Seek the list of commonly used drugs in clinic (mainly western medicines and injections)

When a drug is ineffective, it is necessary to choose other drugs for reasonable compatibility. But not all compatibility is reasonable, and some compatibility weakens the therapeutic effect of drugs, leading to treatment failure; Some compatibility enhances side effects or toxicity, causing serious adverse reactions; There are also some compatibility that make the therapeutic effect excessively enhanced, which is beyond the tolerance range of the body, and can also cause adverse reactions and even harm patients. These compatibility are taboo. 1 combination. β -lactams and probenecid can reduce the secretion of the former in renal tubules, increase the blood concentration and prolong the action time. Therefore, when they are used together, attention should be paid to reducing the dosage of the former. 2. β -lactam drugs are incompatible with acidic or alkaline drugs. Such as aminoglycosides, amino acids, erythromycin, lincomycin, vitamin C, sodium bicarbonate, aminophylline, sodium glutamate, etc. Therefore, only normal saline can be used to dissolve drugs during infusion, and glucose injection cannot be used to dissolve drugs. 3. Flucloxacillin should not be compatible with blood, plasma, hydrolyzed protein and fat emulsion. Attention should also be paid to other β -lactam drugs. 4. Cephalosporins (especially the first generation cephalosporins) should not be combined with high-efficiency diuretics (such as furosemide) to prevent serious renal damage. Methicillin in penicillin is also incompatible with it. 5. Cefoxitin sodium has antagonistic effect with most cephalosporins, and its compatibility can weaken the antibacterial effect. Compatibility with aztreonam has antagonistic effect in vivo and in vitro, but it does not interfere with the efficacy of nafcillin, oxacillin, erythromycin and vancomycin. 6. Aminoglycosides should not be compatible with drugs with ototoxicity (such as erythromycin) and nephrotoxicity (such as potent diuretics, cephalosporins, dextran and sodium alginate). ), nor with muscle relaxants or drugs with this effect (such as diazepam, etc.). ) to prevent toxicity from strengthening. These drugs are also mutually incompatible. 7. Macrolides can inhibit the normal metabolism of theophylline. The combination of two drugs can lead to abnormal increase of theophylline blood concentration, leading to poisoning and even death. Therefore, the plasma concentration of theophylline should be monitored to prevent accidents. In addition, these drugs are unstable to acid. Therefore, in 500 ml of 5%-10% glucose infusion, 0.5ml of vitamin C injection (containing 1g sodium ascorbate) or 5% sodium bicarbonate injection is added to raise the pH to about 6, and then erythromycin lactobionate is added to help stabilize. In addition, the compatibility of β -lactam drugs with these drugs can reduce the curative effect; Combined with oral contraceptives, it can also be ineffective (because such drugs can block the intestinal and hepatic circulation of sex hormones). Clarithromycin can make digoxin, theophylline, oral anticoagulants, ergotamine or dihydroergotamine and triazolam all show stronger effects, and it can also have similar metabolic blocking effects on carbamazepine, cyclosporine, barbital and phenytoin sodium. To enhance the effect. This kind of drug is compatible with β -lactam drugs, which is generally considered to reduce the curative effect. In addition, fluoroquinolones can also inhibit theophylline metabolism. 8. Norvancomycin can react with many drugs, so other drugs cannot be added to the infusion containing this product. Clindamycin should not be added to compound infusion to avoid incompatibility; In addition, these drugs are antagonistic to erythromycin, so they cannot be used in combination. Fosfomycin can form insoluble precipitate with some metal salts, so it is not suitable for compatibility with calcium, magnesium and other salts. 9. Drugs that inhibit intestinal flora can inhibit the decomposition of sulfasalazine in the intestine, thus affecting the dissociation of 5-aminosalicylic acid, which may reduce the curative effect, especially various broad-spectrum antibacterial drugs. 10. nitrofurantoin and nalidixic acid have antagonistic effects and should not be used together. Furazolidone has monoamine oxidase inhibitory effect, which can inhibit the metabolism of amphetamine and other drugs, leading to an increase in blood pressure; During the use of this product, eating food containing a lot of tyramine can also have a similar reaction. 1 1. Alkaline drugs, anticholinergic drugs and H2 receptor blockers can reduce the acidity of gastric juice and reduce the absorption of quinolones, so they should be avoided. Rifampicin (RNA synthesis inhibitor) and chloramphenicol (protein synthesis inhibitor) can reduce the effects of these drugs, completely eliminate the effects of nalidixic acid and norfloxacin, and partially offset the effects of fluazinic acid and ciprofloxacin. 12. Clindamycin and erythromycin have antagonistic effects, so they can't be used together, so it is not suitable to form compound infusion. 13. Tetracyclines should not be compatible with drugs containing heavy metal ions such as antacids, calcium salts and iron salts, so as to avoid complex reactions and block the absorption of tetracycline drugs. Milk has a similar effect. 14. Sulfanilamide drugs should not be combined with local anesthetics (such as procaine, benzocaine, tetracaine, etc.). ) contains p-aminobenzoyl, so as not to reduce the efficacy. 15. Compatibility of polymyxin B with other drugs with nephrotoxicity or neuromuscular blockade is contraindicated to prevent accidents. 16. Sodium p-aminosalicylate should not be taken with salicylic acid, so as not to aggravate gastrointestinal reaction and lead to gastric ulcer. In addition, this product can interfere with the absorption of rifampicin, and the interval between administration should be 6-8 hours. 17. The absorption of ketoconazole and itraconazole is closely related to the secretion of gastric juice, so it is not suitable to use them together with antacids and anticholinergic drugs 18. Doxapram is forbidden to be used together with alkaline drugs; Use sympathomimetic amine and monoamine oxidase inhibitor (MAOI) with caution. 