1. The combination of β-lactam drugs and propofol can reduce the secretion of the former in the renal tubules, increase the blood concentration and prolong the duration of action. Therefore, when the two are combined, attention should be paid to reduce the dose of the former.
2, β-lactams should not be combined with acidic or alkaline drugs. Such as: aminoglycosides, amino acids, erythromycin, lincomycin, vitamin C, sodium bicarbonate, aminophylline, monosodium glutamate, etc.. Therefore, only saline can be used to dissolve the drug during infusion, not glucose injection.
3. Do not combine flucloxacillin with blood, plasma, hydrolyzed protein and fat milk. Other β-lactam drugs should also be noted.
4.Cephalosporins (especially the first generation cephalosporins) should not be combined with highly effective diuretics (such as tachyphylaxis) to prevent serious kidney damage. Mecillin in penicillin class should not be combined with it.
5. Cefoxitin sodium and most cephalosporins have antagonistic effect, and the antimicrobial efficacy may be weakened when used together. It has antagonistic effect with aminotransim in vitro and in vivo, and does not interfere with nafcillin, cloxacillin, erythromycin, vancomycin, etc. in terms of drug efficacy.
6, aminoglycosides should not be paired with ototoxic (such as erythromycin, etc.) and nephrotoxic (such as strong diuretics, cephalosporins, dextran, sodium alginate, etc.) drugs, and should not be paired with muscle relaxants or drugs with this effect (such as diazepam, etc.) to prevent the strengthening of toxicity. This class of drugs should not be combined with each other.
7, macrolides can inhibit the normal metabolism of theophylline. The combined application of the two can cause abnormal increase in theophylline blood concentration and lead to poisoning and even death, so the blood concentration of theophylline should be monitored when combined to prevent accidents. In addition, these drugs are unstable to acid, therefore, adding vitamin C injection (containing 1g of sodium ascorbate) or 5% sodium bicarbonate injection 0.5ml to 500ml of 5%-10% glucose infusion to raise the pH to about 6, and then adding erythromycin lactobionate will help to stabilize. In addition, β-lactam drugs with this class of drugs, can occur to reduce the effect; combined with oral contraceptives, can also make it reduce the effect (because this class of drugs can block the enterohepatic circulation of sex hormones). Clarithromycin can make digoxin, theophylline, oral anticoagulants, ergotamine or dihydroergotamine, and triazolam all show stronger effects, and can have similar blocked metabolism to carbamazepine, cyclomycin, hexobarbital, and phenytoin sodium to enhance their effects. This class of drugs with β-lactams is generally considered to have a reduced effect. In addition, fluoroquinolones can also inhibit the metabolism of theophylline.
8.Norvamycin and many drugs can produce precipitation reaction, so other drugs should not be added to the infusion containing this product. Clindamycin should not be added to the infusion with complex composition to avoid contraindications; in addition, this class of drugs has antagonistic effect with erythromycin and should not be applied jointly. Fosfomycin and some metal salts can generate insoluble precipitation, do not match with calcium, magnesium and other salts.
9, drugs that inhibit intestinal flora can inhibit the decomposition of salazosulfapyridine in the intestine, thus affecting the free 5-aminosalicylic acid, with the possibility of reduced effectiveness, especially for a variety of broad-spectrum antibacterial drugs.
10, furantoin and nalidixic acid have antagonistic effects, should not be used together. Furazolidone has monoamine oxidase inhibition, can inhibit the metabolism of amphetamines and other drugs and lead to an increase in blood pressure; during the use of this product, the consumption of food containing large amounts of tyramine, can also have a similar reaction.
11.Alkaline drugs, anticholinergic drugs and H2-blockers can reduce the acidity of gastric juice and decrease the absorption of quinolones, so they should be avoided. Rifampicin (RNA synthesis inhibitor), chloramphenicol (protein synthesis inhibitor) can reduce the effect of this class of drugs, so that the effect of nalidixic acid and haloperidol completely disappears, so that the effect of fluazinic acid and ciprofloxacin is partially offset.
12.Clindamycin and erythromycin have antagonistic effects, and should not be used in combination, nor should they form a complex infusion.
13.Tetracyclines avoid pairing with antacids, calcium salts, iron salts and other drugs containing heavy metal ions to prevent complexation reactions and blocking the absorption of tetracyclines. Milk also has a similar effect.
14, sulfonamides should not be combined with local anesthetics containing para-aminobenzoyl (such as: procaine, benzocaine, bupivacaine, etc.) to avoid reducing the effectiveness.
15, polymyxin B and other drugs with nephrotoxic or neuromuscular blocking effects should not be combined to prevent accidents.
16.Sodium p-aminosalicylate should not be taken together with salicylic acid to avoid aggravation of gastrointestinal reaction and gastric ulcer. In addition, this product can interfere with the absorption of rifampicin, the simultaneous application should be 6-8 hours apart.
17.The absorption of ketoconazole and isotraconazole is closely related to the secretion of gastric juice, so it should not be taken with antacids and anticholinergics.
18.Doxapram is forbidden to be combined with alkaline drugs; be careful to combine with sympathomimetic amines and monoamine oxidase inhibitors (MAOI).
19, morphine is prohibited to be combined with chlorpromazine injection. Pethidine should not be combined with promethazine several times to avoid respiratory depression; combined with monoamine oxidase inhibitors (MAOI) can cause excitement, hyperthermia, sweating, confusion. Fentanyl also has this reaction.
20. Combination of aspirin and glucocorticosteroid may aggravate gastrointestinal bleeding and should be prohibited; combination with ibuprofen and other non-steroidal anti-inflammatory drugs will significantly reduce the concentration of the latter, and should not be combined; combination with alkaline drugs may promote the excretion of this product and reduce the efficacy, and should not be combined.