Use ACEI antihypertensive drugs with caution in patients with hypertensive encephalopathy or RPLS, as their hypertension may be due to renal artery stenosis. Bromocriptine tablets are contraindicated in patients with coronary artery disease and other serious cardiovascular diseases, cerebrovascular accidents, and arterial obstructive diseases; levodopa tablets are contraindicated in patients with severe arrhythmias, heart failure, glaucoma, peptic ulcer and history of convulsions; Deltodopa tablets are contraindicated in patients with atrioventricular block and history of bone marrow suppression. Several adverse reactions of antihypertensive drugs: β-blockers and calcium channel blockers alone or in combination may lead to cardiac depression; ACEI common adverse reactions are hypotension, and should not be combined with potassium-protective diuretics for a long time; nifedipine extended-release tablets may cause patients to develop bilateral lower limb edema; diuretics and β-blockers may have an effect on the metabolism of blood lipids, sodium, blood glucose, and blood uric acid. The combination of Lipitor with digoxin in heart failure patients increases the risk of toxicity; Lixin is used for hypertension in emergency cerebrovascular patients; Cipro and calcium antagonist antihypertensive drugs should not be used together clinically.
Many physicians may think of giving haloperidol to treat erratic patients when they encounter them in clinical practice. However, larger doses of haloperidol in patients with heart disease may lead to the possibility of malignant nerve block syndrome. Therefore, this drug should be used with full knowledge of the patient’s heart.
In the acute phase of cerebrovascular disease, there will be varying degrees of blood pressure elevation, depending on the blood pressure, and sublingual cardiac pain relievers and intramuscular lispro are commonly used in emergency departments and are not suitable. Too rapid a fall in blood pressure can aggravate ischemia, such as the formation of watershed cerebral infarction; care should be taken when using antihypertensive drugs in patients with watershed infarction, and blood pressure should be monitored to prevent aggravation after a fall in blood pressure.
Sodium nitroprusside and nitroglycerin should be used with caution in cerebrovascular disease because (1) insufficient cerebral perfusion caused by lower blood pressure; (2) intracranial vasodilation aggravates cranial hypertension. The dose of nitroprusside should be strictly controlled and blood pressure changes should be closely observed. The drug solution should not be stored for more than four hours after configuration. Regarding the application of nitroglycerin in the acute phase of cerebrovascular disease: 1: Please read the instruction manual of nitroglycerin carefully. Increased intracranial pressure is a contraindication! 2: Theoretically, nitroglycerin dilates cardiovascular vessels and should indeed be avoided in the acute phase of cerebral hemorrhage! Cerebrovascular accident patients rehydration less sugar water: cerebrovascular accident patients in the brain in a state of hypoxia, sugar water after replenishment, brain cells in a state of hypoxia will increase glycolysis, lactic acid accumulation, aggravating brain damage; cerebrovascular accident patients combined with heart failure can not be dehydrated with mannitol, fast infusion aggravates heart failure, slow infusion does not work.
Active intracranial hemorrhage and severe intracranial injury in the acute phase should not use cytarabine; vasodilator drugs should be used with caution in the acute phase of cerebral infarction: early stage of large cerebral infarction and ischemic cerebrovascular patients with hyperuricemia should use aspirin with caution. Aspirin should not be used together with certain drugs. The combination of aspirin and diltiazem may prolong the bleeding time and should not be used before and after surgery.
Mannitol is generally not used after extraventricular drainage, and is contraindicated in cases of active intracranial hemorrhage (e.g., in the acute phase of cerebral hemorrhage, especially within 6 hours, application of mannitol may aggravate hemorrhage due to volume expansion). Contraindications to the application of mannitol: patients with urinary closure, cardiac insufficiency, active intracranial hemorrhage and hematuria.
The drug that needs to be emphasized is dexamethasone, a drug commonly used in neurology, which has many side effects in the long term, as we all know, but is still often seen to be abused, especially in elderly stroke patients; dexamethasone is not added to balanced fluids, and insulin is not combined with vitamin C. Hormones are used with caution in patients with myasthenia gravis; if used, they should be hospitalized at the beginning of the medication and closely monitored, because they can aggravate myasthenia gravis. The mechanism is not well understood, the possible ones are: direct inhibition of transmission at the N-M junction; promotion of cholinergic crisis by enhancing the action of cholinesterase inhibitors; increase in blood AchR antibodies; early exacerbation and later efficacy are not relevant. Dexamethasone contains fluoride and should be used with caution in patients with rheumatic diseases.
