of oxyoxyfluoroxine injections are used in patients with a history of epilepsy in the monitoring database reminder: quinolones antimicrobial saurate can cause convulsions, epilepsy and other serious central nervous system adverse reactions, in patients with renal decline or have central nervous system basic diseases, so this type of medicine should not be used in patients with epilepsy or other central nervous system basic diseases 5 Super-adaptive drug use: monitoring database for cases of patients with non-bacterial infections using oxyfloxon injections Reminder: The instructions clearly state that this product is applicable to sensitive bacteria caused by moderate and severe infections It is usually not appropriate to routinely preventively apply antimicrobials: common cold, measles, chickenpox and other viral diseases 6 Unreasonable dose: monitoring reports of unadjusted doses of the administration of older persons in the monitoring database reminder: This product is mainly excreted by the kidneys, because most of the elderly patients have low kidney function, there may be a sustained high concentration of blood medicine, should pay attention to the dose of the drug and careful lying When applying this class of drugs to patients with renal function loss, the drug should be reduced according to the degree of renal function reduction finally, sum up a sentence: can orally do not inject, regulate the use of drugs left oxyfluorosacin after oral absorption is good, high bioavailability, it is recommended to choose the appropriate way of administration according to the actual situation of patients, can oral treatment people do not recommend the use of injection to the way the serious adverse reactions associated with the left oxyfluorasin injection, in addition to the characteristics of the drug itself, but also related to a variety of factors, such as individual differences in patients, overdosion use, unreasonable routes of administration, improper distribution of drugs, infusion speed, etc , it is recommended that clinical use of this product, pay attention to the dose, special population, to avoid super-adaptive drug use, strictly prohibited drug are banned for patients who are allergic to quinolones, patients with allergy and hypersensitivity, patients with epilepsy or other central nervous system underlying diseases, and are strictly prohibited from mixing this product with other drugs with same-bottle drip injections, pay attention to the drug, prevent drug interaction, avoid the use of partial alkaline liquids, cephalospora antibiotics, Chinese medicine injections and other prescriptions What are the characteristics of quinolones? the three most widely used drugs of quinolones are oxyfloxacin, moxisa and ciprofloxacin, with distinct personality and characteristics 1 Left oxyfluorassin: has good antibacterial activity, including streptococcus pneumococcal has a better antibacterial effect, known as "breathing quinolones", and the incidence of adverse reactions to the drug is low, the characteristics of various aspects are more balanced Monotone is the most commonly used in the application of oxyoxyfluoroxeon reminder: almost all of the left oxyfluorosacin by prototype by kidney excretion, the elderly should be used in appropriate adjustment of the dose 2 Moxisar: the antibacterial activity of moxisha is currently the strongest in clinical application of quinolones, streptococcus pneumoniae, haemophilus influenzae, mycoplasma genus, anaerobic bacteria and tuberculosis branch bacteria are more effective than the use of pseudo-oxycodone, because of the community-acquired pneumonia common pathogens have excellent antimicrobial effect, can be used alone to treat community acquired pneumonia reminder: Moxisha xingey by liver metabolism, liver damage cases reported, the use of the process should pay attention to follow-up liver function 3 Cycloprophelym: good antibacterial activity of gram-negative bacteria compared to zooxyfluoracin and mosisha, but the obvious defect is poor antibacterial effect on gram-positive bacteria, including streptococcus genus The antibacterial characteristics of ciprofloxacin are the most antibacterial effect on copper-green pseudomonas in the current quinolones, and are recommended by many guidelines as the treatment of infections such as lower respiratory tract and urinary tract caused by copper-green pseudomonas reminder: plyssacchaxacin oral administration is poorly absorbed, mainly used for intravenous administration quinolones and heart toxicity? quinolones have been used in respiratory medicine for decades and are generally safe, with no cardiac toxicity seen in the vast majority of patients but quinolones cause dtime extension of Q-T in patients do exist Its heart toxicity is mainly related to the dose of the drug when the amount of moxisac is 800 mg, the incidence of q-T inter-period extension increased significantly, so the upper limit of clinical use of the drug is 400 mg, prohibited increase in dose; when the dose of ooxyfluorifion is 500 mg, The extension of Q-T period is not obvious, 750 mg is also safe, but at 1000 mg there will be a significant increase in the incidence of Q-T period extension, therefore, the cesofluorosaride is safer than the clinical application of Mosissar, there is room to increase the dose In addition, ciprofloxacin 1500mg should also be safe for applications it is worth mentioning that patients with underlying diseases who use artichoke should not be combined with quinolones For quinolones, liver toxicity may be more common and cause for concern How do adjust the dose in older patients? elderly patients should adjust the dose of the drug by evaluating the patient's kidney function when applying quinolones for anti-infection treatment Kidney function is evaluated using two formulas: 1 The Cockcroft-Gault formula for calculating the creatinine removal rate: Ccr (mL/min) x (140-age) x weight (kg)/ (blood creatininine value x K) when serum creatininine (Scr) units are mmol/L, K is 0.81, and when Scr units are mg/dl, K is 72 Note: In the case of female patients, the above calculation is multiplied by 0.85, and in the case of obese patients, the weight must be converted to the ideal weight for calculation 2 MDRD formula for calculating renal glomerular filtration rate (eGFR): (click on the image to see the larger picture) Notes: These two formulas are not applicable to patients with advanced age (80-90 years), too small, too fat, too thin and paraplegic Elderly patients should stay 24 hours urine calculation 24 hours eGFR when kidney function declines, the half-life of drugs excreted mainly through the kidneys (e.g oxyfluorosin, ooxyfluorosin) will be removed to varying degrees of longer if the dose is not adjusted, clinically, a variety of adverse reactions are often shown This phenomenon is particularly pronounced in older patients who are older (-70 years old) and who are underweight