19. morphine is forbidden to be used with chlorpromazine injection at the same time. Pethidine should not be used with promethazine for many times to avoid respiratory depression; Combined with monoamine oxidase inhibitor (MAOI), it can cause excitement, high fever, sweating and unconsciousness. Fentanyl also has this reaction. 20. Aspirin combined with glucocorticoid may aggravate gastrointestinal bleeding, and compatibility should be prohibited; The combination with ibuprofen and other non-steroidal anti-inflammatory drugs can obviously reduce the concentration of the latter, so it is not suitable for combination. Compatibility with alkaline drugs can promote the excretion of this product and reduce the curative effect, so it is not suitable for combination. 2 1. antidepressants should not be combined with MAOI. Because of their similar effects, both of them have antidepressant effects, and they must be used in small amounts when combined. In addition, it is not suitable for use with adrenocortical drugs. Antidepressants can enhance the pressor effect of adrenergic drugs. 22. Tramadol is combined with monoamine oxidase inhibitor. Because their functions are opposite to each other and cancel each other out. 23. Levodopa is prohibited from being combined with monoamine oxidase inhibitors, ephedrine, reserpine and adrenergic drugs. Carbidopa should not be combined with amantadine, benzothiophene, proanthocyanidins and trihexyphenidyl. 24. Bromocriptine should be used in combination with antihypertensive drugs, phenothiazines or H2 receptor blockers. 25. When carbamazepine is combined with phenobarbital and phenytoin sodium, it can accelerate the metabolism of carbamazepine and reduce its concentration; Nicotinamide, antidepressants, macrolide antibiotics, isoniazid, cimetidine and other drugs can increase the plasma concentration of carbamazepine and make it prone to toxic reactions. In addition, when lithium salt, thiazine and carbamazepine are used together, it is easy to cause symptoms of nervous system poisoning. Carbamazepine can also weaken the anticoagulant effect of warfarin. When combined with oral contraceptives, vaginal bleeding and contraceptive failure will occur. So pay special attention when sharing. 26. Valproate can inhibit the metabolism of phenytoin sodium, phenobarbital, primidone and clonazepam, which is easy to cause poisoning, so attention should be paid to adjusting the dosage when combined. 27. Phenobarbital is an enzyme inducer of liver drugs, so when it is combined with dicoumarin, hydrocortisone, dexamethasone, testosterone, estrogen, progesterone, oral contraceptives, chlorpromazine, chloramphenicol, doxycycline, griseofulvin, digoxin, digitalis and phenytoin sodium, it can reduce the effect of accelerating metabolism; It can also increase the effect of activating drugs in vivo, such as cyclophosphamide. Other liver drug enzyme inducers (such as allopurinol, amiodarone, chloramphenicol, chlorpromazine, cimetidine, ciprofloxacin, dexpropoxyphene, diltiazem, ethanol (in case of acute poisoning), erythromycin, imipramine, isoniazid, ketoconazole, metoprolol, metronidazole, miconazole, nortriptyline, oral contraceptives and oxybutazone). However, liver drug enzyme inhibitors (such as barbiturates (phenobarbital is the most common), carbamazepine, ethanol (chronic alcoholism), aminolumide, griseofulvin, aminopropyl ester, phenytoin, glucuronide, rifampicin, sulfapyridone (which plays an enzyme inhibitory role in some cases), omeprazole, lansoprazole, etc. ) Just the opposite. 28. Propranolol should not be combined with monoamine oxidase inhibitors. Otherwise, the effect is weakened. 29. Timolol can be absorbed by eye drops to produce systemic effects, so it should not be used with other beta blockers. 30. Verapamil should not be combined with beta blockers, otherwise it will cause hypotension, bradycardia, conduction block and even cardiac arrest. 3 1. During the application of cardiac glycoside, calcium injection, epinephrine, ephedrine and similar drugs are prohibited. Because these drugs will increase toxicity. In addition, reserpine can increase its toxicity to the heart, and we should also be vigilant. Because of their high fat solubility, these drugs are mainly metabolized in the liver, so the dosage should be adjusted when combined with liver enzyme inducer or inhibitor. 32. Drugs such as norepinephrine used in the form of strong base and weak acid salt should be avoided to be compatible with alkaline drugs, otherwise precipitation will occur. 33. Acetylcysteine can increase the excretion of gold preparation; It weakens the antibacterial activity of penicillin, tetracycline and cephalosporins, and is not suitable for combination. If necessary, it can be used alternately at intervals of 4 hours. 34. The combination of codeine central analgesic and central depressant can produce additive effect. 35. Dextromethorphan combined with monoamine oxidase inhibitor can cause high fever, coma and even death. 36. Ephedrine combined with monoamine oxidase inhibitor can cause hypertension. 37. Ketotifen is combined with oral hypoglycemic agents, and thrombocytopenia can be seen in a few patients, so it is not appropriate to combine them. 38. Cimetidine should not be combined with antacids and metoclopramide. If you must merge, the interval should be 1 hour. In addition, it should not be compatible with theophylline, benzodiazepines, digoxin, quinidine, caffeine, warfarin anticoagulant, captopril and aminoglycosides. 39. Enzyme digestive aid should not be combined with antacid, otherwise it will reduce its activity. 40. Gastric motility drugs (domperidone and cisapride) should not be combined with anticholinergic drugs, and their effects cancel each other out. 4 1. Smecta can affect the absorption of other drugs. If necessary, other drugs should be taken 1 hour before taking this product. 42. Iron agent should not be combined with drugs containing calcium, phosphate and tannic acid, antacids, strong tea, etc., otherwise it can form precipitation and affect absorption; Combined with tetracycline, it can affect the absorption of the other side.