Patients with MG: quinine, quinidine, procainamide, penicillamine, psilocybin, phenytoin, lithium, tetracycline and aminoglycoside antibiotics can exacerbate symptoms and should be avoided. Meclofenamate is contraindicated in people who are overexcited and have extrapyramidal symptoms. cytarabine is contraindicated in the acute phase of ICH.
Olepox and Ciprofloxacin should not be used in patients with PD and aggravate extrapyramidal symptoms. Probable contraindications of PD drugs: 1. Antan, contraindicated in patients with glaucoma; when combined with amantadine and anticholinergics, it can strengthen the anticholinergic effect and can cause paralytic intestinal obstruction; 2. Amantadine, contraindicated in pregnant and lactating women; use with caution in patients with epilepsy and history of psychosis; 3. Levodopa, contraindicated in patients with glaucoma, diabetes, arrhythmia, malignant melanoma; contraindicated in lactating women. 4. Silegiline can cause fatal reactions when combined with dulcolax; 5. Tysudar, contraindicated in circulatory failure and acute heart attack. Medopa and Tysudar are contraindicated in patients with psychiatric symptoms, which have the side effect of inducing psychiatric symptoms. contraindications to pharmacological treatment of PD, roughly summarized as follows: 1, anticholinergic drugs: Antan, Kaimajun glaucoma and prostate patients are prohibited, elderly patients can affect memory function and should be used with caution; 2, gentamicin: a history of epilepsy, psychosis, hallucinations, congestive heart failure, renal insufficiency, peripheral Angioedema or upright hypotension in patients with anticonvulsant paralysis with caution; prohibited in newborns and infants under 1 year of age or in nursing mothers; 3, L-Dopa analogues: Medroba, Parkinin in narrow-angle glaucoma, psychiatric patients are prohibited, active peptic ulcer patients should be used with caution; 4, DA receptor agonists: 1. Pergolide 2. Bromocriptine: side effects similar to levodopa, but Delusions and hallucinations are common, prohibited for those with a history of psychosis, recent myocardial infarction, severe peripheral vascular disease and peptic ulcer are relative contraindications 3. New DA receptor agonists: Paramisol, Lopinilol; 5, MAO-B inhibitors: Sigynine, mainly dry mouth, hypogastric and postural hypotension, etc., should be used with caution in patients with gastric ulcers; 6, COMT inhibitors: A ism, Kodan; 7, Chinese medicine or Acupuncture has some auxiliary effect on PD.
The main role of Vit B1 is to participate in sugar metabolism as a coenzyme; when it is deficient, it is difficult for pyruvate to enter the tricarboxylic acid cycle for oxidation, resulting in the accumulation of pyruvate and lactate, so then sugar will aggravate the lack of Vit B1, resulting in a large accumulation of acid, which can induce Wernicke’s encephalopathy, and clinically even acute This can lead to acute coma. If the purpose is to replenish potassium, the use of sugar and insulin will aggravate the potassium deficiency, or at least make it ineffective, because potassium is consumed by glucose metabolism. If the purpose is not to supplement potassium, then sugar and salt can be used. Adrenocorticotropic hormones should also be used with caution in suspected Vit B1 deficiency (Wernicke’s encephalopathy, beriberi, chronic alcoholism, malnutrition, etc.); they have an anti-Vit B1 effect and prevent the oxidation of pyruvate, which can trigger a Wernicke’s encephalopathy attack, or put the patient into a coma or even respiratory arrest. Brain Activator should not be administered in the same bottle with balanced amino acid injection. Insulin with VitC is contraindicated in the Compounding List, and calf blood deprotein extract and hematoxylin (Danshen Chuanxiongzin) injection (described in the instruction manual) should be used with caution in patients with diabetes mellitus. Metformin is contraindicated in neurological stroke combined with diabetic ketosis and diabetic nephropathy. 706 plasma substitute should be used with caution in diabetic patients, and parotid enlargement has been clinically encountered in patients after use.
