Caution in the use of drugs that can cause sudden death

  In recent years, it has been discovered that the improper use of some drugs can lead to sudden death, which is medically referred to as “sudden drug death”.  It is now known that there are many drugs that can cause sudden death, mainly chlorpromazine, quinidine, isoprenaline, chloroquine, penicillin and so on.  Chlorpromazine drugs, including chlorpromazine, Fluphenazine, Fluphenazine decanoate, etc., are strong tranquilizers. According to domestic reports, there have been 18 cases of sudden death caused by chlorpromazine.  There are several reasons for sudden death caused by these drugs: (1) excessive dose or improper combination: some elderly people use this type of drugs in excessive doses, can be due to excessive sedation and deep coma and directly lead to sudden death; if this type of drugs and anti-fibrillation paralysis drugs and atropine drugs used in combination, can be due to the synergistic effect of drugs paralytic intestinal obstruction and indirectly cause sudden death of patients (this situation is mostly seen in elderly patients with constipation (This situation is most often seen in elderly patients with a tendency to constipation).  (2) Sudden death by asphyxia: chronic schizophrenia and a history of epilepsy can cause sudden death by asphyxia due to ataxia of the throat muscles and difficulty in swallowing, resulting in food obstruction of the airway.  (3) Sudden death due to hypotension: Chlorpromazine can sometimes cause severe postural hypotension (i.e., upright deficiency), resulting in sudden loss of consciousness and sudden death due to irreversible shock.  (4) Sudden death from vascular obstruction: some people use this type of drugs, can produce thrombosis or embolic disorders. Among them, pulmonary embolism is very likely to lead to sudden death.  Isoprenaline aerosol (wheezing) is often used in the treatment of asthma and other diseases, because it can make the arterial blood oxygen tension or cause tachycardia, so repeated long-term use of this product, the patient can incur sudden death. It was reported that between 1959 and 1966, the rate of sudden death from asthma in the UK increased dramatically. When the cause was analyzed, it was found to be related to the use of agents containing isoproterenol. Later, the number of people sprayed with this drug decreased and the sudden death rate dropped to its previous level.  Quinidine is an antiarrhythmic drug. When patients with atrial fibrillation are treated with this drug, it can induce the dislodgement of intra-atrial thrombi, resulting in sudden death due to cerebrovascular and coronary artery embolism.  Chloroquine is one of the effective drugs for the treatment of malaria. In the past, it was generally considered to be safe, but in fact, its safety range is relatively narrow. It has been found that even therapeutic doses can cause cardiac arrest and sudden death.  Sudden death caused by cyanotoxin is more common and is mostly associated with allergic reactions, such as sudden death during intradermal testing.  In summary, although the number of sudden death caused by drugs is small, but the threat to the lives of some patients is great and should be given great attention. For drugs that can cause sudden death, we should strictly grasp the indications and use them rationally in the future, and not to abuse them blindly. People with a history of brain disease and cardiac, liver and kidney insufficiency, the malnourished and the old and frail, those who have had hypotension or serious adverse reactions to certain drugs in the past, should be more vigilant and cautious in using the above drugs to avoid misfortune.