Vitamin B12 and folic acid should be used with caution in patients with tumors, which will promote tumor growth; vitamin B12 should be used with caution in patients with cryptococcal meningitis, which will promote the growth of cryptococci; vitamin B6 is needed in patients with tuberculous meningitis applying isoniazid, but less than the regular dosage, which will weaken the effect of isoniazid; vitamin B6 should be used with caution in patients with Parkinson’s applying levodopa, which will enhance peripheral decarboxylation and increase peripheral side effects and reduce the role of the central nervous system. Vitamin B12 needle intramuscular injection is prohibited in gout patients, which can induce acute attacks of gout; use allopurinol cautiously during the acute phase of gout, which can easily induce gout because the use induces purine to free from the gout nodules, leading to a transient increase in uric acid, which instead induces an aggravation of the attack. Stick to it after the acute phase. Hormones, colchicine or anti-inflammatory pain medications can be used during the acute phase. Medicine All. Available online
ATP intravenous push or wheat intake may induce arrhythmia or cardiac arrest. Contraindicated with Valium? Inhibit respiration; use Valium cautiously for irritability caused by respiratory failure, hepatic failure, acute alcoholism, etc.; slow speed is preferable for the static pushing of Valium; small doses of solvents such as saline or sugar will make the solution cloudy; use Valium cautiously for epileptic patients with respiratory failure; use sodium valproate or magnesium valproate or sodium phenytoin. Remember to push aminophylline intravenously slowly, preferably for longer than 15-20 minutes, otherwise it may lead to cardiac arrest.
Use quinolone antibiotics with caution in patients with epilepsy, as such drugs have the potential to cause epileptic seizures; use Tylenol with caution in patients with epilepsy and may be substituted with Benadryl; corticosteroids are contraindicated (for adults); brain activator is contraindicated in patients with epilepsy. Use quinolone antibiotics with caution in some patients with neuromuscular blockage-related disorders, which have the potential to induce seizures; use aminoglycosides with caution. Lithospermidine A is contraindicated in asthma, and pro-brain metabolites are used with caution in epilepsy. Clinically often encountered sick brain, both seizures and intractable psychiatric symptoms, pay attention to the control of psychiatric symptoms disable chlorpromazine (can induce epilepsy).
Anti-epileptic drugs: phenobarbital is a hepatic enzyme inducer, so it can make hydrocortisone, dexamethasone, testosterone, estrogen, progestin, oral contraceptives, chlorpromazine, chloramphenicol, doxycycline, digoxin, digitalis toxins and phenytoin sodium and other drugs when combined with accelerated metabolism efficacy. Sodium valproate can inhibit the metabolism of sodium phenytoin, phenobarbital, paracetamol, and clonazepam, making them easily toxic, so care should be taken to adjust the dose when combining them. When carbamazepine is combined with phenobarbital and sodium phenytoin, the metabolism of carbamazepine can be accelerated and its concentration can be reduced. Antidepressants, macrolide antibiotics, isoniazid, cimetidine and other drugs can increase the blood concentration of carbamazepine, making it susceptible to toxic reactions. Folic acid can exacerbate seizures.
Exacerbation of seizures caused by antiepileptic drugs: carbamazepine, phenytoin sodium, and phenobarbital sodium may aggravate aphasic seizures; carbamazepine and phenytoin sodium may aggravate myoclonic exacerbation; lamotrigine may cause myoclonic exacerbation; and Toltea may cause cognitive impairment, hypothermia, and anosmia in children. Phenytoin sodium may cause gingival hyperplasia, hirsutism, ugly face, unless economic conditions are limited, generally less used by children and female patients; phenytoin sodium and phenobarbital will accelerate the metabolism of oral contraceptives, leading to contraceptive failure; valproate sodium may cause weight gain, beauty ladies or fatter people are also not recommended, if there is suitable, you can use Toltea, but weight loss may occur; valproate sodium is prohibited for pregnant women Ciprofloxacin is contraindicated in patients with depression or Parkinson’s disease; in addition, elderly patients or patients with cognitive dysfunction should not use Antan. Carbamazepine has a myelosuppressive and leukocyte-lowering effect. Hepatic enzyme inducers such as carbamazepine, phenobarbital and phenytoin sodium are not used in epileptic patients with low blood calcium (pseudohypoparasite, etc.) because the latter can lower blood calcium.
Amantadine: Use with caution in patients with a history of epilepsy, psychosis, hallucinations, congestive heart failure, renal insufficiency, peripheral angioedema, or upright hypotension; contraindicated in newborns and infants under 1 year of age or in nursing mothers. XENA: Use with caution in patients with severe cardiovascular or pulmonary disease, bronchial asthma, liver or kidney disease, endocrine system disease, history of gastric ulcer or convulsions, and pregnant women; contraindicated in patients with narrow-angle glaucoma, suspected skin cancer or melanoma.
Use of antibiotics: β-lactams should not be combined with acidic or alkaline drugs. Cephalosporins (especially first-generation cephalosporins) should not be combined with highly effective diuretics (such as tachyphylaxis) to prevent serious kidney damage. Desmethylvancomycin can produce precipitation reaction with many drugs, so other drugs should not be added to the infusion containing this product. Sulfonamide injection drugs such as sulfadiazine injection are not easily combined with acidic drugs, such as Vb, penicillin, tetracycline, ephedrine hydrochloride, etc., otherwise precipitation of sulfonamide is precipitated, and precipitation of sulfonamide is precipitated in the presence of 5% sodium bicarbonate injection. The efficacy of solid dosage form is weakened or even invalidated by procaine, and the toxicity to urinary system will be increased by calcium oxide and ammonium chloride. Application of cephalosporin antibiotics need to temporarily avoid alcohol? Disulfiram-like reactions. Use aminoglycosides and clindamycin with caution in hypokalemic periodic paralysis; in patients with neuromuscular blockade, e.g., Grimballi syndrome, anti-infective drugs should not be used with clindamycin because it can block the neuromuscular junction. Azithromycin and theophylline should be used together with caution; concomitant use with benzylacetone increases the potency of anticoagulants and can elevate digoxin levels and ergotamine or dihydroergotamine can cause acute ergot toxicity symptoms: severe peripheral vasospasm and sensory dullness, and can increase serum levels of carbamazepine, terfenadine, cyclosporine, and phenytoin sodium. Levofloxacin can cause abnormal blood glucose and liver function. Care should be taken when renewing quinolone with salvia, which can cause flocculent precipitation; ampicillin may also cause refractory drug rash in patients.
12 types of drugs that cannot be combined: eugenol and aspirin; anti-inflammatory pain and aspirin; stomach soothing and multi-enzyme tablets; lithoprim and ephedra; oxytetracycline and Baohe pill; quick-acting typhoid capsule and antipyretic; antipyretic and antipyretic and cold and flu clearing punch; safranin hydrochloride and nux vomica pill; sulfonamides and acidic Chinese herbal medicine Shenqu; broad-spectrum antibiotics and concentrated vitamin A; erythromycin and andrographis; antibacterial drugs and calcium , aluminum and iron medicines.
The absolute contraindications of Gastrodin include pheochromocytoma, breast cancer after chemotherapy; Gastrodin and antispasmodic drugs should not be combined, if combined, it will offset the effect of Gastrodin. There is a risk of hallucinations in the elderly after the application of mecamylguanidine. Use pethidine with caution in patients with gastric ulcer. Cimetidine should be used with caution in acute cerebrovascular disease to prevent acute gastric mucosal lesions; in severe cases, omeprazole can be used instead of static push, and in mild cases, it should be given orally. Because it can pass the blood-brain barrier, it has certain neurotoxicity, and the more common symptoms are dizziness, headache, fatigue and drowsiness. A few patients may experience restlessness, dullness, slurred speech, sweating, local convulsions or epileptic-like seizures, hallucinations and delusions; bradycardia and facial flushing may occur. Occasionally, blood pressure may drop, premature atrial contractions, and cardiac arrest during intravenous injection.
Statins can cause rhabdomyolysis. When patients taking statins develop myalgia and muscle weakness and creatine kinase rises significantly, the drug should be stopped promptly. Transient aphasia can occur after heavy application of lidocaine. Lumi sodium is contraindicated in patients with severe hepatic and renal dysfunction, bronchial asthma. 10% chloral hydrate is contraindicated in arteriosclerosis, nephritis, liver disease. Nimesulide (Provera) may cause facial swelling. In elderly patients with small sediment-like gallstones, care should be taken when using anti-inflammatory and cholagogue tablets, as there is a risk of bile duct impaction leading to acute biliary pancreatitis.
Application of Warfarin for anticoagulation therapy, such as pulmonary thromboembolism, and long-term anticoagulation therapy in patients with atrial fibrillation can be used with oral Warfarin and requires testing of INR values. When applying Warfarin, it is important to note that the early application of Warfarin leads to a temporary, transient hypercoagulable state (protein C, protein S depletion), so it is necessary to combine it with heparin subcutaneous anticoagulation during the first 3 to 5 days of its application. This is because of the slow onset of action of warfarin and because of the transient, temporary hypercoagulability it causes. In the case of bleeding due to warfarin, although it is common to think of administering vitamin K to counteract the effect of warfarin, this can cause problems with subsequent anticoagulation. Therefore, the drug may be discontinued at this time. Continue observation and if bleeding is heavy and active, consider fresh plasma and supplementation with coagulation factors. Low molecular dextrose may cause refractory drug rash in patients and should be used with caution.